-
Diagnostic and Interventional Radiology... Jan 2019We aimed to evaluate magnetic resonance imaging (MRI) features, including signal intensities, enhancement patterns and T2 signal intensity ratios to differentiate...
PURPOSE
We aimed to evaluate magnetic resonance imaging (MRI) features, including signal intensities, enhancement patterns and T2 signal intensity ratios to differentiate oncocytoma from chromophobe renal cell carcinoma (RCC).
METHODS
This retrospective study included 17 patients with oncocytoma and 33 patients with chromophobe RCC who underwent dynamic MRI. Two radiologists independently reviewed images blinded to pathology. Morphologic characteristics, T1 and T2 signal intensities were reviewed. T2 signal intensities, wash-in, wash-out values, T2 signal intensity ratios were calculated. Sensitivity and specificity analyses were performed.
RESULTS
Mean ages of patients with oncocytoma and chromophobe RCC were 61.0±11.6 and 58.5±14.0 years, respectively. Mean tumor size was 60.6±47.3 mm for oncocytoma, 61.7±45.9 mm for chromophobe RCC. Qualitative imaging findings in conventional MRI have no distinctive feature in discrimination of two tumors. Regarding signal intensity ratios, oncocytomas were higher than chromophobe RCCs. Renal oncocytomas showed higher signal intensity ratios and wash-in values than chromophobe RCCs in all phases. Fast spin-echo T2 signal intensities were higher in oncocytomas than chromophobe RCCs.
CONCLUSION
Signal intensity ratios, fast spin-echo T2 signal intensities and wash-in values constitute diagnostic parameters for discriminating between oncoytomas and chromophobes. In the excretory phase of dynamic enhanced images, oncocytomas have higher signal intensity ratio than chromophobe RCC and high wash-in values strongly imply a diagnosis of renal oncocytoma.
Topics: Adenoma, Oxyphilic; Adult; Aged; Carcinoma, Renal Cell; Diagnosis, Differential; Female; Humans; Image Enhancement; Kidney Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity
PubMed: 30644365
DOI: 10.5152/dir.2018.18013 -
Medicina (Kaunas, Lithuania) Oct 2020: The use of non-invasive techniques to predict the histological type of renal masses can avoid a renal mass biopsy, thus being of great clinical interest. The aim of...
: The use of non-invasive techniques to predict the histological type of renal masses can avoid a renal mass biopsy, thus being of great clinical interest. The aim of our study was to assess if quantitative multiphasic multidetector computed tomography (MDCT) enhancement patterns of renal masses (malignant and benign) may be useful to enable lesion differentiation by their enhancement characteristics. : A total of 154 renal tumors were retrospectively analyzed with a four-phase MDCT protocol. We studied attenuation values using the values within the most avidly enhancing portion of the tumor (2D analysis) and within the whole tumor volume (3D analysis). A region of interest (ROI) was also placed in the adjacent uninvolved renal cortex to calculate the relative tumor enhancement ratio. : Significant differences were noted in enhancement and de-enhancement (diminution of attenuation measurements between the postcontrast phases) values by histology. The highest areas under the receiver operating characteristic curves (AUCs) of 0.976 (95% CI: 0.924-0.995) and 0.827 (95% CI: 0.752-0.887), respectively, were demonstrated between clear cell renal cell carcinoma (ccRCC) and papillary RCC (pRCC)/oncocytoma. The 3D analysis allowed the differentiation of ccRCC from chromophobe RCC (chrRCC) with a AUC of 0.643 (95% CI: 0.555-0.724). Wash-out values proved useful only for discrimination between ccRCC and oncocytoma (43.34 vs 64.10, < 0.001). However, the relative tumor enhancement ratio (corticomedullary (CM) and nephrographic phases) proved useful for discrimination between ccRCC, pRCC, and chrRCC, with the values from the CM phase having higher AUCs of 0.973 (95% CI: 0.929-0.993) and 0.799 (95% CI: 0.721-0.864), respectively. : Our observations point out that imaging features may contribute to providing prognostic information helpful in the management strategy of renal masses.
