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Sample records for renal mass biopsy

  1. Renal mass biopsy--a renaissance?

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    Lane, Brian R; Samplaski, Mary K; Herts, Brian R; Zhou, Ming; Novick, Andrew C; Campbell, Steven C

    2008-01-01

    Advances in our understanding of the natural history and limited aggressive potential of many small renal masses, expanding treatment options and the integration of molecular factors into prognostic and therapeutic algorithms have stimulated renewed interest in percutaneous renal mass biopsy. A comprehensive literature review was performed using MEDLINE/PubMed to evaluate the indications, techniques, complications and efficacy of renal mass biopsy. Reported techniques of renal mass biopsy vary widely with different modes of radiographic guidance, needle size, number of cores and pathological analyses. Percutaneous renal mass biopsy with 2 or 3 cores using 18 gauge needles may improve diagnostic accuracy without increasing morbidity. Serious complications of percutaneous biopsy are rare and the minor complication rate in recent series has been less than 5%. The reported rate of technical failure of renal mass biopsy due to insufficient material was about 9% before 2001 and 5% in more recent studies. The likelihood of indeterminate or inaccurate pathological findings has decreased from 10% to 4% when comparing clinical studies before and since 2001. Currently a total success rate of greater than 90% is attainable using renal mass biopsy with standard histopathological analysis. Recent studies demonstrated that combining immunohistochemical and molecular analyses may further improve renal mass biopsy accuracy. Research on expanded analysis of percutaneous renal mass biopsy specimens should remain a top priority. Enhanced renal mass biopsy should not change treatment in most patients with small renal masses, who should be treated with surgical excision. However, future clinical algorithms will likely incorporate enhanced biopsy in situations in which decision making is more challenging.

  2. Current status of renal biopsy for small renal masses.

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    Ha, Seung Beom; Kwak, Cheol

    2014-09-01

    Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.

  3. Current Status of Renal Biopsy for Small Renal Masses

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    Ha, Seung Beom

    2014-01-01

    Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered. PMID:25237457

  4. Percutaneous needle biopsy for indeterminate renal masses: a national survey of UK consultant urologists

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    Arya Manit

    2007-07-01

    Full Text Available Abstract Background The use of percutaneous needle biopsy in the evaluation of indeterminate renal masses is controversial and its role in management remains largely unclear. We set to establish current practice on this issue in UK urology departments. Methods We conducted a national questionnaire survey of all consultant urologists in the UK, to establish current practice and attitudes towards percutaneous needle biopsy in the management of indeterminate renal masses. Results 139 (43% consultant urologists never use biopsy, whereas 111 (34% always employ it for the diagnosis of indeterminate renal masses. 75 (23% urologists use biopsy only for a selected patient group. Mass in a solitary kidney, bilateral renal masses and a past history of non-renal cancer were the main indications for use of percutaneous biopsy. The risk of false negative results and biopsy not changing the eventual management of their patients were the commonest reasons not to perform biopsy. Conclusion There is a wide and varied practice amongst UK Consultant Urologists in the use of percutaneous biopsy as part of the management of indeterminate renal masses. The majority of urologists believe biopsy confers no benefit. However there is a need to clarify this issue in the wake of recent published evidence as biopsy results may provide critical information for patients with renal masses in a significant majority. It not only differentiates benign from malignant tissue but can also help in deciding the management option for patients undergoing minimally invasive treatments.

  5. Percutaneous needle biopsy for indeterminate renal masses: a national survey of UK consultant urologists

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    Khan, Azhar A; Shergill, Iqbal S; Quereshi, Sheila; Arya, Manit; Vandal, Mohammed T; Gujral, Sandeep S

    2007-01-01

    Background The use of percutaneous needle biopsy in the evaluation of indeterminate renal masses is controversial and its role in management remains largely unclear. We set to establish current practice on this issue in UK urology departments. Methods We conducted a national questionnaire survey of all consultant urologists in the UK, to establish current practice and attitudes towards percutaneous needle biopsy in the management of indeterminate renal masses. Results 139 (43%) consultant urologists never use biopsy, whereas 111 (34%) always employ it for the diagnosis of indeterminate renal masses. 75 (23%) urologists use biopsy only for a selected patient group. Mass in a solitary kidney, bilateral renal masses and a past history of non-renal cancer were the main indications for use of percutaneous biopsy. The risk of false negative results and biopsy not changing the eventual management of their patients were the commonest reasons not to perform biopsy. Conclusion There is a wide and varied practice amongst UK Consultant Urologists in the use of percutaneous biopsy as part of the management of indeterminate renal masses. The majority of urologists believe biopsy confers no benefit. However there is a need to clarify this issue in the wake of recent published evidence as biopsy results may provide critical information for patients with renal masses in a significant majority. It not only differentiates benign from malignant tissue but can also help in deciding the management option for patients undergoing minimally invasive treatments. PMID:17610739

  6. Role of percutaneous needle core biopsy in diagnosis and clinical management of renal masses.

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    Hu, Rong; Montemayor-Garcia, Celina; Das, Kasturi

    2015-04-01

    Percutaneous needle core biopsies are routinely performed for renal mass diagnosis in some institutions. Because of limited tissue availability, accurate diagnosis can be challenging, and the role of needle core biopsy (NCB) remains debatable in kidney tumor management. In the present study, we reported our experience in diagnosing renal masses via percutaneous NCB and the role it plays in clinical management of these masses. We studied 301 consecutive cases of percutaneous NCBs performed for 280 renal masses from 269 patients between year 2008 and 2011 by reviewing final pathology diagnosis, hematoxylin and eosin slides, and ancillary studies. Diagnostic accuracy was determined by comparing biopsy and nephrectomy diagnoses in a subset of renal masses. Clinical data including demographic information, clinical presentation, radiographic findings, and treatment information were reviewed subsequently if available. The size of renal masses in our study cohort ranged from 0.5 to 24 cm, and 78% of them were small renal masses. Definite diagnoses were rendered in 89% of the renal masses by NCBs, and 23% of them were benign. Renal mass NCB was 100% accurate in diagnosing primary renal malignancy and 93% accurate in determining histologic subtypes. Clinical management was analyzed for 180 renal masses. There was significant difference in clinical management between different diagnostic groups. We conclude that percutaneous NCB is a powerful tool not only for definite tissue diagnosis of renal masses before treatment but also plays an important role in guiding patient management and obtaining material for future molecular studies for targeted therapies.

  7. Percutaneous renal tumour biopsy.

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    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo

    2014-09-01

    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  8. Evaluation of renal mass biopsy risk stratification algorithm for robotic partial nephrectomy--could a biopsy have guided management?

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    Rahbar, Haider; Bhayani, Sam; Stifelman, Michael; Kaouk, Jihad; Allaf, Mohamad; Marshall, Susan; Zargar, Homayoun; Ball, Mark W; Larson, Jeffrey; Rogers, Craig

    2014-11-01

    We evaluated a published biopsy directed small renal mass management algorithm using a large cohort of patients who underwent robotic partial nephrectomy for tumors 4 cm or smaller. A simplified algorithm of biopsy directed small renal mass management previously reported using risk stratified biopsies was applied to 1,175 robotic partial nephrectomy cases from 5 academic centers. A theoretical assumption was made of perfect biopsies that were feasible for all patients and had 100% concordance to final pathology. Pathology risk groups were benign, favorable, unfavorable and intermediate. The algorithm assigned favorable or intermediate tumors smaller than 2 cm to active surveillance and unfavorable or intermediate 2 to 4 cm tumors to treatment. Higher surgical risk patients were defined as ASA® 3 or greater and age 70 years or older. Patients were assigned to the pathology risk groups of benign (23%), favorable (13%), intermediate (51%) and unfavorable (12%). Patients were also assigned to the management groups of benign pathology (275, 23%), active surveillance (336, 29%) and treatment (564, 48%). Most of the 611 (52%) patients in the benign or active surveillance groups were low surgical risk and had safe treatment (2.6% high grade complications). A biopsy may not have been feasible or accurate in some tumors that were anterior (378, 32%), hilar (93, 7.9%) or less than 2 cm (379, 32%). Of 129 (11%) high surgical risk patients the biopsy algorithm assigned 70 (54%) to benign or active surveillance groups. The theoretical application of a biopsy driven, risk stratified small renal mass management algorithm to a large robotic partial nephrectomy database suggests that about half of the patients might have avoided surgery. Despite the obvious limitations of a theoretical assumption of all patients receiving a perfect biopsy, the data support the emerging role of renal mass biopsies to guide management, particularly in high surgical risk patients. Copyright

  9. Small renal mass biopsy--how, what and when: report from an international consensus panel.

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    Tsivian, Matvey; Rampersaud, Edward N; del Pilar Laguna Pes, Maria; Joniau, Steven; Leveillee, Raymond J; Shingleton, William B; Aron, Monish; Kim, Charles Y; DeMarzo, Angelo M; Desai, Mihir M; Meler, James D; Donovan, James F; Klingler, Hans Christoph; Sopko, David R; Madden, John F; Marberger, Michael; Ferrandino, Michael N; Polascik, Thomas J

    2014-06-01

    To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point. Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: 'non-diagnostic samples' should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine-needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful-waiting candidates. We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications.

  10. Improving needle biopsy accuracy in small renal mass using tumor-specific DNA methylation markers.

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    Chopra, Sameer; Liu, Jie; Alemozaffar, Mehrdad; Nichols, Peter W; Aron, Manju; Weisenberger, Daniel J; Collings, Clayton K; Syan, Sumeet; Hu, Brian; Desai, Mihir; Aron, Monish; Duddalwar, Vinay; Gill, Inderbir; Liang, Gangning; Siegmund, Kimberly D

    2017-01-17

    The clinical management of small renal masses (SRMs) is challenging since the current methods for distinguishing between benign masses and malignant renal cell carcinomas (RCCs) are frequently inaccurate or inconclusive. In addition, renal cancer subtypes also have different treatments and outcomes. High false negative rates increase the risk of cancer progression and indeterminate diagnoses result in unnecessary and potentially morbid surgical procedures. We built a predictive classification model for kidney tumors using 697 DNA methylation profiles from six different subgroups: clear cell, papillary and chromophobe RCC, benign angiomylolipomas, oncocytomas, and normal kidney tissues. Furthermore, the DNA methylation-dependent classifier has been validated in 272 ex vivo needle biopsy samples from 100 renal masses (71% SRMs). In general, the results were highly reproducible (89%, n=70) in predicting identical malignant subtypes from biopsies. Overall, 98% of adjacent-normals (n=102) were correctly classified as normal, while 92% of tumors (n=71) were correctly classified malignant and 86% of benign (n=29) were correctly classified benign by this classification model. Overall, this study provides molecular-based support for using routine needle biopsies to determine tumor classification of SRMs and support the clinical decision-making.

  11. Core Needle Biopsy and Fine Needle Aspiration Alone or in Combination: Diagnostic Accuracy and Impact on Management of Renal Masses.

