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Renal cell carcinoma: histological classification and correlation with imaging findings.

Muglia VF, Prando A - Radiol Bras (2015 May-Jun)

Bottom Line: The histological classification of RCCs is of utmost importance, considering the significant prognostic and therapeutic implications of its histological subtypes.The present study is aimed at reviewing the main clinical and imaging findings of histological RCC subtypes.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Postdoctoral Scholar, Associate Professor at Centro de Ciências das Imagens e Física Médica (CCIFM) - Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.

ABSTRACT
Renal cell carcinoma (RCC) is the seventh most common histological type of cancer in the Western world and has shown a sustained increase in its prevalence. The histological classification of RCCs is of utmost importance, considering the significant prognostic and therapeutic implications of its histological subtypes. Imaging methods play an outstanding role in the diagnosis, staging and follow-up of RCC. Clear cell, papillary and chromophobe are the most common histological subtypes of RCC, and their preoperative radiological characterization, either followed or not by confirmatory percutaneous biopsy, may be particularly useful in cases of poor surgical condition, metastatic disease, central mass in a solitary kidney, and in patients eligible for molecular targeted therapy. New strategies recently developed for treating renal cancer, such as cryo and radiofrequency ablation, molecularly targeted therapy and active surveillance also require appropriate preoperative characterization of renal masses. Less common histological types, although sharing nonspecific imaging features, may be suspected on the basis of clinical and epidemiological data. The present study is aimed at reviewing the main clinical and imaging findings of histological RCC subtypes.

No MeSH data available.


Related in: MedlinePlus

Papillary RCC variant. A: MRI, axial, T2-weighted image showingexpansile, homogeneous lesion with intense hyposignal. B:Contrast-enhanced MRI, axial, T1-weighted image showing a remarkably hypovascularlesion in relation to the adjacent cortex.
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f04: Papillary RCC variant. A: MRI, axial, T2-weighted image showingexpansile, homogeneous lesion with intense hyposignal. B:Contrast-enhanced MRI, axial, T1-weighted image showing a remarkably hypovascularlesion in relation to the adjacent cortex.

Mentions: At CT and MRI, such tumors tend to appear more homogeneous than ccRCC and hypovascularas compared with the adjacent renal parenchyma(15,16,22). In the corticomedullary phase at contrast-enhanced CT,these tumors tend to present a mean density ranging between 50-60 HU, and 65-75 HU inthe nephrographic phase (progressive uptake). At MRI, papillary carcinomas frequentlymanifest as peripheral lesions with intense hyposignal on T2-weighted images (Figure 4), presumably due to the intratumoralhemosiderin content(23) or to theirarchitectural arrangement. Lesions > 4.0 cm in diameter may be heterogeneous due tothe presence of necrosis, hemorrhage and calcification. Only rarely these tumors maypresent internal foci of macroscopic fat (interstitial macrophage with cholesterol) oreven intracytoplasmic fat and, in this case, signal loss is also observed on the out ofphase sequence at chemical shift imaging.


Renal cell carcinoma: histological classification and correlation with imaging findings.

Muglia VF, Prando A - Radiol Bras (2015 May-Jun)

Papillary RCC variant. A: MRI, axial, T2-weighted image showingexpansile, homogeneous lesion with intense hyposignal. B:Contrast-enhanced MRI, axial, T1-weighted image showing a remarkably hypovascularlesion in relation to the adjacent cortex.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492569&req=5

f04: Papillary RCC variant. A: MRI, axial, T2-weighted image showingexpansile, homogeneous lesion with intense hyposignal. B:Contrast-enhanced MRI, axial, T1-weighted image showing a remarkably hypovascularlesion in relation to the adjacent cortex.
Mentions: At CT and MRI, such tumors tend to appear more homogeneous than ccRCC and hypovascularas compared with the adjacent renal parenchyma(15,16,22). In the corticomedullary phase at contrast-enhanced CT,these tumors tend to present a mean density ranging between 50-60 HU, and 65-75 HU inthe nephrographic phase (progressive uptake). At MRI, papillary carcinomas frequentlymanifest as peripheral lesions with intense hyposignal on T2-weighted images (Figure 4), presumably due to the intratumoralhemosiderin content(23) or to theirarchitectural arrangement. Lesions > 4.0 cm in diameter may be heterogeneous due tothe presence of necrosis, hemorrhage and calcification. Only rarely these tumors maypresent internal foci of macroscopic fat (interstitial macrophage with cholesterol) oreven intracytoplasmic fat and, in this case, signal loss is also observed on the out ofphase sequence at chemical shift imaging.

Bottom Line: The histological classification of RCCs is of utmost importance, considering the significant prognostic and therapeutic implications of its histological subtypes.The present study is aimed at reviewing the main clinical and imaging findings of histological RCC subtypes.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Postdoctoral Scholar, Associate Professor at Centro de Ciências das Imagens e Física Médica (CCIFM) - Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.

ABSTRACT
Renal cell carcinoma (RCC) is the seventh most common histological type of cancer in the Western world and has shown a sustained increase in its prevalence. The histological classification of RCCs is of utmost importance, considering the significant prognostic and therapeutic implications of its histological subtypes. Imaging methods play an outstanding role in the diagnosis, staging and follow-up of RCC. Clear cell, papillary and chromophobe are the most common histological subtypes of RCC, and their preoperative radiological characterization, either followed or not by confirmatory percutaneous biopsy, may be particularly useful in cases of poor surgical condition, metastatic disease, central mass in a solitary kidney, and in patients eligible for molecular targeted therapy. New strategies recently developed for treating renal cancer, such as cryo and radiofrequency ablation, molecularly targeted therapy and active surveillance also require appropriate preoperative characterization of renal masses. Less common histological types, although sharing nonspecific imaging features, may be suspected on the basis of clinical and epidemiological data. The present study is aimed at reviewing the main clinical and imaging findings of histological RCC subtypes.

No MeSH data available.


Related in: MedlinePlus