Topics: Adenoma, Oxyphilic; Carcinoma, Renal Cell; Cell Differentiation; Diagnosis, Differential; Humans; Kidney Neoplasms; Retrospective Studies
PubMed: 33126571
DOI: 10.3390/medicina56110569 -
Medicine Dec 2017Renal hybrid oncocytic/chromophobe tumors (HOCTs) are benign tumors containing a mixture of cells with features of chromophobe renal cell carcinoma (CHRCC) and renal... (Review)
Review
RATIONALE
Renal hybrid oncocytic/chromophobe tumors (HOCTs) are benign tumors containing a mixture of cells with features of chromophobe renal cell carcinoma (CHRCC) and renal oncocytoma (RO). Sporadic HOCT, which means HOCT occurs in patients without Birt-Hogg-Dubé syndrome (BHDS) or renal oncocytosis, is extremely rare. In this article, we would report a new case of a patient with both sporadic HOCT and multiple Schwannomas, which is even rarer than simplex sporadic HOCT.
PATIENT CONCERNS
A 48-year-old female was noted with multiple left-kidney masses and a history of multiple Schwannomas. She had no complaints of urological symptoms, abdominal pain, and osphyalgia. The vital sign was stable and blood biochemistry test showed normal renal function. Enhanced computed tomography (CT) found multiple lesions occupying parenchyma of the left kidney. The largest one was measured 3.5 × 3.1 × 3.2 cm. It showed apparently enhancement in arterial phase and low-density in venous phase.
DIAGNOSES
The preoperative diagnosis was renal cell carcinomas.
INTERVENTIONS
The masses were removed by laparoscopic partial left nephrectomy.
OUTCOMES
The diagnosis of HOCT was made by histopathology after surgery. No evidence of local recurrence or distant metastasis was noted on imaging after 2-month follow-up.
LESSONS
We searched PubMed for cases of sporadic HOCT and a total of 26 patients were evaluated. Our case was the first one involving sporadic HOCT and multiple Schwannomas. Although rare, sporadic HOCT does exist in patients presented with renal mass. Urological surgeons should be aware of the existence of HOCT when considering masses on kidney due to the different prognosis between HOCT and renal cell carcinoma. Further, a possible genetic relationship between HOCT and Schwannoma may contribute to a common pathogenesis in these 2 tumors.
Topics: Adenoma, Oxyphilic; Carcinoma, Renal Cell; Diagnosis, Differential; Female; Humans; Kidney Neoplasms; Middle Aged; Neoplasms, Multiple Primary; Neurilemmoma
PubMed: 29310387
DOI: 10.1097/MD.0000000000008939 -
Hematology/oncology Clinics of North... Aug 2011Ninety percent or more of kidney cancers are believed to be of epithelial cell origin, and are referred to as renal cell carcinoma (RCC), which are further subdivided... (Review)
Review
Ninety percent or more of kidney cancers are believed to be of epithelial cell origin, and are referred to as renal cell carcinoma (RCC), which are further subdivided based on histology into clear-cell RCC (75%), papillary RCC (15%), chromophobe tumor (5%), and oncocytoma (5%). Some genes confer an increased risk of these various histologic RCC subtypes. In practice, there is some overlap among the histologic subtypes, and there are some shared molecular features among these tumor types. This review focuses primarily on the most common form of RCC, clear-cell renal carcinoma, noting some recent advances in the other histologic subtypes.
Topics: Adenoma, Oxyphilic; Carcinoma, Renal Cell; Gene Expression Regulation, Neoplastic; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Kidney Neoplasms; Vascular Endothelial Growth Factor A; Von Hippel-Lindau Tumor Suppressor Protein
PubMed: 21763962
DOI: 10.1016/j.hoc.2011.04.004 -
Cancer Imaging : the Official... Jan 2021Benign and malignant renal tumors share similar some imaging findings.
BACKGROUND
Benign and malignant renal tumors share similar some imaging findings.
METHODS
Sixty-six patients with clear cell renal cell carcinoma (CCRCC), 13 patients with renal angiomyolipoma with minimal fat (RAMF) and 7 patients with renal oncocytoma (RO) were examined. For diffusion kurtosis imaging (DKI), respiratory triggered echo-planar imaging sequences were acquired in axial plane (3 b-values: 0, 500, 1000s/mm). Mean Diffusivity (MD), fractional Anisotropy (FA), mean kurtosis (MK), kurtosis anisotropy (KA) and radial kurtosis (RK) were performed.
