Abstract
Purpose
In some cases with uncertain renal tumour lesions, it would be helpful to perform biopsies for the preoperative differential diagnosis. In our study, we evaluated the benefit of multi-colour interphase fluorescence in situ hybridization (M-FISH) on fine-needle core biopsies in uncertain renal masses.
Methods
We prospectively performed three ultrasound-guided percutaneous biopsies in 25 patients with indeterminate renal masses preoperatively. Histopathology was performed on two remaining cores samples. M-FISH was performed on one core for chromosomes 1, 2, 6, 9, 7, 17, the loci 3p24pter, and 3p13p14. After interphase FISH evaluation, we classified tumours and compared the results with histopathological findings.
Results
16 were classified as renal malignancies: 14 (56%) clear cell renal cell carcinomas (RCCs), 1 papillary RCCs (4%), and 1 “adenocarcinoma” (4%). Seven patients (28%) had a benign tumour, i.e. 6 (24%) were oncocytomas and 1 was classified as leiomyoma (4%). In two cases (8%), no renal neoplasms were found. In 19 out of 21 cases (90.5%), the preoperative diagnostic fine-needle biopsy matched the final histological findings. The combination of histopathological examination and M-FISH leads to a higher (95.5 vs. 90.5%) diagnostic fidelity as histology alone.
Conclusions
Ultrasound-guided percutaneous renal tumour biopsy is an accurate and safety method for the histopathologic evaluation of uncertain renal masses. The M-FISH represents a new highly sensitive and specific method to confirm histopathological classification in less than 24 h which can be used in routine laboratory diagnosis.
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References
Receveur AO, Couturier J, Molinie V, Vieillefond A, Desangles F, Guillaud-Bataille M, Danglot G, Coullin P, Bernheim A (2005) Characterization of quantitative chromosomal abnormalities in renal cell carcinomas by interphase four-color fluorescence in situ hybridization. Cancer Genet Cytogenet 158:110–118
Richter F, Kasabian NG, Irwin RJ Jr, Watson RA, Lang EK (2000) Accuracy of diagnosis by guided biopsy of renal mass lesions classified indeterminate by imaging studies. Urology 55:348–352
Shannon BA, Cohen RJ, de Bruto H, Davies RJ (2008) The value of preoperative needle core biopsy for diagnosing benign lesions among small, incidentally detected renal masses. J Urol 180:1257–1261 (discussion 1261)
Amin MB, Corless CL, Renshaw AA, Tickoo SK, Kubus J, Schultz DS (1997) Papillary (chromophil) renal cell carcinoma. Histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases. Am J Surg Pathol 21:621–635
Cheville JC, Lohse CM, Zincke H, Weaver AL, Blute ML (2003) Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol 27:612–624
Sanjmyatav J, Rubtsov N, Starke H, Schubert J, Hindermann W, Junker K (2005) Identification of tumor entities of renal cell carcinoma using interphase fluorescence in situ hybridization. J Urol 174:731–735
Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z (2006) 2004 WHO classification of the renal tumors of the adults. Eur Urol 49:798–805
Junker K, Weirich G, Amin MB, Moravek P, Hindermann W, Schubert J (2003) Genetic subtyping of renal cell carcinoma by comparative genomic hybridization. Recent Results Cancer Res 162:169–175
Reichelt O, Gajda M, Chyhrai A, Wunderlich H, Junker K, Schubert J (2007) Ultrasound-guided biopsy of homogenous solid renal masses. Eur Urol 52:1421–1426
Remzi M, Katzenbeisser D, Waldert M, Klingler HC, Susani M, Memarsadeghi M, Heinz-Peer G, Haitel A, Herwig R, Marberger M (2007) Renal tumour size measured radiologically before surgery is an unreliable variable for predicting histopathological features: benign tumours are not necessarily small. BJU Int 99:1002–1006
Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170:2217–2220