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    Cate, Frances; Kapp, Meghan E; Arnold, Shanna A; Gellert, Lan L; Hameed, Omar; Clark, Peter E; Wile, Geoffrey; Coogan, Alice; Giannico, Giovanna A

    2017-06-01

    Fine needle aspiration with and without concurrent core needle biopsy is a minimally invasive method to diagnose and assist in management of renal masses. We assessed the pathological accuracy of fine needle aspiration compared to and associated with core needle biopsy and the impact on management. We performed a single institution, retrospective study of 342 cases from 2001 to 2015 with small and large renal masses (4 or less and greater than 4 cm, respectively). Diagnostic and concordance rates, and the impact on management were analyzed. Adequacy rates for fine needle aspiration only, core needle biopsy only and fine needle aspiration plus core needle biopsy were 21%, 12% and 8% (aspiration vs aspiration plus biopsy p aspiration plus biopsy group adding aspiration to biopsy and biopsy to aspiration reduced the inadequacy rate from 23% to 8% and from 27% to 8% for a total reduction rate of 15% and 19%, respectively, corresponding to 32 cases (9.3%). Rapid on-site examination contributed to a 22.5% improvement in fine needle aspiration adequacy rates. In this cohort 30% of aspiration only, 5% of biopsy only and 12% of aspiration plus biopsy could not be subtyped (aspiration vs biopsy p aspiration vs aspiration plus biopsy p biopsy vs aspiration plus biopsy p = 0.06). The diagnostic concordance rate with surgical resection was 99%. Conversion of an inadequate specimen to an adequate one by a concurrent procedure impacted treatment in at least 29 of 32 patients. Limitations include the retrospective design and accuracy measurement based on surgical intervention. Fine needle aspiration plus core needle biopsy vs at least fine needle aspiration alone may improve diagnostic yield when sampling renal masses but it has subtyping potential similar to that of core needle biopsy only. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Renal Tumor Biopsy Technique

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    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  13. Evaluation of percutaneous biopsies of renal masses under MRI-guidance: a retrospective study about 26 cases

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    Garnon, J.; Schlier, A.; Tsoumakidou, G. [Nouvel Hopital Civil, Department of Interventional Radiology, Strasbourg (France); Buy, X. [Institut Bergonie, Department of Radiology, Bordeaux (France); Mathelin, M. de; Breton, E. [ICube, University of Strasbourg, CNRS, Strasbourg (France); Gangi, A. [Nouvel Hopital Civil, Department of Interventional Radiology, Strasbourg (France); ICube, University of Strasbourg, CNRS, Strasbourg (France)

    2014-10-15

    To determine whether MRI allows safe and accurate guidance for biopsies of renal masses. Between May 2010 and September 2013, 26 patients (15 men and 11 women) with 26 renal masses underwent MRI-guided percutaneous biopsy. For each patient, we retrospectively collected the epidemiological, procedural and histopathological data. Mean size of tumour was 3.6 cm (range 0.6 - 9 cm). Mean procedure time was 48 minutes (range 37 - 70 min). Malignancy was found in the percutaneous samples in 81 % (21/26) of the masses. All these cases were considered as true positive biopsies. Benignity was found in the percutaneous samples in 5/26 (19 %) of the masses but was confirmed only in 3 cases. The other 2 cases included one false negative case and one undetermined biopsy, as patient was lost to follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of this study were 95.4 %, 100 %, 100 %, 75 % and 96 %, respectively MRI-guidance is safe and accurate to target renal masses. (orig.)

  14. Lessons learned from the comparative study between renal mass biopsy and the analysis of the surgical specimen.

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    Domínguez-Esteban, M; Villacampa-Aubá, F; Garcia-Muñóz, H; Tejido Sánchez, A; Romero Otero, J; de la Rosa Kehrmann, F

    2014-12-01

    The role of renal mass (RM) biopsy is currently under discussion. As a result of the progressive increase in the incidental diagnosis of RMs (which have a higher percentage of benignity and well-differentiated cancers), new approaches have emerged such as observation, especially with elderly patients or those with significant comorbidity. RM biopsy (RMB) should provide sufficient information for making this decision, but so far this has not been the case. We examine our prospective series of in-bench RMBs after surgery and compare them with the anatomy of the removed specimen. We obtained (prospectively, in-bench and with a 16-gauge needle) 4 biopsies of RMs operated on in our department from October 2008 to December 2009. These RMs were analyzed by 2 uropathologists and compared with the results of the specimen. We analyzed 188 biopsies (47 RMs); 12.75% were "not valid". The ability of biopsy to diagnose malignancy or benignity was 100%, and the coincidence in the histological type was 95%. The success in determining the tumor grade was 100% when the cancer was low-grade and 62% when high-grade. None of the analyzed data (necrosis, size, etc.) influenced the results in a statistically significant manner. RMB with a 16-G needle enables the differentiation between malignancy and benignity in 100% of cases, with a very similar diagnostic accuracy in the tumor type. Tumor grade is still the pending issue with renal mass biopsy. Copyright © 2014 AEU. Published by Elsevier Espana. All rights reserved.

  15. Protocol biopsies for renal transplantation

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    Rush David

    2010-01-01

    Full Text Available Protocol biopsies in renal transplantation are those that are procured at predetermined times post renal transplantation, regardless of renal function. These biopsies have been useful to study the natural history of the transplanted kidney as they have detected unexpected - i.e. "subclinical" pathology. The most significant subclinical pathologies that have been detected with protocol biopsies have been acute lesions, such as cellular and antibody mediated rejection, and chronic lesions, such as interstitial fibrosis and tubular atrophy, and transplant glomerulopathy. The potential benefit of early recognition of the above lesions is that their early treatment may result in improved long-term outcomes. Conversely, the identification of normal histology on a protocol biopsy, may inform us about the safety of reduction in overall immunosuppression. Our centre, as well as others, is attempting to develop non-invasive methods of immune monitoring of renal transplant patients. However, we believe that until such methods have been developed and validated, the protocol biopsy will remain an indispensable tool for the complete care of renal transplant patients.

  16. 3D cone-beam CT guidance, a novel technique in renal biopsy - results in 41 patients with suspected renal masses

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    Braak, Sicco J.; Heesewijk, Johannes P.M. van; Strijen, Marco J.L. van [St Antonius Hospital, Department of Radiology, PO Box 2500, Nieuwegein (Netherlands); Melick, Harm H.E. van; Onaca, Mircea G. [St Antonius Hospital, Department of Urology, Nieuwegein (Netherlands)

    2012-11-15

    To determine whether 3D cone-beam computed tomography (CBCT) guidance allows safe and accurate biopsy of suspected small renal masses (SRM), especially in hard-to-reach anatomical locations. CBCT guidance was used to perform 41 stereotactic biopsy procedures of lesions that were inaccessible for ultrasound guidance or CT guidance. In CBCT guidance, a 3D-volume data set is acquired by rotating a C-arm flat-panel detector angiosystem around the patient. In the data set, a needle trajectory is determined and, after co-registration, a fusion image is created from fluoroscopy and a slice from the data set, enabling the needle to be positioned in real time. Of the 41 lesions, 22 were malignant, 17 were benign, and 2 were nondiagnostic. The two nondiagnostic lesions proved to be renal cell carcinoma. There was no growth during follow-up imaging of the benign lesions (mean 29 months). This resulted in a sensitivity, specificity, PPV, NPV, and accuracy of 91.7, 100, 100, 89.5, and 95.1%, respectively. Mean dose-area product value was 44.0 Gy.cm{sup 2} (range 16.5-126.5). There was one minor bleeding complication. With CBCT guidance, safe and accurate biopsy of a suspected SRM is feasible, especially in hard-to-reach locations of the kidney. (orig.)

  17. Ultrasound-guided renal biopsy with automated biopsy

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    Choi, Pil Yeob; Kwon, Jae Soo [Masan Samsung Hospital, Masan (Korea, Republic of)

    1998-01-01

    To elevate the diagnostic yield and complications of percutaneous ultrasound-guided renal biopsy using a biopsy gun in patients with diffuse renal disease. Using an automated biopsy gun mounted with a 16 G needle, biopsies were performed on 90 patients with diffuse renal disease. In a total of 95 biopsies, diagnostic yield, the mean number of glomeruli and frequency of complication were retrospectively analysed. Tissue adequate for histological diagnosis was obtained in 92 % of procedures. Mean glomerular yield was 8.3, and complications were seen in 26% of the procedures, 25 % of these were minor, and 1% were major. For the diagnosis of diffuse renal disease, ultrasound-guided percutaneous renal biopsy using an automated biopsy gun is accurate and safe. (author). 25 refs., 1 tab.

  18. Retroperitoneoscopic renal biopsy in children

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    Carlos M. Jesus

    2007-08-01

    Full Text Available OBJECTIVE: We present our experience in a series of 17 consecutive pediatric patients submitted to retroperitoneal laparoscopic renal biopsy. MATERIALS AND METHODS: Retroperitoneal laparoscopic renal biopsy (LRB was performed in 5 boys and 12 girls. Mean age was 8.1 years and age range from 2 to 12. Two or three trocars were used to expose the inferior pole of the kidney, remove enough cortical parenchymal specimen and fulgurate the biopsy site. Assessment included surgical time, estimated blood loss, hospitalization period, analgesia requirements, complications and number of glomeruli present in the specimen. RESULTS: LRB was successfully performed in all 15 patients (88%. In two cases, LRB was not possible to be performed. One patient was converted to a transperitoneal laparoscopy due to tear in the peritoneum. The other patient had had previous abdominal surgery and, during retroperitoneal balloon dilation, the peritoneum was opened and the open biopsy was performed. A third patient had postoperatively a perirenal hematoma, which was solved spontaneously. Complication rate was 17.6% (3/17 cases. Mean operative time was 65 minutes, while mean estimated blood loss was 52 mL, mean hospital stay was 2.2 days and mean analgesic requirement was 100 mg of tramadol. The mean number of glomeruli present in the specimen was 60. CONCLUSION: Retroperitoneal laparoscopic renal biopsy in children is a simple, safe. Bleeding is still the most common complication. However, direct vision usually allows a safe control of this drawback. In our institution, laparoscopic approach is the chosen procedure in pediatric patients older than one - year - old.

  19. Tumor Seeding With Renal Cell Carcinoma After Renal Biopsy

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    M.F.B. Andersen; Norus, T.P.

    2016-01-01

    Tumor seeding following biopsy of renal cell carcinoma is extremely rare with an incidence of 1:10.000. In this paper two cases with multiple recurrent RRC metastasis in the biopsy tract following biopsy of renal tumor is presented and the current literature is shortly discussed.