RESULTS
For MD, a significant higher value was shown in CCRCC (3.08 ± 0.23) than the rest renal tumors (2.93 ± 0.30 for RO, 1.52 ± 0.24 for AML, P < 0.05). The MD values were higher for RO than for AML (2.93 ± 0.30 vs.1.52 ± 0.24, P < 0.05), while comparable MD values were found between CCRCC and RO (3.08 ± 0.23 vs. 2.93 ± 0.30, P > 0.05). For MK, KA and RK, a significant higher value was shown in AML (1.32 ± 0.16, 1.42 ± 0.23, 1.41 ± 0.29) than CCRCC (0.43 ± 0.08, 0.57 ± 0.16, 0.37 ± 0.11) and RO (0.81 ± 0.08, 0.86 ± 0.16, 0.69 ± 0.08) (P < 0.05). The MK, KA and RK values were higher for RO than for CCRCC (0.81 ± 0.08 vs. 0.43 ± 0.08, 0.86 ± 0.16 vs. 0.57 ± 0.16, 0.69 ± 0.08 vs. 0.37 ± 0.11, P < 0.05). Using MD values of 2.86 as the threshold value for differentiating CCRCC from RO and AML, the best result obtained had a sensitivity of 76.1%, specificity of 72.6%. Using MK, KA and RK values of 1.19,1.13 and 1.11 as the threshold value for differentiating AML from CCRCC and RO, the best result obtained had a sensitivity of 91.2, 86.7, 82.1%, and specificity of 86.7, 83.2, 72.8%.
CONCLUSION
DKI can be used as another noninvasive biomarker for benign and malignant renal tumors' differential diagnosis.
Topics: Adenoma, Oxyphilic; Adult; Angiomyolipoma; Anisotropy; Carcinoma, Renal Cell; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Diffusion Tensor Imaging; Female; Humans; Kidney Neoplasms; Magnetic Resonance Spectroscopy; Male; Middle Aged; Sensitivity and Specificity
PubMed: 33413681
DOI: 10.1186/s40644-020-00369-0 -
Radiologia 2016Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected...
Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.
Topics: Adenoma, Oxyphilic; Diagnosis, Differential; Humans; Incidental Findings; Kidney Neoplasms; Lipoma; Radiology
PubMed: 26723224
DOI: 10.1016/j.rx.2015.10.008 -
BMC Cancer May 2010Chromophobe renal cell carcinoma (chRCC) and renal oncocytoma are two distinct but closely related entities with strong morphologic and genetic similarities. While chRCC...
BACKGROUND
Chromophobe renal cell carcinoma (chRCC) and renal oncocytoma are two distinct but closely related entities with strong morphologic and genetic similarities. While chRCC is a malignant tumor, oncocytoma is usually regarded as a benign entity. The overlapping characteristics are best explained by a common cellular origin, and the biologic differences between chRCC and oncocytoma are therefore of considerable interest in terms of carcinogenesis, diagnosis and clinical management. Previous studies have been relatively limited in terms of examining the differences between oncocytoma and chromophobe RCC.
METHODS
Gene expression profiling using the Affymetrix HGU133Plus2 platform was applied on chRCC (n = 15) and oncocytoma specimens (n = 15). Supervised analysis was applied to identify a discriminatory gene signature, as well as differentially expressed genes. High throughput single-nucleotide polymorphism (SNP) genotyping was performed on independent samples (n = 14) using Affymetrix GeneChip Mapping 100 K arrays to assess correlation between expression and gene copy number. Immunohistochemical validation was performed in an independent set of tumors.
RESULTS
A novel 14 probe-set signature was developed to classify the tumors internally with 93% accuracy, and this was successfully validated on an external data-set with 94% accuracy. Pathway analysis highlighted clinically relevant dysregulated pathways of c-erbB2 and mammalian target of rapamycin (mTOR) signaling in chRCC, but no significant differences in p-AKT or extracellular HER2 expression was identified on immunohistochemistry. Loss of chromosome 1p, reflected in both cytogenetic and expression analysis, is common to both entities, implying this may be an early event in histogenesis. Multiple regional areas of cytogenetic alterations and corresponding expression biases differentiating the two entities were identified. Parafibromin, aquaporin 6, and synaptogyrin 3 were novel immunohistochemical markers effectively discriminating the two pathologic entities.
