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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

Chromophobe RCC. MRI, axial T2-weighted image identifying expansile, welldelimited lesion in left kidney, with intermediate signal intensity, a distinctpseudocapsule (arrow) and a central scar area.
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f06: Chromophobe RCC. MRI, axial T2-weighted image identifying expansile, welldelimited lesion in left kidney, with intermediate signal intensity, a distinctpseudocapsule (arrow) and a central scar area.

Mentions: At imaging studies, chromophobe carcinomas tend to be more homogeneous than clear cellcarcinomas(13,14,21). Such lesionsare hypovascular as compared with the renal cortex, and most of times present a moderatecontrast uptake (80-100 HU in the corticomedullary phase at CT scan), and therefore lessintense than the clear cell variant, and more intense as compared with the papillaryvariant(21) (Figure 5). Not rarely, however, crRCC may appear as ahomogeneous and remarkably vascularized lesion in the corticomedullary phase (120-140HU). At MRI, the lesion tends to present a slight hyposignal or intermediate signalintensity at T2-weighted sequences (Figure 6), andalso may present a central scar. It is important to note that findings of crRCC areindistinguishable from those of oncocytomas (benign tumors originated from intercalatedtype B cells of the cortical collecting ducts), which may also present a central scar.Necrosis may occur in the voluminous lesions.


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

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

Chromophobe RCC. MRI, axial T2-weighted image identifying expansile, welldelimited lesion in left kidney, with intermediate signal intensity, a distinctpseudocapsule (arrow) and a central scar area.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f06: Chromophobe RCC. MRI, axial T2-weighted image identifying expansile, welldelimited lesion in left kidney, with intermediate signal intensity, a distinctpseudocapsule (arrow) and a central scar area.
Mentions: At imaging studies, chromophobe carcinomas tend to be more homogeneous than clear cellcarcinomas(13,14,21). Such lesionsare hypovascular as compared with the renal cortex, and most of times present a moderatecontrast uptake (80-100 HU in the corticomedullary phase at CT scan), and therefore lessintense than the clear cell variant, and more intense as compared with the papillaryvariant(21) (Figure 5). Not rarely, however, crRCC may appear as ahomogeneous and remarkably vascularized lesion in the corticomedullary phase (120-140HU). At MRI, the lesion tends to present a slight hyposignal or intermediate signalintensity at T2-weighted sequences (Figure 6), andalso may present a central scar. It is important to note that findings of crRCC areindistinguishable from those of oncocytomas (benign tumors originated from intercalatedtype B cells of the cortical collecting ducts), which may also present a central scar.Necrosis may occur in the voluminous lesions.

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