Diagnostic accuracy of core biopsies of renal masses: Experience in a real-life setting from a tertiary center.

Altay A. Y., Karatay H., Bakir B., Erdem S., Buyuk M., Ozcan F., ...Daha Fazla

Annals of diagnostic pathology, cilt.55, ss.151830, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 55
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1016/j.anndiagpath.2021.151830
  • Dergi Adı: Annals of diagnostic pathology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.151830
  • Anahtar Kelimeler: Renal core biopsy, Small renal mass, Immunohistochemistry, Renal cell carcinoma, PERCUTANEOUS BIOPSY, CELL CARCINOMA, HISTOLOGICAL SUBTYPE, INTERFERON-ALPHA, GUIDED BIOPSY, LESIONS, IMMUNOHISTOCHEMISTRY, IMPACT, GRADE
  • İstanbul Üniversitesi Adresli: Evet

Özet

Objective: To document and analyze diagnostic accuracy of renal core biopsy (RCB), its diagnostic correlation with resection specimens, and to question the need for immunohistochemistry (IHC) in the preoperative diagnosis of renal masses. Material and method: RCBs performed at a reference center between 2007 and 2017 were included. Pathological, clinical, and radiological data were obtained from medical records. Results: Among 302 biopsies included in this study, 274 (90.7%) were diagnostic. Two hundred sixty-six were neoplastic and 179 were of primary renal origin. The most common secondary neoplasms were hematolymphoid (n = 35) and metastatic (n = 17). Sixty-nine tumors were classified as small renal masses (SRMs) (<4 cm in diameter) and 53 of them were malignant. Nephrectomy was performed in 58 patients. Overall diagnostic accuracy between resections and RCBs was 88.7%. IHC was performed in 160 (53%) cases. In 15 of those, a definite diagnosis could not be rendered. Renal cell origin and subtype were determined by histomorphology alone in 81 and 75 cases, respectively. Sixty primary neoplasms of renal cell origin required IHC for diagnosis. Conclusion: RCB is a safe and highly accurate method for the diagnosis of both primary and secondary renal neoplasms. IHC is mostly required for the diagnosis of secondary tumors. Histomorphology is still the primary diagnostic tool, highly dependent on the experience of the surgical pathologist.