CONCLUSIONS
Gene expression profiles, high-throughput SNP genotyping, and pathway analysis effectively distinguish chRCC from oncocytoma. We have generated a novel transcript predictor that is able to discriminate between the two entities accurately, and which has been validated both in an internal and an independent data-set, implying generalizability. A cytogenetic alteration, loss of chromosome 1p, common to renal oncocytoma and chRCC has been identified, providing the opportunities for identifying novel tumor suppressor genes and we have identified a series of immunohistochemical markers that are clinically useful in discriminating chRCC and oncocytoma.
Topics: Adenoma, Oxyphilic; Aquaporin 6; Biomarkers, Tumor; Carcinoma, Renal Cell; Chromosomes, Human, Pair 1; Cytogenetic Analysis; Diagnosis, Differential; Gene Dosage; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Gene Regulatory Networks; Genetic Testing; Humans; Immunohistochemistry; Kidney Neoplasms; Membrane Proteins; Nerve Tissue Proteins; Odds Ratio; Oligonucleotide Array Sequence Analysis; Polymorphism, Single Nucleotide; Predictive Value of Tests; Reproducibility of Results; Synaptogyrins; Tumor Suppressor Proteins
PubMed: 20462447
DOI: 10.1186/1471-2407-10-196 -
BMC Medical Imaging Jan 2023Although the central scar is an essential imaging characteristic of renal oncocytoma (RO), its utility in distinguishing RO from renal cell carcinoma (RCC) has not been...
BACKGROUND
Although the central scar is an essential imaging characteristic of renal oncocytoma (RO), its utility in distinguishing RO from renal cell carcinoma (RCC) has not been well explored. The study aimed to evaluate whether the combination of CT characteristics of the peripheral tumor parenchyma (PTP) and central hypodense area (CHA) can differentiate typical RO with CHA from RCC.
METHODS
A total of 132 tumors on the initial dataset were retrospectively evaluated using four-phase CT. The excretory phases were performed more than 20 min after the contrast injection. In corticomedullary phase (CMP) images, all tumors had CHAs. These tumors were categorized into RO (n = 23), clear cell RCC (ccRCC) (n = 85), and non-ccRCC (n = 24) groups. The differences in these qualitative and quantitative CT features of CHA and PTP between ROs and ccRCCs/non-ccRCCs were statistically examined. Logistic regression filters the main factors for separating ROs from ccRCCs/non-ccRCCs. The prediction models omitting and incorporating CHA features were constructed and evaluated, respectively. The effectiveness of the prediction models including CHA characteristics was then confirmed through a validation dataset (8 ROs, 35 ccRCCs, and 10 non-ccRCCs).
RESULTS
The findings indicate that for differentiating ROs from ccRCCs and non-ccRCCs, prediction models with CHA characteristics surpassed models without CHA, with the corresponding areas under the curve (AUC) being 0.962 and 0.914 versus 0.952 and 0.839 respectively. In the prediction models that included CHA parameters, the relative enhancement ratio (RER) in CMP and enhancement inversion, as well as RER in nephrographic phase and enhancement inversion were the primary drivers for differentiating ROs from ccRCCs and non-ccRCCs, respectively. The prediction models with CHA characteristics had the comparable diagnostic ability on the validation dataset, with respective AUC values of 0.936 and 0.938 for differentiating ROs from ccRCCs and non-ccRCCs.
CONCLUSION
The prediction models with CHA characteristics can help better differentiate typical ROs from RCCs. When a mass with CHA is discovered, particularly if RO is suspected, EP images with longer delay scanning periods should be acquired to evaluate the enhancement inversion characteristics of CHA.
Topics: Humans; Carcinoma, Renal Cell; Adenoma, Oxyphilic; Retrospective Studies; Reactive Oxygen Species; Kidney Neoplasms; Tomography, X-Ray Computed; Diagnosis, Differential
PubMed: 36707788
DOI: 10.1186/s12880-023-00972-0 -
International Journal of Urology :... Apr 1999A unique case of metanephric adenoma of the left kidney is reported in a 61-year-old woman presenting with an incidental renal mass on ultrasonography.