  20. Accuracy of Percutaneous Core Biopsy in the Diagnosis of Small Renal Masses (≤4.0 cm: A Meta-analysis

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    Qiqi He

    2015-02-01

    Full Text Available Objective To use meta-analysis to determine the accuracy of percutaneous core needle biopsy in the diagnosis of small renal masses (SMRs≤4.0 cm. Materials and Methods Studies were identified by searching PubMed, Embase, and the Cochrane Library database up to March 2013. Two of the authors independently assessed the study quality using QUADAS-2 tool and extracted data that met the inclusion criteria. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR and also summary receiver operating characteristic (SROC curve were investigated and draw. Deek’s funnel plot was used to evaluate the publication bias. Result A total of 9 studies with 788 patients (803 biopsies were included. Failed biopsies without repeated or aborted from follow-up/surgery result were excluded (232 patients and 353 biopsies. For all cases, the pooled sensitivity was 94.0% (95% CI: 91.0%, 95.0%, the pooled positive likelihood was 22.57 (95% CI: 9.20-55.34, the pooled negative likelihood was 0.09 (95% CI: 0.06-0.13, the pooled DOR was 296.52(95% CI: 99. 42-884.38. The area under the curve of SROC analysis was 0.959±0.0254. Conclusion Imaging-guided percutaneous core needle biopsy of small renal masses (SMRs≤4.0 cm is highly accurate to malignant tumor diagnosis with unknown metastatic status and could be offered to some patients after clinic judgment prior to surgical intervention consideration.

  1. Renal Biopsy in Type 2 Diabetic Patients

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    Eugenia Espinel

    2015-05-01

    Full Text Available The majority of diabetic patients with renal involvement are not biopsied. Studies evaluating histological findings in renal biopsies performed in diabetic patients have shown that approximately one third of the cases will show pure diabetic nephropathy, one third a non-diabetic condition and another third will show diabetic nephropathy with a superimposed disease. Early diagnosis of treatable non-diabetic diseases in diabetic patients is important to ameliorate renal prognosis. The publication of the International Consensus Document for the classification of type 1 and type 2 diabetes has provided common criteria for the classification of diabetic nephropathy and its utility to stratify risk for renal failure has already been demonstrated in different retrospective studies. The availability of new drugs with the potential to modify the natural history of diabetic nephropathy has raised the question whether renal biopsies may allow a better design of clinical trials aimed to delay the progression of chronic kidney disease in diabetic patients.

  2. Needle tract seeding following percutaneous biopsy of renal cell carcinoma.

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    Chang, Dwayne T S; Sur, Hariom; Lozinskiy, Mikhail; Wallace, David M A

    2015-09-01

    A 66-year-old man underwent computed tomography-guided needle biopsy of a suspicious renal mass. Two months later he underwent partial nephrectomy. Histology revealed a 30-mm clear cell renal cell carcinoma, up to Fuhrman grade 3. An area of the capsule was interrupted, which corresponded to a hemorrhagic area on the cortical surface. Under microscopy, this area showed a tongue of tumor tissue protruding through the renal capsule. A tumor deposit was found in the perinephric fat. These features suggest that tumor seeding may have occurred during the needle biopsy.

  3. Retroperitoneoscopic renal biopsy: still a good indication!

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    Micali, Salvatore; Dandrea, Matteo; De Carne, Cosimo; Martorana, Eugenio; De Stefani, Stefano; Cappelli, Gianni; Bianchi, Giampaolo

    2014-01-01

    The histological evaluation of the renal parenchyma is often essential in cases of several renal diseases and provides useful information in determining the prognosis and guiding treatment. In patients with contraindications to percutaneous kidney biopsy, retroperitoneal laparoendoscopic single-site surgery (LESS) is to be preferred as a minimally invasive technique. However, there are cases in which the LESS technique is difficult to perform, especially given that the learning curve is not optimal. We present a case of a Jehovah's Witness patient with severe obesity, in whom conventional retroperitoneal laparoscopic renal biopsy was preferred to the LESS technique.

  4. Renal biopsy with 16G needle: a safety study.

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    Guerrero-Ramos, F; Villacampa-Aubá, F; Jiménez-Alcaide, E; García-González, L; Ospina-Galeano, I A; de la Rosa-Kehrmann, F; Rodríguez-Antolín, A; Passas-Martínez, J; Díaz-González, R

    2014-11-01

    The development of percutaneous renal biopsy as a routinary diagnostic procedure for renal masses is topic of discussion for the last few years. However, this technique has been associated with some complications, although infrequent, and morbidity. Our objective is to carry out a descriptive study about complications and outcomes of orthotopic kidney biopsies with 16 G needle. A retrospective review of 180 orthotopic ultrasound-guided renal biopsies performed in our service among January 2008 to May 2010 was carried out. The procedure was developed using an automated biopsy gun (16G needle). Multiple clinical variables, early post-procedure complications and its management were collected. Complication rates as well as the relationship between risk factors and occurrence of complications were studied. Mean age was 55.8 years. The average number of biopsy cylinders per intervention was 2.49. The overall complication rate was 5.6%. An interventionist attitude derived from complication of the procedure was necessary in only 3 patients (1.67%). No surgical interventions were required and no death as consequence of procedure was registered. No relationship between hypertension (P=.09) previous anticoagulation (P=.099) or previous antiaggregation (P=.603) and complications were demonstrated. In 2.8% of biopsies the material obtained was insufficient for diagnosing. Percutaneous ultrasound-guided renal biopsy with 16G needle is a safe technique with high diagnostic performance. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  5. Ultrasound-guided percutaneous renal biopsy with an automated biopsy gun in diffuse renal disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Yang; Moon, Jeoung Mi; Park, Ji Hyun; Kwon, Jae Soo; Song, Ik Hoon; Kim, Sung Rok [Masan Koryo General Hospital, Masan (Korea, Republic of)

    1994-12-15

    We evaluated the effectiveness and clinical usefulness of percutaneous renal biopsy by using automated biopsy gun under the real-time ultrasonographic guidance that was performed in 17 patients with diffuse renal disease. We retrospectively analysed the histopathological diagnosis and the patients' status after percutaneous renal biopsy.Adequate amount of tissue for the histologic diagnosis could be obtained in al patients. Histopathologic diagnosis included the minimal change nephrotic syndrome in 6 patients, the membrano proliferative glomerulonephritis in 4,the membranous glomerulonephritis in 2, the glomerulosclerosis in 2, Ig A nephropathy in 2, and the normal finding in 1. Significant complication occurred in only one patient who developed a transient loss of sensation at and around the biopsy site. In conclusion, automated biopsy gun was a very useful device in performing percutaneous biopsy for diffuse renal disease with a high success rate and a low complication rate

  6. Core biopsies of renal tumors: A study on diagnostic accuracy, interobserver, and intraobserver variability

    DEFF Research Database (Denmark)

    Kummerlin, I.; Kate, F. ten; Smedts, F.;

    2008-01-01

    Objective: The diagnostic accuracy of in-bench core biopsies (CBs) from renal masses, and the interobserver and intraobserver variability in pathological subtyping of renal tumors were assessed. Methods: We performed two CBs in 62 consecutive renal masses suspected for renal cell carcinoma (RCC...

  7. Transarterial embolization for serious renal hemorrhage following renal biopsy.

    Science.gov (United States)

    Zeng, Dan; Liu, Guihua; Sun, Xiangzhou; Zhuang, Wenquan; Zhang, Yuanyuan; Guo, Wenbo; Yang, Jianyong; Chen, Wei

    2013-01-01

    The goal of this study is to evaluate the feasibility and efficacy of percutaneous transarterial embolization for the treatment of serious renal hemorrhage after renal biopsy. Nine patients with renal hemorrhage had frank pain and gross hematuria as main symptoms after renal biopsy. Intrarenal arterial injuries and perinephric hematoma were confirmed by angiography in all cases. The arterial injuries led to two types of renal hemorrhage, Type I: severe renal injure or intrarenal renal artery rupture (n=5), with contrast medium spilling out of the artery and spreading into renal pelvis or kidney capsule in angiography; Type II, pseudo aneurysm or potential risk of intrarenal artery injure (n=4), where contrast medium that spilled out of intraartery was retained in the parenchyma as little spots less than 5 mm in diameter in angiography. Transcatheter superselective intrarenal artery embolization was performed with coils or microcoils (Type I intrarenal artery injure) and polyvinyl alcohol particles (Type II injure). The intrarenal arterial injuries were occluded successfully in all patients. Light or mild back or abdominal pain in the side of the embolized kidney was found in three patients following embolization procedures and disappeared 3 days later. Serum creatinine and perinephric hematoma were stable, and gross hematuresis stopped immediately (n=4) or 3-5 days (n=3) after embolization. In conclusions, transcatheter superselective intrarenal artery embolization as a minimally invasive therapy is safe and effective for treatment of serious renal hemorrhage following percutaneous renal biopsy.

  8. Factors that can minimize bleeding complications after renal biopsy.

    Science.gov (United States)

    Zhu, M S; Chen, J Z; Xu, A P

    2014-10-01

    Renal biopsy is a very important diagnostic tool in the evaluation of renal diseases. However, bleeding remains to be one of the most serious complications in this procedure. Many new techniques have been improved to make it safer. The risk factors and predictors of bleeding after percutaneous renal biopsy have been extensively reported in many literatures, and generally speaking, the common risk factors for renal biopsy complications focus on hypertension, high serum creatinine, bleeding diatheses, amyloidosis, advanced age, gender and so on. Our primary purpose of this review is to summarize current measures in recent years literature aiming at minimizing the bleeding complication after the renal biopsy, including the drug application before and after renal biopsy, operation details in percutaneous renal biopsies, nursing and close monitoring after the biopsy and other kinds of biopsy methods.

  9. Efficacy of ultrasonography-guided renal biopsy for the evaluation of renal dysfunction following renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jae; Choi, Chul Soon; Min, Seon Jeong; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won; Bae, Sang Hoon [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2003-12-15

    To evaluate the usefulness and complications of renal biopsy under ultrasonography-guidance in renal dysfunction after renal transplantation. Ultrasonography-guided renal biopsy was done in 47 patients with the transplanted kidney. The subjects consisted of 30 males and 17 females, age ranged from 16 to 66 years (average age=38 years). Biopsies were done once in 27 patients, twice in 17 patients, three times in 3 patients, a total of 70 biopsies. The success rate of renal biopsy for the accurate pathologic diagnosis and the incidence and types of complications following biopsy were evaluated. The success rate of renal biopsy for the accurate pathologic diagnosis was 96%(67/70). Pathologic diagnosis included 27 cases of acute rejection (39%), 8 cases of acute tubular necrosis (11%), 4 cases of acute rejection and acute tubular necrosis (6%), 4 cases of cyclosporin toxicity (6%), 4 cases of primary disease recurrence (6%), 4 cases of infection (6%) and others. Complications after renal biopsy included 15 cases of microscopic hematuria (21%), 1 case of gross hematuria with spontaneous cessation and 1 case of life threatening hemorrhage. Ultrasonography-guided renal biopsy is a safe and effective diagnostic method for the evaluation of renal dysfunction following renal transplantation.

