Interpretation of needle biopsies of the kidney for investigation of renal masses

Lhermitte, Benoît; Leval, Laurence de

doi:10.1007/s00428-012-1255-6

Cited by 9 publications

(5 citation statements)

References 45 publications

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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: Resultssupporting

confidence: 53%

“…This is becoming increasingly important because the range of management options for renal neoplasms has increased in recent years. 11 Depending on the histologic subtype and malignant potential as determined on RCB, the clinical management varied significantly in our study. However, the biopsy diagnosis clearly did not influence the clinical management in 16 cases with relatively small tumors, in which the tumors were ablated at the same sitting as the biopsy procedure.…”

Section: Resultsmentioning

confidence: 93%

“…However, the overall risk of tumor seeding is reported to be less than 0.01%. [9][10][11] In most reported cases, tumor seeding has been associated with urothelial carcinoma rather than RCC. 12,13 The improvement in biopsy equipment and technique, including the use of coaxial biopsy needles, may be one of the reasons for the rarity of this complication in more recent years.…”

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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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: Resultssupporting

confidence: 53%

Section: Resultsmentioning

confidence: 93%

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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“…Some of those small renal masses do not present radiological criteria allowing determining the nature of these tumors. 15% to 35% of these incidentally discovered small renal masses are benign after final histological diagnosis [1]. A more precise pretherapeutic diagnosis is now required in order to avoid unnecessary surgical removal.…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Papillary Renal Cell Carcinoma Seeding along a Percutaneous Biopsy Tract

Busset¹,

Vijgen²,

Lhermitte³

et al. 2018

OJPathology

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We report a rare case of a papillary renal cell carcinoma seeding along a percutaneous biopsy tract detected at the time of partial nephrectomy in a 51-year-old man with a 3.5 cm renal mass discovered on computed tomography scan (CT scan). Although renal percutaneous biopsy is now considered as an accurate and safe technique to provide valuable diagnostic information for indeterminate renal lesions, some inherent risks have been reported to associate with this procedure. One of the risks is tumor needle tract seeding, which is a very rare complication of renal percutaneous biopsy. Our well-documented case report could provide some useful information to evaluate the prognosis of patients with tumor seeding along a percutaneous biopsy tract.

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“…14,16,23,46 Tumour cores should be fixed in 10% buffered formal saline with each core separated into individual cassettes. 47 The cores should be handled using a tissue conservation protocol with serial levels being obtained on microtomy. Charged slides should be used in case imunohistochemical stains are required.…”

Section: Tissue Core Handlingmentioning

confidence: 99%

Percutaneous renal tumour biopsy

Delahunt¹,

Samaratunga²,

Martignoni

et al. 2014

Histopathology

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The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

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Interpretation of needle biopsies of the kidney for investigation of renal masses

Cited by 9 publications

References 45 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

A Case Report of Papillary Renal Cell Carcinoma Seeding along a Percutaneous Biopsy Tract

Percutaneous renal tumour biopsy

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