Volpe A, Terrone C, Scarpa RM (2009) The current role of percutaneous needle biopsies of renal tumours. Arch Ital Urol Androl 81:107–112
Kunkle DA, Egleston BL, Uzzo RG (2008) Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review. J Urol 179:1227–1233 (discussion 1233–1224)
Wunderlich H, Hindermann W, Al Mustafa AM, Reichelt O, Junker K, Schubert J (2005) The accuracy of 250 fine needle biopsies of renal tumors. J Urol 174:44–46
Herts BR, Baker ME (1995) The current role of percutaneous biopsy in the evaluation of renal masses. Semin Urol Oncol 13:254–261
Neuzillet Y, Lechevallier E, Andre M, Daniel L, Coulange C (2004) Accuracy and clinical role of fine needle percutaneous biopsy with computerized tomography guidance of small (less than 4.0 cm) renal masses. J Urol 171:1802–1805
Lechevallier E, Andre M, Barriol D, Daniel L, Eghazarian C, De Fromont M, Rossi D, Coulange C (2000) Fine-needle percutaneous biopsy of renal masses with helical ct guidance. Radiology 216:506–510
Remzi M, Marberger M (2009) Renal tumor biopsies for evaluation of small renal tumors: why, in whom, and how? Eur Urol 55:359–367
Wood BJ, Khan MA, McGovern F, Harisinghani M, Hahn PF, Mueller PR (1999) Imaging guided biopsy of renal masses. Indications, accuracy and impact on clinical management. J Urol 161:1470–1474
Barriol D, Lechevallier E, Andre M, Daniel L, Ortega JC, Rossi D, Coulange C (2000) CT-guided percutaneous fine needle biopsy of solid tumors of the kidney. Prog Urol 10:1145–1151
Eshed I, Elias S, Sidi AA (2004) Diagnostic value of CT-guided biopsy of indeterminate renal masses. Clin Radiol 59:262–267
Storkel S (1999) Epithelial tumors of the kidney. Pathological subtyping and cytogenetic correlation. Urologe A 38:425–432
Barocas DA, Rohan SM, Kao J, Gurevich RD, Del Pizzo JJ, Vaughan ED Jr, Akhtar M, Chen YT, Scherr DS (2006) Diagnosis of renal tumors on needle biopsy specimens by histological and molecular analysis. J Urol 176:1957–1962
Kovacs G, Akhtar M, Beckwith BJ, Bugert P, Cooper CS, Delahunt B, Eble JN, Fleming S, Ljungberg B, Medeiros LJ, Moch H, Reuter VE, Ritz E, Roos G, Schmidt D, Srigley JR, Storkel S, van den Berg E, Zbar B (1997) The Heidelberg classification of renal cell tumours. J Pathol 183:131–133
Grady B, Goharderakhshan R, Chang J, Ribeiro-Filho LA, Perinchery G, Franks J, Presti J, Carroll P, Dahiya R (2001) Frequently deleted loci on chromosome 9 may harbor several tumor suppressor genes in human renal cell carcinoma. J Urol 166:1088–1092
Herbers J, Schullerus D, Muller H, Kenck C, Chudek J, Weimer J, Bugert P, Kovacs G (1997) Significance of chromosome arm 14q loss in nonpapillary renal cell carcinomas. Genes Chromosom Cancer 19:29–35
Renshaw AA, Lee KR, Madge R, Granter SR (1997) Accuracy of fine needle aspiration in distinguishing subtypes of renal cell carcinoma. Acta Cytol 41:987–994
Glukhova L, Goguel AF, Chudoba I, Angevin E, Pavon C, Terrier-Lacombe MJ, Meddeb M, Escudier B, Bernheim A (1998) Overrepresentation of 7q31 and 17q in renal cell carcinomas. Genes Chromosom Cancer 22:171–178
Kovacs G (1999) Renal oncocytoma—cytogenetic study? Orv Hetil 140:2325
Nagy A, Buzogany I, Kovacs G (2004) Microsatellite allelotyping differentiates chromophobe renal cell carcinomas from renal oncocytomas and identifies new genetic changes. Histopathology 44:542–546
Iqbal MA, Akhtar M, Ulmer C, Al-Dayel F, Paterson MC (2000) Fish analysis in chromophobe renal-cell carcinoma. Diagn Cytopathol 22:3–6
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Chyhrai, A., Sanjmyatav, J., Gajda, M. et al. Multi-colour FISH on preoperative renal tumour biopsies to confirm the diagnosis of uncertain renal masses. World J Urol 28, 269–274 (2010). https://doi.org/10.1007/s00345-010-0551-5
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DOI: https://doi.org/10.1007/s00345-010-0551-5