  10. Factors that can minimize bleeding complications after renal biopsy

    OpenAIRE

    Zhu, M. S.; J. Z. Chen; A.P. Xu

    2014-01-01

    Renal biopsy is a very important diagnostic tool in the evaluation of renal diseases. However, bleeding remains to be one of the most serious complications in this procedure. Many new techniques have been improved to make it safer. The risk factors and predictors of bleeding after percutaneous renal biopsy have been extensively reported in many literatures, and generally speaking, the common risk factors for renal biopsy complications focus on hypertension, high serum creatinine, bleeding dia...

  11. Clinical role of the renal transplant biopsy

    Science.gov (United States)

    Williams, Winfred W.; Taheri, Diana; Tolkoff-Rubin, Nina; Colvin, Robert B.

    2013-01-01

    Percutaneous needle core biopsy is the definitive procedure by which essential diagnostic and prognostic information on acute and chronic renal allograft dysfunction is obtained. The diagnostic value of the information so obtained has endured for over three decades and has proven crucially important in shaping strategies for therapeutic intervention. This Review provides a broad outline of the utility of performing kidney graft biopsies after transplantation, highlighting the relevance of biopsy findings in the immediate and early post-transplant period (from days to weeks after implantation), the first post-transplant year, and the late period (beyond the first year). We focus on how biopsy findings change over time, and the wide variety of pathological features that characterize the major clinical diagnoses facing the clinician. This article also includes a discussion of acute cellular and humoral rejection, the toxic effects of calcineurin inhibitors, and the widely varying etiologies and characteristics of chronic lesions. Emerging technologies based on gene expression analyses and proteomics, the in situ detection of functionally relevant molecules, and new bioinformatic approaches that hold the promise of improving diagnostic precision and developing new, refined molecular pathways for therapeutic intervention are also presented. PMID:22231130

  12. Need for Renal Biopsy Registry in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al-Homrany Mohammad

    2008-01-01

    Full Text Available Many renal lesions may result in chronic kidney disease if not detected early or treated properly. Glomerulonephritis is considered one of the leading causes of end-stage renal disease. The prevalence of different renal lesions were identified by inconsistent studies. The causes of inconsistencies include lack of unified methods in diagnosing and processing renal biopsies by different pathologists, patients selection′s bias for renal biopsy, and the variable policies and protocols adopted by different nephrologists. Establishment of renal biopsy registry may help to surmount these differences. In addition, combined data obtained from renal biopsy renal and replacement therapy registries can help study the long-term outcome of patients with renal diseases.

  13. Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy

    Directory of Open Access Journals (Sweden)

    Christopher Caputo

    2014-01-01

    Full Text Available We describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN, a perinephric hematoma was encountered. The hematoma was not present on preoperative imaging and was likely a result of the renal biopsy. The renal cell carcinoma (RCC and the associated hematoma were widely excised with negative surgical margins. On follow-up imaging at five months postoperatively, a recurrent renal mass at the surgical resection bed and several new nodules in the omentum were detected. During completion left robotic total nephrectomy and omental excision, intraoperative frozen sections confirmed metastatic RCC. We believe that a hematoma seeded with RCC formed as a result of the renal biopsy, and subsequent disruption of the hematoma during RPN caused contamination of RCC into the surrounding structures.

  14. Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient

    Directory of Open Access Journals (Sweden)

    Zhang Qing

    2012-12-01

    Full Text Available Abstract Ultrasound-guided percutaneous renal biopsy is an important technique for diagnosis of glomerular diseases, and the biopsy-induced life-threatening bleeding rarely happens. Primary systemic amyloidosis is a rare disease which may lead to organ dysfunction including arterial stiffness. The accessory renal artery is a kind of renal vascular variation which goes into the renal parenchyma directly or via the renal hilum. Here we reported a rare case of percutaneous renal biopsy-induced accessory renal artery life-threatening bleeding in a renal amyloidosis patient, and our experience of successful rescue in this patient. Virtual Slides http://www.diagnosticpathology.diagnomx.eu/vs/1524207344817819

  15. Transjugular renal biopsy in the treatment of patients with cirrhosis and renal abnormalities.

    Science.gov (United States)

    Jouët, P; Meyrier, A; Mal, F; Callard, P; Guettier, C; Stordeur, D; Trinchet, J C; Beaugrand, M

    1996-11-01

    When renal lesions are suspected in patients with cirrhosis, clotting disorders often preclude percutaneous renal biopsy. This study was undertaken to determine whether transjugular renal biopsy is possible, safe, and useful in such patients. From 1987 to 1994, 70 patients with cirrhosis and clotting disorders underwent transjugular renal biopsies, providing renal tissue in 55. Of these 55 patients, 41 were Child-Pugh class B or C, 35 were alcoholic, serum creatinine levels were > or = 130 micromol/L in 46, and proteinuria was > or = 0.5 g/d in 37. Clinically significant complications of transjugular renal biopsy were persistent hematuria in 4 and perirenal hematoma in 4, requiring blood transfusions in 1 and 2 cases, respectively. There were no deaths related to renal biopsy. Renal lesions were identified as glomerular in 41 (74.5%), interstitial in 7, and end-stage in 2 and were absent in 5. Transjugular renal biopsy influenced treatment in 21 patients (38%), including 11 who were proposed for liver transplantation and 4 who had chronic liver rejection. Decisions based on results of transjugular renal biopsy were to perform liver transplantation in 8 and combined renal and liver transplantation in 5, whereas 2 were refused. In 6 other patients, the results of renal biopsy modified the medical regimen. We conclude that transjugular renal biopsy may be a useful procedure in patients with cirrhosis and clotting disorders. This technique does not entail undue risks and may influence treatment decisions, particularly in patients proposed for liver transplantation.

  16. Bilateral Renal Mass-Renal Disorder: Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ozlem Tiryaki

    2013-01-01

    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  17. Transvenous Renal Transplant Biopsy via a Transfemoral Approach.

    Science.gov (United States)

    Schmid, A; Jacobi, J; Kuefner, M A; Lell, M; Wuest, W; Mayer-Kadner, I; Benz, K; Schmid, M; Amann, K; Uder, M

    2013-05-01

    Percutaneous renal biopsy (PRB) of kidney transplants might be prevented by an elevated risk of bleeding or limited access to the allograft. In the following, we describe our initial experience with 71 transvenous renal transplant biopsies in 53 consecutive patients with unexplained reduced graft function who were considered unsuitable candidates for PRB (4.2% of all renal transplant biopsies at our institution). Biopsies were performed via the ipsilateral femoral vein with a renal biopsy set designed for transjugular renal biopsy (TJRB) of native kidneys. Positioning of the biopsy system within the transplant vein was achievable in 58 of 71 (81.7%) procedures. The specimen contained a median of 10 glomeruli (range 0-38). Tissue was considered as adequate for diagnosis in 56 of 57 (98.2%) biopsies. With respect to BANFF 50.9% of the specimen were adequate (>10 glomeruli), 47.4% marginally adequate (1-9 glomeruli) and 1.8% inadequate (no glomeruli). After implementation of real-time assessment all specimen contained glomeruli. One of the fifty-eight (1.8%) procedure-related major complications occurred (hydronephrosis requiring nephrostomy due to gross hematuria). Transfemoral renal transplant biopsy (TFRTB) is feasible and appears to be safe compared to PRB. It offers a useful new alternative for histological evaluation of graft dysfunction in selected patients with contraindications to PRB.

  18. Angio-embolization of a renal pseudoaneurysm complicating a percutaneous renal biopsy: a case report.

    Science.gov (United States)

    Rafik, Hicham; Azizi, Mounia; El Kabbaj, Driss; Benyahia, Mohammed

    2015-01-01

    We report the treatment of a bleeding renal pseudoaneurysm by angio-embolization. A 21 years old woman developed macroscopic haematuria following renal biopsy. Renal angio-scan showed a 1.4 cm renal pseudoaneurysm in the left kidney. The presence of pseudoaneurysm was confirmed by selective renal angiography. Successful embolization was performed using gelatine sponge particles.

  19. Role of bone biopsy in renal osteodystrophy

    Directory of Open Access Journals (Sweden)

    Al Badr Wisam

    2009-01-01

    Full Text Available Renal osteodystrophy (ROD, the abnormal bone histology that occurs in the context of kidney disease, is a disease spectrum and not a uniform progressive bone disease. It is an important component of the broad disturbances of bone and mineral metabolism associated with chronic kidney disease (CKD. There are multiple pathogenetic factors which contribute to the histological abnormalities seen on bone biopsy. The patients with ROD are rarely symp-tomatic in the early stages of CKD. It is also noteworthy that the clinical manifestations are usually preceded by biochemical changes that are insidious and subtle. This makes it difficult for the clinician to suspect the presence of bone and mineral metabolism abnormalities without direct testing. The serum calcium, phosphorus, and alkaline phosphatase levels are usually normal until late in the course of CKD. The main screening test for abnormal bone and mineral metabolism is the measurement of parathyroid hormone which is also somewhat delayed. The clinical signs and symptoms are also challenging to interpret because of their slow and non-specific nature which may include vague, ill-defined, bone aches and pains, and muscle weakness. The gold standard for diagnosis of ROD is bone biopsy with mineralized bone histology after double tetracycline labeling, iron staining and aluminum staining. The currently used histomorphometric descriptions of bone histology are not well integrated clinically and a new nomenclature that is clinically more relevant and useful has been proposed. Additional studies are required to define the spectrum of ROD in the current therapeutic era, and to find clinically useful non-invasive biomarkers to improve the treatment and monitoring of the abnormal bone in the setting of CKD.

  20. Renal biopsy in the management of lupus nephritis during pregnancy.

    Science.gov (United States)

    Chen, T K; Gelber, A C; Witter, F R; Petri, M; Fine, D M

    2015-02-01

    The differential diagnosis of proteinuria and hematuria in pregnancy is broad and includes active lupus nephritis. Identification of the correct diagnosis often has a profound therapeutic impact on not only the mother but also the fetus. To date, relatively few reports exist on the role of renal biopsy during pregnancy among women with systemic lupus erythematosus (SLE). We present a case series of 11 pregnant women with SLE who underwent a renal biopsy to evaluate a presumptive flare of lupus nephritis. The electronic medical record was retrospectively analyzed for pre-biopsy serum creatinine, proteinuria, hematuria, antinuclear antibodies (ANA), and antibodies to double-stranded DNA (anti-dsDNA); histologic findings on renal biopsy; and the clinical course of each mother and fetus. From 2001 to 2012, 11 pregnant women with SLE flares during pregnancy underwent a renal biopsy at an academic tertiary medical center. At the time of biopsy, median gestational age was 16 weeks (range 9 to 27), median serum creatinine was 0.6 mg/dl (interquartile range 0.5 to 0.9), six (55%) had hematuria, and all had proteinuria >500 mg/24 hours. Proliferative lupus nephritis was found in 10 (91%) of 11 biopsies (five with ISN/RPS Class III; five with ISN/RPS Class IV). All but one individual underwent a change in management guided by information gleaned from renal biopsy. No apparent biopsy-related complications occurred to mother or fetus. Three women elected to terminate their pregnancy; although many factors were involved, the findings on renal biopsy informed the decision-making process. Among the remaining cases, there were three pre-term deliveries, one fetus with complete heart block, one in utero demise, and one maternal death. Renal biopsy is helpful at informing the management of patients with lupus nephritis during pregnancy.

