Image-guided biopsy in the evaluation of renal mass lesions in contemporary urological practice: indications, adequacy, clinical impact, and limitations of the pathological diagnosis

Shah, Rajal B.; Bakshi, Nasir; Hafez, Khaled S.; Wood, David P.; Kunju, Lakshmi P.

doi:10.1016/j.humpath.2005.09.011

Cited by 40 publications

(42 citation statements)

References 23 publications

(27 reference statements)

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“…Somewhat similar results have been reported in other recent series, indicating that the decisions about patient management based on radiological or clinical evaluations alone can get altered based on RCB findings. 11,17,19,24,25,34 Based on our study and the experience reported in recent series, percutaneous RCB can have a meaningful role in the management of renal tumors, including those with metastatic disease at presentation, while taking into account other clinical parameters.…”

Section: Resultsmentioning

confidence: 52%

“…However, the methods and accuracy of RCB interpretation have been examined in our prior ex vivo study 23 and other contemporary series. [24][25][26][27][28][29][30] The main focus of the present study was to investigate not only the diagnostic accuracy but also particularly the impact of biopsy diagnosis on the clinical management.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, with the use of IHC, it is now easier even for pathologists working in centers with limited RCB volumes to arrive at an accurate diagnosis. However, few studies 24,25 have reported the impact of RCB diagnosis on the clinical management. The aims of our study were to investigate the diagnostic accuracy of RCB in a large in vivo cohort and its potential influence on subsequent clinical management.…”

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confidence: 99%

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The Diagnostic Accuracy of Percutaneous Renal Needle Core Biopsy and Its Potential Impact on the Clinical Management of Renal Cortical Neoplasms

Gellert

Mehra

Chen

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context While biopsies are now increasingly being performed for the diagnosis of renal cortical neoplasms, the influence of the rendered pathological diagnoses on the clinical management is only rarely documented. Objectives To report our experience with consecutively performed renal biopsies and the potential impact of the diagnosis on subsequent clinical management. Design Material from needle biopsies performed consecutively at our institution between 2006 and 2011 was reviewed. The influence of the reported pathology results on the clinical management was determined from patient follow-up medical record review. Results In total, 218 percutaneous biopsies for renal masses were performed during this period. Among them, 181 (83%) yielded neoplastic tissue, including 81 clear cell renal cell carcinomas, 29 low-grade oncocytic neoplasms, 7 papillary renal cell carcinomas, 5 clear cell papillary renal cell carcinomas, 5 angiomyolipomas, and 14 urothelial carcinomas. Fourteen additional cases (6%) contained lesional material from clinically known nonneoplastic processes, for a total diagnostic yield of 89%. Twenty-three (11%) were nonrepresentative of lesional tissue. In 10 of these, repeat biopsies or resections established the diagnosis of renal tumors. Biopsy diagnosis was confirmed in 29 of 30 cases (97%) on subsequent nephrectomy. Following the biopsy diagnosis, there were significant differences in the clinical management; overall, 79% of clear cell renal cell carcinomas received therapeutic interventions, and 17% were put on active surveillance. In contrast, 77% of the benign or low-grade lesions were put on active surveillance. Conclusions Accurate and specific diagnosis can be rendered on renal core biopsy in most renal tumors, and the biopsy diagnosis can have a definitive role in their clinical management.

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Section: Resultsmentioning

confidence: 52%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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The Diagnostic Accuracy of Percutaneous Renal Needle Core Biopsy and Its Potential Impact on the Clinical Management of Renal Cortical Neoplasms

Gellert

Mehra

Chen

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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“…This percentage is similar to that found in other series, in which larger needles, and more passes, and even core biopsies for histology were used. 3,6,26,27 This rate of aspirates inadequate for diagnosis is far lower than the 60% of inadequate aspirates obtained by Campbell et al 15 in a series of 25 small (<5 cm), solid, clinically localized renal masses aspirated with 22G Chiba needles under CT guidance. In our series there were only four cases (44%) inadequate for diagnosis out of the nine renal tumors measuring <5.5 cm at their largest diameter.…”

Section: Discussionmentioning

confidence: 79%

Solid renal masses in adults: Image‐guided fine‐needle aspiration cytology and imaging techniques—“Two Heads Better Than One?”

