Female ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; diagnosis ; Rhabdoid Tumor ; diagnosis

OBJECTIVETo review hot issues and future direction of renal tumor biopsy (RTB) technique.

DATA SOURCESThe literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.

STUDY SELECTIONWe included all the relevant articles on RTB technique in English, with no limitation of study design.

RESULTSComputed tomography and ultrasound were usually used for guiding RTB with respective advantages. Core biopsy is more preferred over fine needle aspiration because of superior accuracy. A minimum of two good-quality cores for a single renal tumor is generally accepted. The use of coaxial guide is recommended. For biopsy location, sampling different regions including central and peripheral biopsies are recommended.

CONCLUSIONIn spite of some limitations, RTB technique is relatively mature to help optimize the treatment of renal tumors.

OBJECTIVETo investigate the morphologic features and diagnostic criteria of various types pf renal adenomas of the kidney.

METHODSIn addition to light microscopy, electron microscopy, histochemical and immunohistochemical assays were applied. All 19 cases of adenomas were followed up.

RESULTSThree (3) cases of papillary adenoma were featured as papillary or tubulopapillary growth in patterns consisting of tumor cells with basophilic or acidophilic cytoplasm and were positive for both epithelial membrane antigen (EMA) and cytokeratin (CK7). Thirteen (13) cases of oncocytoma were characterized by the diversity of the structures including to be nest, tubular and papillary in pattern; a mixture of cell types including the classic oncocytes, oncoblasts and clear cells which were negative for vimentin and CK7 but positive for EMA. Enormous large mitochondria were obtained in 4 cases of oncocytoma by electronic microscopy. Three (3) cases of metanephric adenoma consisted of closely packed, round tubules lined by small bland cells with solid, glomeruloid constructure. Branching, elongated tubules and polypoid fronds were also detected. Tumor cells were negative for EMA, negative or only focally positive for CK7. Eighteen (18) patients were alive except one oncocytoma patient died 5 years after the diagnosis convinced. All the cases reported in this article had been followed up of 3 - 5 years.

CONCLUSIONSThere are 3 kinds of renal adenomas, namely, the papillary adenoma, oncocytoma, and metanephric adenoma and each kind has its own clincopathological features. The latter two can be recognized by their distinctive morphology, and the former can only be diagnosed according to the size of the tumor as the reference. Histochemical and immohistochemical assays are helpful in differential diagnosis.

Mesoblastic nephroma is an important differential diagnosis of a renal mass occurring in the neonatal period or in early childhood. It is a rare monomorphous congenital renal neoplasm most commonly recognized during the first 3 months of life. With the widespread application of ultrasound imaging, many cases are recognized prior to birth. We report a case of mesoblastic nephroma detected by ultrasonograph at 36 weeks of intrauterine fetal life and removed after birth. It showed a well circumscribed, grayish white, solid mass measuring 4x3x2 cm. The tumor was predominantly a classic type with a focal cellular pattern. Immunohistochemical and electron microscopic studies were done.
Diagnosis, Differential ; Kidney ; Kidney Neoplasms ; Nephroma, Mesoblastic* ; Parturition ; Ultrasonography

To explore the application of radiomic analysis in differential diagnosis of renal cell carcinoma in patients with hydronephrosis and renal calculi using supervised machine learning methods.The abdominal CT scan data were retrospectively analyzed for 66 patients with pathologically confirmed hydronephrosis and renal calculi, among whom 35 patients had renal cell carcinoma. In each case 18 non-texture features and 344 texture features were extracted from the region of interest (ROI). Infinite feature selection (InfFS)-based forward feature selection method coupled with support vector machine (SVM) classifier was used to select the optimal feature subset. SVM was trained and performed the prediction using the selected feature subset to classify whether hydronephrosis with renal calculi was associated with renal cell carcinoma.A total of 12 texture features were selected as the optimal features. The area under curve (AUC), accuracy, sensitivity, specificity, false positive rate and false negative rate of the SVM- InfFS model for predicting accompanying renal tumors in patients with hydronephrosis and calculi were 0.907, 81.0%, 70.0%, 90.9%, 9.1%, and 30.0%, respectively. The diagnostic accuracy, sensitivity, specificity, false positive and false negative rates by the clinicians provided with these classification results were 90.5%, 80.0%, 100%, 0.00%, and 20.0%, respectively.The computer-aided classification model based on supervised machine learning can effectively extract the diagnostic information and improve the diagnostic rate of renal cell carcinoma associated with hydronephrosis and renal calculi.
Carcinoma, Renal Cell ; diagnosis ; Diagnosis, Differential ; Humans ; Hydronephrosis ; diagnosis ; Kidney Calculi ; Kidney Neoplasms ; diagnosis ; Retrospective Studies