  1. US-guided biopsy of renal allografts using 18G biopsy gun: analysis of 200 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Lee, Jong Tae; Kim, Myeong Jin; Yoo, Hyung Sik; Kim, Ki Whang; Park, Ki Ill; Chung, Hyun Joo [Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    1995-05-15

    We evaluated the effectiveness and safety of 18G biopsy gun with US guidance in the transplanted kidneys. We performed 200 US-guided percutaneous biopsies using 18G biopsy gun. Diagnostic efficacy and complication of the biopsy in these patients were analyzed. Biopsy specimens were adequate for histologic diagnoses in 193 patients(96.5%). The mean of the biopsy frequency was 3, the mean of total glomerular number was 21.64 and the mean glomerular number per one biopsy was 6.93. Major complications occurred in 3 (1.5%) of the 200 biopsies; hematuria developed in two patients, AV fistula in one. These complications were successfully controlled either by only transfusion or by coil embolization. There were no statistical differences in blood pressure, hemoglobin, BUN/Cr between pre-and post-renal biopsies. US-guided percutaneous biopsy of renal allograft with 18G biopsy gun is simple, safe, and accurate method in evaluating the renal allograft dysfunction.

  2. Renal biopsy findings among Indigenous Australians: a nationwide review.

    Science.gov (United States)

    Hoy, Wendy E; Samuel, Terence; Mott, Susan A; Kincaid-Smith, Priscilla S; Fogo, Agnes B; Dowling, John P; Hughson, Michael D; Sinniah, Rajalingam; Pugsley, David J; Kirubakaran, Meshach G; Douglas-Denton, Rebecca N; Bertram, John F

    2012-12-01

    Australia's Indigenous people have high rates of chronic kidney disease and kidney failure. To define renal disease among these people, we reviewed 643 renal biopsies on Indigenous people across Australia, and compared them with 249 biopsies of non-Indigenous patients. The intent was to reach a consensus on pathological findings and terminology, quantify glomerular size, and establish and compare regional biopsy profiles. The relative population-adjusted biopsy frequencies were 16.9, 6.6, and 1, respectively, for Aboriginal people living remotely/very remotely, for Torres Strait Islander people, and for non-remote-living Aboriginal people. Indigenous people more often had heavy proteinuria and renal failure at biopsy. No single condition defined the Indigenous biopsies and, where biopsy rates were high, all common conditions were in absolute excess. Indigenous people were more often diabetic than non-Indigenous people, but diabetic changes were still present in fewer than half their biopsies. Their biopsies also had higher rates of segmental sclerosis, post-infectious glomerulonephritis, and mixed morphologies. Among the great excess of biopsies in remote/very remote Aborigines, females predominated, with younger age at biopsy and larger mean glomerular volumes. Glomerulomegaly characterized biopsies with mesangiopathic changes only, with IgA deposition, or with diabetic change, and with focal segmental glomerulosclerosis (FSGS). This review reveals great variations in biopsy rates and findings among Indigenous Australians, and findings refute the prevailing dogma that most indigenous renal disease is due to diabetes. Glomerulomegaly in remote/very remote Aboriginal people is probably due to nephron deficiency, in part related to low birth weight, and probably contributes to the increased susceptibility to kidney disease and the predisposition to FSGS.

  3. Comparison of the renal disease at the Tibetan plateaus and plain based on renal biopsy data

    Institute of Scientific and Technical Information of China (English)

    周岩

    2014-01-01

    Objective To compare the characteristics of renal disease based on renal biopsy data between the Tibetan plateaus and the plain.Methods 160 chronic kidney diseases patients underwent renal biopsy from the plain and80 cases from Tibet plateau were compared in a parallel controlled manner.The relationship of renal pathology and clinical signs were also compared.Results(1)The male to female ratio was quite different between Tibet

  4. An experimental study on vascular changes in renal biopsy injury

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Jae Hoon; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1981-12-15

    An experimental study on the vascular alternations of the kidney following biopsy procedure was carried out in 47 kidneys from 28 rabbits to clarify their nature and frequency by renal arteriography and microangiography together with histopathologic investigation. Renal arteriography and microangiography were performed immediately 2 days, 1 week, and 2 weeks after percutaneous biopsy and the findings were correlated with histological nature. The results are summarized as follows: 1. Important biopsy injuries verified by renal arteriography and microangiography were arterial spasm, perfusion defect, arteriovenous fistula, injury to vasa rectae and renal tubules, intrarenal and extrarenal extravasation of contrast media, and arterial obstruction, in order of frequency. 2. Arterial spasm observed in majority of the cases were relieved during the period of 2 weeks. 3. Detectability of perfusion detect was 57% and 72% angiography and microangiography, respectively, and this perfusion defect seemed to be mostly caused by renal infraction due to vascular injury, such as arteriovenous fistula, arterial obstruction and other vascular injuries. 4. Arteriovenous fistula was detected in 28% by angiography and 50% by microangiography. Many of the arteriovenous fistulae appeared to be closed spontaneous within a week. Above findings suggest that renal biopsy procedure results in various degree of vascular injuries with their sequential modification, and that microangiography is assumed the most effective approach in analysis of biopsy injuries such as small arteriovenous fistula, perfusion defect, injury to vasa recta and renal tubules, overcoming the limitation of traditional angiography.

  5. Future of the Renal Biopsy: Time to Change the Conventional Modality Using Nanotechnology

    Science.gov (United States)

    Khosroshahi, Hamid Tayebi; Sarbaz, Yashar; Shakeri Bavil, Abolhassan

    2017-01-01

    At the present time, imaging guided renal biopsy is used to provide diagnoses in most types of primary and secondary renal diseases. It has been claimed that renal biopsy can provide a link between diagnosis of renal disease and its pathological conditions. However, sometimes there is a considerable mismatch between patient renal outcome and pathological findings in renal biopsy. This is the time to address some new diagnostic methods to resolve the insufficiency of conventional percutaneous guided renal biopsy. Nanotechnology is still in its infancy in renal imaging; however, it seems that it is the next step in renal biopsy, providing solutions to the limitations of conventional modalities.

  6. Risk Factors for Severe Bleeding Complications in Percutaneous Renal Biopsy.

    Science.gov (United States)

    Xu, Da-Min; Chen, Min; Zhou, Fu-de; Zhao, Ming-Hui

    2017-03-01

    Percutaneous renal biopsy is essential for diagnosis of many renal diseases. Previous studies have revealed a variety of factors associated with bleeding complications of renal biopsy; however, data are not sufficient in the Chinese population. We aimed to investigate the risk factors for severe post-biopsy bleeding events in a large cohort of Chinese patients. The data of patients who underwent percutaneous renal biopsy from January 2008 to December 2012 were collected. Severe bleeding complication was defined as requiring intervention, including blood transfusion or an invasive procedure (radiological or surgical) due to bleeding. Logistic regression analysis was used to assess risk factors. Over the 5-year period, 3,577 native kidney biopsies were performed. Severe bleeding complication occurred in 14 biopsies (0.39%). The patients with complications were older, had higher blood pressure, lower hemoglobin, lower platelet count and worse renal function. Multivariable logistic regression demonstrated that platelet level and the estimated glomerular filtration rate were independently associated with the risk of complications. Each 10 × 10(9)/L increase of platelet count was associated with an 11% decrease of severe bleeding risk (odds ratio = 0.89; 95% CI: 0.80-0.98; P = 0.02). Each 1mL/minute/1.73m(2) increase of the estimated glomerular filtration rate was associated with a 4% decrease of severe bleeding risk (odds ratio = 0.96; 95% CI: 0.94-0.99; P = 0.004). Patients with worse renal function and lower platelet counts had a higher risk of developing severe bleeding events after renal biopsy. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  7. Follow-up Sonography after Sonoguided Renal Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Soo; Park, Cheol Min; Cha, In Ho [Korea University College of Medicine, Seoul (Korea, Republic of)

    1996-06-15

    To assess ultrasonographic findings and clinical significance after renal biopsy. 174 cases of post-biopsy sonography were studied retrospectively. We classified post-biopsy hematoma on the basis of their size as small (thickness less than 1 cm, length less than 3cm), medium (thickness less than 1cm, length greater than 3 cm), large (thickness greater than 1 cm, length greater than 3 cm). We also compared bleeding parameters (prothrombin time, partial thromboplastin time) and renal function in both cases which had hematoma or not. Total 33 hematomas were found (19%). Small hematoma was observed in 14 cases, medium hematoma in 16 cases, large hematoma in 3 cases. Severe complications requiring prompt therapy occurred in 1 case(0.6%). In 6 cases hematocrit fell by more than 4%, all of these hematomas were observed on US. Severe complications after sonoguided renal biopsy were rare. There was poor correlation between prebiopsybleeding parameter, renal function and post-biopsy hematomas. And sonography is considered as adequate method for follow up of post-biopsy hematoma

  8. Cortical and medullary vascularity in renal allograft biopsies

    OpenAIRE

    2012-01-01

    Aim: To evaluate the relation between cortical and medullary peritubular capillaries (PTCs) and scarring. There are presently no studies about medullary PTCs in renal allograft biopsies. Materials and methods: Nonprotocol allograft biopsies were evaluated and 41 with adequate medullary and cortical tissues were selected. Vascular structures were counted separately at the medulla and cortex on anti-CD34 stained sections. Other histopathological and clinical findings were retrieved from the p...

  9. Do we still need renal biopsy in lupus nephritis?

    Science.gov (United States)

    Haładyj, Ewa; Cervera, Ricard

    2016-01-01

    The natural course of systemic lupus erythematosus (SLE) is characterized by periods of disease activity and remissions. Prolonged disease activity results in cumulative organ damage. Lupus nephritis is one of the most common and devastating manifestations of SLE. In the era of changing therapy to less toxic regimens, some authors have stated that if mycophenolate mofetil can be used for the induction and maintenance treatment in all histological classes of lupus nephritis, renal biopsy can be omitted. This article aims to answer the question of what brings the bigger risk: renal biopsy or its abandonment.

  10. Complications of percutaneous renal tumor biopsy: An analysis of 340 consecutive biopsies

    DEFF Research Database (Denmark)

    René Rasmussen, Lars; Loft, Martina; Høyer, Søren;

    Purpose Ultrasound Guided Percutaneous Kidney Biopsy (UGPKB) plays a major role in diagnosis of renal tumours. There seems to be little consensus regarding post-biopsy observation period. We aim to identify complications in UGPKB among outpatients with a suspected malignant renal lesion as well...... as the timing of onset of these complications, helping to clarify the optimal observation period. Many studies in this field suggest a lower complication risk for outpatients compared to hospitalized patients. In the latter group, an observation period of 24h after biopsy is often recommended. Material...... discrepancy. Results As for one third of the patients, analysed up until now, we find a total of one major complication and a few minor, all arisen within less than 6 hours after biopsy. Conclusions Rates of both major and minor complications in UGPKB are very low suggesting a shorter observation period...