García‐Solano

Acosta-Ortega

Pérez-Guillermo

et al. 2007

Diagnostic Cytopathology

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We have compared the diagnostic accuracy of image-guided 25G-FNA (fine-needle aspiration) and imaging modalities in a group of 31 patients with solid space-occupying renal lesions. All patients had undergone total nephrectomy and histologic sections were available for review.By FNA there were 24 malignant diagnoses, I benign diagnosis, and 6 cases with yield inadequate for diagnosis. The FNA accuracy for malignancy was 100% with no false positive cases; cancer typing by FNA matched the final histologic diagnoses in 91.6% of cases. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 14%, 80%, and 14%, respectively.Radiologically there were 26 diagnoses of malignancy, I of benignity, and 4 indeterminate lesions (IL). Accuracy for malignancy was 100%, with one false positive case; cancer typing matched the final histologic diagnoses in 84%. Sensitivity of imaging modalities was 86%, specificity 17%, positive predictive value 83%, and negative predictive value 20%. Four IL corresponded to renal cell carcinoma in the final histologic report: two IL had a previous diagnosis of malignancy by FNA, and the yield of two was inadequate for cytologic diagnosis.Both techniques have 100% accuracy for the diagnosis of malignancy. The sensitivity, specificity, positive predictive value, and negative predictive value of imaging techniques are slightly higher than those obtained by FNA. Imaging techniques and FNA of solid renal masses complement each other in IL and in nondiagnostic FNAs. Diagn. Cytopathol. 2008;36:8-12.' 2007 Wiley-Liss, Inc.Key Words: solid renal masses; fine-needle aspiration; needle biopsy; cytology; imaging techniques Fine-needle aspiration (FNA) has a well-defined and traditional role in the diagnosis and treatment of numerous conditions in almost every organ of the body. Its utility is undeniable in space-occupying lesions of various locations; however, the use of FNA in space-occupying lesions of the kidney has recently tended to be confined to specific clinico-pathological conditions, mainly because of the refinement of imaging techniques. [1][2][3][4][5][6] The purpose of this article is 3-fold: to assess the diagnostic accuracy of image-guided 25G-FNA and imaging modalities in a group of 31 patients with solid space-occupying renal lesions who later underwent total nephrectomy (TN) for histologic confirmation; to compare the diagnostic accuracy of the two techniques; and to investigate whether FNA provides valuable information for the clinical management of patients with solid renal masses. Material and MethodsBetween January 2000 and July 2006 a total number of 129 patients of our hospital had been referred to either image-guided 25G-FNA as preoperative diagnostic procedure of renal space-occupying lesions, or to some type of imaging modality for planning clinical management, or had been referred to both. Of these 129 patients, the 31 in whom image-guided FNA, imaging studies, and TN were available were chosen for the present study.The cytologic specimens of im...

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“…Neither one of these strategies is free of pitfalls. Particularly in cases of radiofrequency ablation wherein the cellular architecture is preserved for some time after ablation, hematoxylin and eosin staining can be misleading with false-positive results [ 42 ]. Viability staining (e.g., nicotinamide adenine dinucleotide hydrogenase) may be necessary to confi rm complete ablation of the tumor.…”

Section: Patients With Suspected Rcc Managed With Ablation Therapymentioning

confidence: 99%

Renal Mass Biopsy

Ahrar

Javadi

Ahrar

2013

Percutaneous Image-Guided Biopsy

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Image-guided biopsy in the evaluation of renal mass lesions in contemporary urological practice: indications, adequacy, clinical impact, and limitations of the pathological diagnosis

Cited by 40 publications

References 23 publications

The Diagnostic Accuracy of Percutaneous Renal Needle Core Biopsy and Its Potential Impact on the Clinical Management of Renal Cortical Neoplasms

The Diagnostic Accuracy of Percutaneous Renal Needle Core Biopsy and Its Potential Impact on the Clinical Management of Renal Cortical Neoplasms

Solid renal masses in adults: Image‐guided fine‐needle aspiration cytology and imaging techniques—“Two Heads Better Than One?”

Renal Mass Biopsy

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