BACKGROUND
A unique case of metanephric adenoma of the left kidney is reported in a 61-year-old woman presenting with an incidental renal mass on ultrasonography.
METHODS/RESULTS
On radiographic examination, the presence of hypovascular renal cell carcinoma was suspected and left radical nephrectomy was performed. The resected tumor, measuring 4.9 x 4.7 x 4.5 cm, was well-circumscribed and solid and its cut surface was tan-pink with foci of focal hemorrhage and cystic change. Microscopically, the tumor was composed of uniformly small acini with hyperchromatic round nuclei. Some acini were dilated and occasionally contained glomeruloid-like bodies and psamoma bodies. Immunohistochemically, tumor cells showed positive immunoreaction for vimentin, cytokeratin and Leu 7. Cytogenetically, the tumor did not show numerical aberrations of chromosome 7 or 17 by fluorescence in situ hybridization.
CONCLUSIONS
The patient is alive without recurrence or metastasis 4 years after surgery. Metanephric adenoma must be differentiated from other renal tumors, particularly Wilms' tumor or low-grade renal cell carcinoma. Immunohistochemical and cytogenetic analysis may be helpful in difficult cases.
Topics: Adenoma; Biomarkers, Tumor; Cytogenetics; DNA, Neoplasm; Female; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Keratins; Kidney; Kidney Neoplasms; Magnetic Resonance Imaging; Middle Aged; S100 Proteins; Tumor Suppressor Protein p53; Vimentin
PubMed: 10226840
DOI: 10.1046/j.1442-2042.1999.06448.x -
BioMed Research International 2020The present techniques of clinical and histopathological diagnosis hardly distinguish chromophobe renal cell carcinoma (ChRCC) from renal oncocytoma (RO). To identify...
The present techniques of clinical and histopathological diagnosis hardly distinguish chromophobe renal cell carcinoma (ChRCC) from renal oncocytoma (RO). To identify differentially expressed genes (DEGs) as effective biomarkers for diagnosis and prognosis of ChRCC and RO, three mRNA microarray datasets (GSE12090, GSE19982, and GSE8271) were downloaded from the GEO database. Functional enrichment analysis of DEGs was performed by DAVID. STRING and Cytoscape were applied to construct the protein-protein interaction (PPI) network and key modules of DEGs. Visualized plots were conducted by the R language. We downloaded clinical data from the TCGA database and the influence of key genes on the overall survival of ChRCC was performed by Kaplan-Meier and Cox analyses. Gene set enrichment analysis (GSEA) was utilized in exploring the function of key genes. A total of 79 DEGs were identified. Enrichment analyses revealed that the DEGs are closely related to tissue invasion and metastasis of cancer. Subsequently, 14 hub genes including ESRP1, AP1M2, CLDN4, and CLDN7 were detected. Kaplan-Meier analysis indicated that the low expression of CLDN7 and GNAS was related to the worse overall survival in patients with ChRCC. Univariate Cox analysis showed that CLDN7 might be a helpful biomarker for ChRCC prognosis. Subgroup analysis revealed that the expression of CLDN7 showed a downtrend with the development of the clinical stage, topography, and distant metastasis of ChRCC. GSEA analysis identified that cell adhesion molecules cams, B cell receptor signaling pathway, T cell receptor signaling pathway, RIG-I like receptor signaling pathway, Toll-like receptor signaling pathway, and apoptosis pathway were associated with the expression of CLDN7. In conclusion, ESRP1, AP1M2, CLDN4, PRSS8, and CLDN7 were found to distinguish ChRCC from RO. Besides, the low expression of CLDN7 was closely related to ChRCC progression and could serve as an independent risk factor for the overall survival in patients with ChRCC.
Topics: Adenoma, Oxyphilic; Carcinoma, Renal Cell; Computational Biology; Databases, Nucleic Acid; Disease-Free Survival; Female; Gene Expression Regulation, Neoplastic; Genes, Neoplasm; Humans; Kidney Neoplasms; Male; Survival Rate
PubMed: 31998788
DOI: 10.1155/2020/4030915