  11. Subtyping of renal cortical neoplasms in fine needle aspiration biopsies using a decision tree based on genomic alterations detected by fluorescence in situ hybridization

    OpenAIRE

    Gowrishankar, Banumathy; Cahill, Lynnette; Arndt, Alexandra E; Al-Ahmadie, Hikmat; Lin, Oscar; Chadalavada, Kalyani; Chaganti, Seeta; Nanjangud, Gouri J; Murty, Vundavalli V; Chaganti, Raju S K; Reuter, Victor E.; Houldsworth, Jane

    2014-01-01

    Objectives To improve the overall accuracy of diagnosis in needle biopsies of renal masses, especially small renal masses (SRMs), using fluorescence in situ hybridization (FISH), and to develop a renal cortical neoplasm classification decision tree based on genomic alterations detected by FISH. Patients and Methods Ex vivo fine needle aspiration biopsies of 122 resected renal cortical neoplasms were subjected to FISH using a series of seven-probe sets to assess gain or loss of 10 chromosomes ...

  12. Percutaneous Renal Biopsy : A Report of 200 Caces

    Directory of Open Access Journals (Sweden)

    M. Bahadori

    1966-01-01

    Full Text Available In the diffuse medical diseases of kidney, percutaneous renal biopsy is a valuable, safe and hazardless procedure. With the aid of this nearly new technique renal pathology, the natural history of renal diseases and the response of renal diseases to therapy, as well as the prognosis of renal disorders can be evaluated."nWe have analysed 210 percutaneous biopsies in Tehran. Complications were observed in 13% of cases, there is no mortality and no patient required drastic therapeutic intervention. Anuria, peri-renal colic and peri-renal hematoma were the only serious complications, which were seen in 4 patients, and were. readily controled with simple measures We obtained renal tissue in 95% cases of our patients and in 9 I% of them the tissue was adequate for c'ear diagnosis."nLike other authors, we believe that the procedure, when properly performed, can give a far more valuable informations about the patients without any realy dangerous risk.

  13. A Renal Perforating Artery Mistaken for Arterial Bleeding after Percutaneous Renal Biopsy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ye Lim; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min [Korea University College of Medicine, Seoul (Korea, Republic of)

    2009-12-15

    Perirenal hematoma after a renal biopsy is a common complication that usually resolves spontaneously, but this rarely requires transfusions or surgical/radiological intervention. We report here on a case of a renal perforating artery that was mistaken for renal arterial bleeding in a 53-year-old woman who was complicated with perirenal hematoma after undergoing a percutaneous renal biopsy. On the color and pulsed wave Doppler ultrasonography, linear blood flow was seen in the perirenal hematoma, which extended perpendicularly from the renal parenchyma into the perirenal space, and this linear blood flow exhibited an arterial pulse wave. On CT angiography, the renal perforating artery was demonstrated as a curvilinear vessel coursing tangentially to the renal margin and we decided that it was a pseudolesion caused by the renal perforating artery. A renal perforating artery may be mistaken for renal arterial bleeding after a percutaneous renal biopsy. A renal perforating artery and arterial bleeding can be differentiated by the location and shape seen on a color Doppler examination and the pulse waves characteristics

  14. Utility of renal biopsy in the clinical management of renal disease.

    Science.gov (United States)

    Dhaun, Neeraj; Bellamy, Christopher O; Cattran, Daniel C; Kluth, David C

    2014-05-01

    Characterizing chronic kidney disease (CKD) at all stages is an essential part of rational management and the renal biopsy plays a key role in defining the processes involved. There remain no global guidelines available to the renal community on indications for this important diagnostic, prognostic, and relatively safe test. Although most nephrologists recognize several clear indications for a renal biopsy, it is still underutilized. It not only helps the clinician to manage the patient with CKD, but it can also help clarify the epidemiology of CKD, and aid research into the pathobiology of disease with the aim of discovering new therapies. It may be useful for instance in elderly patients with CKD, those with diabetes and presumed 'hypertensive nephropathy', and in some patients with advanced CKD as part of the pretransplant work-up. In some populations (for example, immunoglobulin A nephropathy and ANCA vasculitis), renal biopsy allows disease classification that may predict CKD progression and response to therapy. For the individual, interval renal biopsy may be of use in providing ongoing therapeutic and prognostic information. Molecular advances will change the landscape of renal pathology and add a new dimension to the diagnostic precision of kidney biopsy. Organizing the multiplicity of information available in a renal biopsy to maximize benefits to the patient, as well as to the epidemiologist and researcher, is one of the challenges that face the nephrology community.

  15. IgG Subclass Staining in Routine Renal Biopsy Material.

    Science.gov (United States)

    Hemminger, Jessica; Nadasdy, Gyongyi; Satoskar, Anjali; Brodsky, Sergey V; Nadasdy, Tibor

    2016-05-01

    Immunofluorescence staining plays a vital role in nephropathology, but the panel of antibodies used has not changed for decades. Further classification of immunoglobulin (Ig)G-containing immune-type deposits with IgG subclass staining (IgG1, IgG2, IgG3, and IgG4) has been shown to be of diagnostic utility in glomerular diseases, but their value in the evaluation of renal biopsies has not been addressed systematically in large renal biopsy material. Between January 2007 and June 2014, using direct immunofluorescence, we stained every renal biopsy for the IgG subclasses if there was moderate to prominent glomerular IgG staining and/or IgG-predominant or IgG-codominant glomerular staining. The total number of biopsies stained was 1084, which included 367 cases of membranous glomerulonephritis, 307 cases of lupus nephritis, 74 cases of fibrillary glomerulonephritis, 53 cases of proliferative glomerulonephritis with monoclonal IgG deposits, and 25 cases of antiglomerular basement membrane disease, among others. We found that monoclonality of IgG deposits cannot always be reliably determined on the basis of kappa and lambda light chain staining alone, particularly if concomitant (frequently nonspecific) IgM staining is present. In IgG heavy and heavy and light chain deposition disease (3 cases), subclass staining is very helpful, and in proliferative glomerulonephritis with monoclonal IgG deposits subclass staining is necessary. IgG subclass staining is useful in differentiating primary from secondary membranous glomerulonephritis. In proliferative glomerulonephritis with polyclonal IgG deposition, IgG1 dominance/codominance with concomitant IgG3 and IgG2 but weak or absent IgG4 staining favors an underlying autoimmune disease. IgG subclass staining is a very useful diagnostic method in a selected cohort of renal biopsies, particularly in biopsies with glomerulonephritis with monoclonal IgG deposits.

  16. [Kidney diseases with chronic renal failure in the Italian renal biopsy registries].

    Science.gov (United States)

    Lupo, A; Bernich, P; Antonucci, F; Dugo, M; Riegler, P; Carraro, M

    2008-01-01

    The prevalence of chronic renal failure (CRF) at the time of kidney biopsy ranges between 5% and 37% in different renal biopsy registries. This wide variability is mainly dependent on the different definitions of CRF. In the period 1998-2006, the Triveneto Renal Biopsy Registry recorded 816 cases with CRF (defined as serum creatinine persistently > or =1.5 mg/dL), accounting for a prevalence of 27%. At the time of biopsy, the average age and glomerular filtration rate were 54 years and 41 mL/min, respectively; 70% of CRF patients are men and the prevalence of CRF increases with age. IgA nephropathy (IgAN) is the main histological form of glomerulonephritis, accounting for 23% of all cases of CRF. However, in subjects older than 65 years, membranous glomerulonephritis (MG) exceeds IgAN, thus becoming the main diagnosis in elderly patients with renal impairment. With a cutoff value for proteinuria of 3 g/day, the main diagnoses in cases with proteinuria below and above the cutoff are IgAN and MG, respectively. IgAN remains the main histological form of nephropathy throughout all levels of renal failure. These data confirm the findings of the Italian Registry of Renal Biopsies, but correspond only in part with data from other registries. The differences can to a certain extent be explained by the different criteria for the definition of renal impairment, patient selection, and differences in diagnosis among registries.

  17. Percutaneous renal graft biopsy: a clinical, laboratory and pathological analysis

    Directory of Open Access Journals (Sweden)

    Marilda Mazzali

    1999-03-01

    Full Text Available CONTEXT: Renal allograft biopsies have been used as a good method for monitoring the evolution of kidney transplants for at least 20 years.1 Histological analysis permits differential diagnosis of the causes of allograft dysfunction to be made. OBJECTIVES: To correlate the data of urinalysis and serum creatinine with histological diagnosis of renal graft in a group of renal transplant patients. DESIGN: Accuracy study, retrospective analysis. SETTING: A university terciary referral center. SAMPLE: 339 percutaneous allograft biopsies obtained from 153 patients. Blood and urine samples were obtained before the graft biopsy. MAIN MEASUREMENTS: Laboratory evaluation and hystological analysis (light microscopy, imunofluorescent eletronic microscopy. RESULTS: Most of the biopsies (58.9% were performed during the first month post-transplant. An increase in serum creatinine was associated with acute tubular and/or cortical necrosis. Proteinuria and normal serum creatinine were associated with glomerular lesions. Non-nephrotic range proteinuria and an increase in serum creatinine were associated with chronic rejection. CONCLUSIONS: Evaluation of serum creatinine and urinalysis can be useful in suggesting the histological graft diagnosis.

  18. Renal involvement in non-Hodgkin lymphoma: proven by renal biopsy.

    Science.gov (United States)

    Li, Shi-Jun; Chen, Hui-Ping; Chen, Ying-Hua; Zhang, Li-hua; Tu, Yuan-Mao; Liu, Zhi-hong

    2014-01-01

    To determine the spectrum of renal lesions in patients with kidney involvement in non-Hodgkin's lymphoma (NHL) by renal biopsy. The clinical features and histological findings at the time of the renal biopsy were assessed for each patient. We identified 20 patients with NHL and renal involvement, and the diagnosis of NHL was established following the kidney biopsy in 18 (90%) patients. The types of NHL include the following: chronic lymphocytic leukemia/small lymphocytic lymphoma (n = 8), diffuse large B-cell lymphoma (n = 4), T/NK cell lymphoma (n = 3), lymphoplasmacytic lymphoma (n = 2), cutaneous T-cell lymphoma (n = 1), mucosa-associated lymphoid tissue lymphoma (n = 1) and mantle cell lymphoma (n = 1). All presented with proteinuria, and 15 patients had impaired renal function. The pathological findings included (1) membranoproliferative glomerulonephritis-like pattern in seven patients; (2) crescent glomerulonephritis in four; (3) minimal-change disease in three, and glomeruli without specific pathological abnormalities in three; (4) intraglomerular large B-cell lymphoma in one; (5) intracapillary monoclonal IgM deposits in one; (6) primary diffuse large B-cell lymphoma of the kidneys in one; and (7) lymphoma infiltration of the kidney in eight patients. A wide spectrum of renal lesions can be observed in patients with NHL, and NHL may be first proven by renal biopsies for evaluation of kidney injury or proteinuria. Renal biopsy is necessary to establish the underlying cause of renal involvement in NHL.