Diagnosis, Differential ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; diagnosis ; pathology ; Nephroma, Mesoblastic ; diagnosis ; pathology

Adult ; Carcinoma, Renal Cell ; diagnosis ; Diagnosis, Differential ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; diagnosis

Multicystic dysplastic kidney (MCDK) is a relatively common developmental anomaly in infants and children and has a good prognosis. In contrast, a malignant rhabdoid tumor of the kidney (MRTK) is one of the most lethal neoplasms of early life. However, the presentation of such a lethal tumor combined with multicystic dysplasia has not been reported to date. In this report, we describe a case of MRTK in a 5-yr-old girl who also had multicystic dysplasia. She was previously diagnosed with MCDK at birth due to a huge palpable mass on the right side of the abdomen. The right kidney was extensively replaced by numerous grossly dilated, variable-sized cysts. Microscopically, the tumor cells show a diffusely infiltrative growth pattern, which revealed large non-cohesive, round-to-polygonal tumor cells with vesicular nuclei. Some tumor cells had eccentric nuclei and large, round, eosinophilic cytoplasmic inclusions. There were metanephrons present, with the central ureteric bud and peripheral branches surrounded by condensing mesenchyma, immature glomeruli, and metaplastic cartilage in the adjacent parenchyma. To our knowledge, this is the first combined case of the two aforementioned diseases and this case may, in fact, suggest a new disease entity.
Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms/*complications/*diagnosis ; Multicystic Dysplastic Kidney/*complications/*diagnosis ; Prognosis ; Rhabdoid Tumor/*complications/*diagnosis

Multilocular cyst of the kidney is a rare pathologic entity, noninherited benign renal neoplasm occurring in the both children and adults. The entities commonly were known as multilocular cyst of the kidney or multilocular cystic nephroma. The controversy over the pathogenesis of multilocular cyst-neoplasm versus developmental anomaly- is still unsettled. We report two cases of multilocular renal cyst, one in a 8-year-old child with a chief complaint of gross hematuria and another in a 44-year-old woman with epigastric discomfortness. They were preoperatively suspected multilocular cyst by ultrasonography and computed tomography. We performed a simple nephrectomy as the treatment of choice because of the difficulty in accurate diagnosis and the documented association with renal neoplasia.
Adult ; Child ; Diagnosis ; Female ; Hematuria ; Humans ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Ultrasonography

Urinothorax occurs when urine leakes into thoracic cavity and it was first reported by Correie in 1968. The mechanism of its occurrence is an accumulation of urine in thoracic cavity by retroperitoneal urinoma formed by urinary tract obstruction or trauma. Retroperitoneal inflammation, malignant neoplasm, kidney transplantation, and kidney biopsy can also induce urinothorax. The diagnosis of urinothorax may be delayed due to its rare incidence rate, but if diagnosis is confirmed the treatment is possible by urinary diversion. We report our experience of a case of urinothorax associated with retroperitoneal urinoma followed by blunt renal trauma with review of literatures.
Biopsy ; Diagnosis ; Incidence ; Inflammation ; Kidney ; Kidney Neoplasms ; Pleural Effusion ; Thoracic Cavity ; Urinary Diversion ; Urinary Tract ; Urinoma