  19. Renal biopsy in the elderly: a single-center experience.

    Science.gov (United States)

    Harmankaya, Ozlem; Okuturlar, Yildiz; Kocoglu, Hakan; Kaptanogullari, Hakan; Yucel, Sibel Kocak; Ozkan, Hanise; Acarer, Didem; Erdogan, Ezgi; Yilmaz, Murvet; Hursitoglu, Mehmet

    2015-08-01

    Aging population has been increasing worldwide. So the number of elderly patients presenting with kidney disease has also been increasing. In this retrospective study, we assessed biopsy results of elderly patients and their clinical presentations. Native renal biopsy results of 98 elderly patients (≥65 years) were analyzed. These 98 patients consisted of 56 males (57.1 %) and 42 females (42.9 %) with a mean age of 70.59 ± 5.31 years (65-88 years). The clinical presentations of our elderly patients were nephritic syndrome (n = 45), acute kidney injury (n = 35), nephrotic syndrome (n = 33), chronic kidney disease (n = 32) and combined nephritic and nephrotic syndrome (n = 14). In patients with nephritic syndrome, the most common diagnosis was crescentic GN (17.8 % type 3 and 13.3 % types 1 and 2). Crescentic GN was also the most frequent among patients with acute kidney injury (37.1 %), while membranous nephropathy was the major histopathological diagnosis in chronic kidney disease patients. In nephrotic syndrome, the most common histopathological diagnosis was AA amyloidosis. None of the patients had a major life-threatening complication. Biopsies in the elderly are as safe as in the general population. Renal biopsy should be performed to provide an accurate diagnosis and initiate specific treatment in elderly patients.

  20. Efficacy and complications of ultrasound-guided percutaneous renal biopsy using 18 G automatic biopsy gun in diffuse renal disease: Analysis of 203 cases

    Energy Technology Data Exchange (ETDEWEB)

    Gwon, Dong Il; Lee, Kang Hoon; Song, Kyung Sup; An, Suk Joo; Son, Sang Bum; Kim, Hyeon Suk [The Catholic University of Korea, St. Paul' s Hospital, Seoul (Korea, Republic of); Kim, Jee Young; Kim, Won Young; Park, Young Ha [The Catholic University of Korea, St. Vincent' s Hospital, Suwon (Korea, Republic of)

    2000-12-15

    To evaluate the efficacy and complications of ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun in patients with diffuse renal disease. 203 ultrasound-guided renal biopsies using 18G automatic biopsy gun were performed in 197 patients for the diagnosis of diffuse renal disease. The success and complication rates were retrospectively evaluated by analysis of pathologic and clinical records and post-procedure ultrasonograms of the patients. Out of 203 renal biopsies, adequate tissues for pathologic diagnosis were obtained in 184 (90.6%) biopsies. The mean number of needle passes was 2.08, and the mean number of retrieved glomeruli was 7.71 {+-} 4.23. Minor complications occurred in seven biopsies (3.45%) including asymptomatic macroscopic hematuria in five (2.45%) and small subcapsular hematomas in two (1%). No patients required transfusion or surgery because of biopsy-related complication. Ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun was an effective method for the pathologic diagnosis of diffuse renal disease and safe with low complication rate related to the procedure.

  1. Cryoablation for Small Renal Masses

    Directory of Open Access Journals (Sweden)

    J. L. Dominguez-Escrig

    2008-01-01

    Full Text Available Advances in imaging techniques (CT and MRI and widespread use of imaging especially ultrasound scanning have resulted in a dramatic increase in the detection of small renal masses. While open partial nephrectomy is still the reference standard for the management of these small renal masses, its associated morbidity has encouraged clinicians to exploit the advancements in minimally invasive ablative techniques. The last decade has seen the rapid development of laparoscopic partial nephrectomy and novel ablative techniques such as, radiofrequency ablation (RFA, high-intensity focused ultrasound (HIFU, and cryoablation (CA. In particular, CA for small renal masses has gained popularity as it combines nephron-sparing surgery with a minimally invasive approach. Studies with up to 5-year followup have shown an overall and cancer-specific 5-year survival of 82% and 100%, respectively. This manuscript will focus on the principles and clinical applications of cryoablation of small renal masses, with detailed review of relevant literature.

  2. Isolated Renal Hydatidosis Presenting as Renal Mass: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Datteswar Hota

    2015-07-01

    Full Text Available Hydatid disease is a parasitic infestation by larval form of Echinococcus granulosus. Isolated renal involvement is extremely rare. There are no specific signs and symptoms of renal hydatidosis. However it may present as palpable mass, flank pain, hematuria, malaise, fever, and hydatiduria or as a complication of it such as infection, abscess, hemorrhage, necrosis and pelviureteric junction obstruction, renal failure etc. Except hydatiduria, none are pathognomonic for renal hydatidosis. There is no literature on renal hydatidosis presenting as renal mass we report 2 cases of isolated renal hydatidosis, which mimicked a renal mass on imaging study.

  3. Efficacy and Complications of Ultrasound-Guided Percutaneous Renal Biopsy Using Automatic Biopsy Gun in Pediatric Diffuse Renal Disease: Analysis of 97 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Han, Seung Min; Chung, Tae Woong; Yoon, Woong [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To evaluate the diagnostic efficacy and complications of ultrasound-guided percutaneous renal biopsy using automatic biopsy gun in patients with pediatric diffuse renal disease. Using an 18G automatic biopsy gun, biopsies were performed on 97 pediatric patients with clinically suspicious diffuse renal disease. The acquired tissue specimens were analyzed by photomicroscopy, immunofluorescence, and electron microscopy to support the diagnosis. In the 97 biopsies, the success of the histologic diagnosis, number of glomeruli, and complication rates were retrospectively evaluated by analyzing the variable exams and clinical records. Adequate tissue for histologic diagnosis was obtained in 91 of 97 biopsies (94%) and the mean number of glomeruli was 9.6. Complications such as minute pain, gross hematuria, and small perirenal hematoma presented in 22 of the 97 biopsies (23%), all of which either improved within 5-72 hours or did not need specific treatment. Ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun is an effective and safe method for the histologic diagnosis of pediatric diffuse renal disease without any major complication

  4. Changes in pathological pattern and treatment regimens based on repeat renal biopsy in lupus nephritis

    Institute of Scientific and Technical Information of China (English)

    WANG Guo-bao; XU Zheng-jin; LIU Hong-fa; ZHOU Qiu-gen; ZHOU Zhan-mei; JIA Nan

    2012-01-01

    Background Relapses occur frequently in patients with lupus nephritis.Renal biopsy is the gold standard for assessing renal activity and hence guiding the treatment.Whether repeat renal biopsy is helpful during flares of lupus nephritis remains inconclusive.In the present study,we retrospectively reviewed the patients with lupus nephritis who had more than one renal biopsy with the hope to find the clinical value of repeat biopsy.Methods Patients who had a diagnosis of lupus nephritis and two or more renal biopsies were selected from the database of the patient pathology registration at this renal division.Renal biopsy was evaluated according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification of lupus nephritis.The pathological patterns and treatment regimens were analyzed after a repeat biopsy.Results We identified 44 systemic lupus erythematosus patients with serial renal biopsies.In total,there were 94 renal biopsies.Overall,the pathological transition occurred in 64% instances according to the ISN/RPS class.When the transition was analyzed according to proliferative,membranous or mix lesions,it showed different profile:35% in patients with proliferative lesion,23.5% patients with mix lesions,100% in patients with pure membranous lesion.The pathological transition could not be predicted by any clinical characteristics.After the repeat renal biopsy,34% of patients had a change in their treatment regimens.Conclusions The pathological conversion was very prevalent in patients with lupus nephritis.However,the transitions became less prevalent when they were analyzed according to pure membranous,proliferative,and mix lesion.Repeat biopsy might be helpful to avoid unnecessary increased immunosuppression therapy.

  5. Computer tomographic and sonographic demonstration of renal haematomas following percutaneous renal biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Nebel, G.; Lingg, G.; Berg, E.; Fischer, R.

    1982-04-01

    The incidence of post-puncture haematomas following percutaneous renal biopsy in 23 patients (24 punctures) is reported. The incidence of renal haematomas was 29.1%. The diagnostic value of computer tomography and sonography is discussed. Amongst small haematomas (less than 7 ml. blood), which could only be demonstrated by computer tomography, 8.2% were purely intrarenal, 8.2% were sub-capsular and 12.3% showed combined intrarenal, subcapsular and perirenal bleeding. The incidence of sub-capsular and perirenal haematomas of 20.5% is considerably lower than has previously been reported in literature.

  6. Optimizing RNA Extraction of Renal Papilla Biopsy Tissue in Kidney Stone Formers: A New Methodology for Genomic Study.

    Science.gov (United States)

    Taguchi, Kazumi; Usawachintachit, Manint; Hamamoto, Shuzo; Unno, Rei; Tzou, David T; Sherer, Benjamin A; Wang, Yongmei; Okada, Atsushi; Stoller, Marshall L; Yasui, Takahiro; Chi, Thomas

    2017-08-11

    Endoscopic tools have provided versatile examination and treatment for kidney stone procedures. Despite endourologists researching urinary stone disease using endoscopes to collect tissue, this tissue collection method is limited. Endoscopically removed tissues are small in size, restricting the types of genome-based examination possible. We investigated a new method of renal papilla biopsy and RNA extraction to establish a genomic research methodology for kidney stone disease. We conducted a prospective multi-institutional study and collected renal papilla specimens from consecutive percutaneous nephrolithotomy and ureteroscopy (URS) cases performed for removal of upper urinary tract stones. Renal papilla tissue was extracted using ureteroscopic biopsy forceps after stone removal. RNA was extracted using two different extraction kits, and their quantity and quality were examined. Additionally, the impact of biopsy on surgical complications was compared between cases performed with and without biopsy by matched case-control analysis adjusted for age, gender, body mass index, bilaterality, and stone burden. A total of 90 biopsies from 49 patients were performed, and the median duration between specimen collection and RNA extraction was 61 days. Both univariate and multivariate analyses showed BIGopsy(®) forceps usage significantly increased the total yield (p = 0.004) and quality (p = 0.001 for A260/280, p = 0.004 for A260/A230) of extracted RNA. Extraction using the RNeasy Micro Kit(®) also improved A260/A230, whereas reduced RNA integrity number of extracted RNA by univariate and multivariate analyses (p = 0.002 and p case-control study demonstrated that endoscopic renal papilla biopsy caused no significant surgical complications, including bleeding, decreased stone clearance and hematocrit, and renal dysfunction. Biopsies during URS imparted an average of 20 minutes of procedure time over nonbiopsy cases. We demonstrate a safe methodology for

  7. Current Safety of Renal Allograft Biopsy With Indication in Adult Recipients: An Observational Study.

    Science.gov (United States)

    Tsai, Shang-Feng; Chen, Cheng-Hsu; Shu, Kuo-Hsiung; Cheng, Chi-Hung; Yu, Tung-Min; Chuang, Ya-Wen; Huang, Shih-Ting; Tsai, Jun-Li; Wu, Ming-Ju

    2016-02-01

    Renal biopsy remains the golden standard diagnosis of renal function deterioration. The safety in native kidney biopsy is well defined. However, it is a different story in allograft kidney biopsy. We conduct this retrospective study to clarify the safety of allograft kidney biopsy with indication.All variables were grouped by the year of biopsy and they were compared by Mann-Whitney U test (for continuous variables) or Chi-square test (for categorical variables). We collected possible factors associated with complications, including age, gender, body weight, renal function, cause of uremia, status of coagulation, hepatitis, size of needle, and immunosuppressants.We recruited all renal transplant recipients undergoing allograft biopsy between January of 2009 and December of 2014. This is the largest database for allograft kidney biopsy with indication. Of all the 269 biopsies, there was no difference in occurrence among the total 14 complications (5.2%) over these 6 years. There were only 3 cases of hematomas (1.11%), 6 gross hematuria (2.23%), 1 hydronephrosis (0.37%), and 2 hemoglobin decline (0.74%). The outcome of this cohort is the best compared to all other studies, and it is even better than the allograft protocol kidney biopsy. Among all possible factors, patients with pathological report containing "medullary tissue only" were susceptible to complications (P biopsy with indication. Identifying the renal capsule before biopsy to avoid puncture into medulla is the most important element to prevent complications.

  8. Natural History of Small Renal Masses

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2015-01-01

    Objective:To review the natural history and growth kinetics of small renal masses (SRMs).Data Sources:The literature concerning natural history and growth kinetics of SRMs was collected from PubMed published from 1990 to 2014.Study Selection:We included all the relevant articles on the active surveillance (AS) or delayed treatment for SRMs in English,with no limitation of study design.Results:SRMs under AS have a slow growth potential in general.The mean linear growth rate is 0.33 cm/year,the mean volumetric growth rate is 9.48 cm3/year.The rate of metastasis during AS is below 2%.Some factors are associated with the growth rate of SRMs,including tumor grade,histological subtype,initial tumor size,age,radiographic characteristics,and molecular markers.No definite predictor of growth rate of SRMs is defined at present.SRMs with high tumor grade and the subtype of clear cell renal cell carcinoma may have aggressive growth potential.Conclusions:AS is a reasonable choice for elderly patients with SRMs,who are at high risk from surgery.Progression during observation is the biggest concern while performing AS.There is no definite predictor of progression for SRMs under AS.Percutaneous renal biopsy providing immunohistological and genic biomarkers may improve the understanding of natural history of SRMs.

  9. Retroperitoneal Gastrointestinal Type Schwannoma Presenting as a Renal Mass

    Directory of Open Access Journals (Sweden)

    Susan J. Hall

    2015-11-01

    Full Text Available Retroperitoneal schwannomas are extremely rare, and unreported in Urology. Often thought to be malignant from imaging the diagnosis is often delayed until Histology. We report a case of retroperitoneal schwanoma thought to be a malignant renal mass. Seventy three year old lady presented with abdominal pain. Imaging showed a mass attached to the renal pelvis thus she underwent a radical nephrectomy. Histology reported retroperitoneal schwannoma. Malignant forms are rare however treatment for these is surgical excision. Awareness of the existence of these tumors may help in avoiding unnecessary radical surgeries by opting for biopsy preoperatively.

  10. Sono-Guided Percutaneous Automated Gun Biopsy in Pediatric Renal Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Chul [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1996-12-15

    To evaluate whether sono-guided percutaneous automated gun biopsy is also useful in pediatricpatients with renal diseases. In the prone position of twenty pediatric patients with renal parenchymal diseases, percutaneous biopsy was done through lateral aspect of the lower pole of left kidney with automated biopsy gun under the guidance of ultrasonography. The biopsy needle was either of 18 or 20 gauge. The obtained core of renal tissue was examined with light, immunofluorescent or electron microscope by the renal pathologist. In 18 among 20 patients, adequate renal tissue core sufficient to be pathologically diagnosed was obtained. The histologic findings were as follows : IG A nephropathy (n = 2), lupus nephritis (n =2), minimal change glomerulonephritis (n = 5), membranoproliferative glomerulonephritis (n = 3), mesangialproliferative glomeru-lonephritis (n = 1), diffuse proliferative glomerulonephritis (n = 3), focalglomerulo-sclerosis (n = 1), membranous glomerulopathy (n = 1). No significant complications occurred during or after the biopsy. Sono-guided percutaneous renal biopsy using automated biopsy gun is also useful todiagnose renal parenchymal diseases without significant complications in pediatric patients

  11. Assessing the safety and quality of ward-based renal transplant biopsies

    Directory of Open Access Journals (Sweden)

    Kenneth Wu

    2010-10-01

    Full Text Available Kenneth Wu1, Bindhu Musunuru1, Chera Arunachalam1, Aung Sett1, Paul Musker21Renal Unit, St James’ University Hospital, Leeds, West Yorkshire, UK; 2Renal Unit, St Luke’s Hospital, Bradford, West Yorkshire, UKAbstract: The aim of this pilot study was to compare renal transplant biopsies carried out by ward-based nephrology trainees and departmental based radiologists, primarily reviewing major complications and glomerular yield. There was only one patient who developed a single episode of major complication out of the 145 procedures recorded. We concluded there is no significant difference in complication rate and glomerular yield for renal allograft biopsies between nephrology trainees and radiologists, regardless of location.Keywords: renal transplant, kidney biopsy complications, renal hemorrhage, glomerular yield

  12. Biopsies

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Biopsies - Overview A biopsy is the removal of tissue ... What are the limitations of biopsies? What are biopsies? A biopsy is the removal of tissue in ...

  13. Behcet's syndrome and renal involvement: a histological and immunofluorescent study of eleven renal biopsies.

    Science.gov (United States)

    Herreman, G; Beaufils, H; Godeau, P; Cassou, B; Wechsler, B; Boujeau, J; Chomette, G

    1982-01-01

    The finding of focal glomerulonephritis in a patient with Behcet's syndrome led us to perform systematic renal biopsies in ten other patients with the disease. None of the patients had symptoms of renal disease. Proteinuria was found in five, two of whom had associated leukocyturia. By light microscopy mesangial and extramembranous glomerular deposits were observed in eight patients. Arterioles in ten patients showed subendothelial and medial hyaline deposits. A granular pattern of fluorescent staining identified the presence of the third component of complement in these deposits. Circulating immune deposits were sought and found in six out of seven patients. The finding of circulating immune complexes and deposition of complement in glomerular and arteriolar tissues supports an immune complex mediated nephropathy and is consistent with the hypothesis of an immunological pathogenesis in Behcet's syndrome.

  14. Value of Renal Biopsy in Diagnosing Infantile Nephropathic Cystinosis Associated With Secondary Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Joyce, Emily; Ho, Jacqueline; El-Gharbawy, Areeg; Salgado, Cláudia M; Ranganathan, Sarangarajan; Reyes-Múgica, Miguel

    2017-01-01

    Cystinosis is the most common cause of inherited renal Fanconi syndrome in young children, and typically presents with laboratory findings of a proximal tubulopathy and corneal crystals by one year of age. We describe here renal biopsy findings in a 20-month-old patient with an atypical presentation of distal renal tubular acidosis, diabetes insipidus, and the absence of corneal crystals. Although renal biopsy is usually not necessary to establish the diagnosis of cystinosis, when the patient presents with atypical signs and symptoms, a renal biopsy may be extremely valuable. A 20-month-old boy presented with failure to thrive, polyuria, polydipsia, and rickets. He initially showed evidence of a renal tubular acidosis, mild renal insufficiency, and nephrogenic diabetes insipidus. His initial ophthalmologic examination did not demonstrate corneal crystals. His subsequent workup revealed phosphaturia, suggesting a partial proximal tubulopathy. Concomitantly, a renal biopsy revealed prominent podocytes with an immature glomerular appearance, and electron microscopy analysis showed numerous intracellular crystals within tubular epithelial cells. Subsequent laboratory and genetic testing confirmed a diagnosis of infantile nephropathic cystinosis. This case highlights the variability in the clinical presentation of cystinosis, resulting in an uncommon clinical picture of a rare disease. Given that treatment is available to prolong renal function and minimize the extra-renal manifestations of this disorder, early diagnosis is essential. It is important to raise the index of suspicion of cystinosis by recognizing its subtle morphological changes in young patients, and that nephrogenic diabetes insipidus can be secondary to this disorder.

  15. Arteriovenous fistula and pseudoaneurysm as complications of renal biopsy treated with percutaneous intervention

    Institute of Scientific and Technical Information of China (English)

    JIANG Wen-xia; WANG Hui-fang; MA Jun; HAN Hong-jie

    2010-01-01

    @@ Symptomatic arteriovenous fistula (AVF) with pseudoaneurysm after percutaneous renal biopsy is an uncommon anomaly, occurring from 0.34% to 6.3%.1Most of these vascular lesions are of little clinical importance. However, severe bleeding,2 persistent hematuria, or acute urinary retention may occur, requiring treatment. Here we report a case of gross hematuria and acute urinary retention after renal biopsy in a male patient.An arteriovenous fistula with pseudoaneurysm was detected by renal ultrasound, confirmed by angiography and then successfully treated by transcatheter arterial embolization3 without damage to renal parenchyma.

  16. Cancer detection rates of different prostate biopsy regimens in patients with renal failure.

    Science.gov (United States)

    Hoşcan, Mustafa Burak; Özorak, Alper; Oksay, Taylan; Perk, Hakkı; Armağan, Abdullah; Soyupek, Sedat; Serel, Tekin Ahmet; Koşar, Alim

    2014-07-01

    We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure.

  17. Renal biopsy in patients with systemic lupus erythematosus: Not just lupus glomerulonephritis!

    Science.gov (United States)

    Howell, David N

    2017-01-01

    Kidney biopsy is a mainstay in the diagnosis and management of renal disease in patients with systemic lupus erythematosus. Though biopsies from patients with lupus typically show various forms of immune complex glomerulonephritis, other pathologies are occasionally encountered, including unusual lupus-related nephropathies, other forms of autoimmune disease, and occasional renal disorders without any direct connection with lupus or autoimmunity. Electron microscopy is a powerful tool for detecting and classifying these unusual conditions, which frequently have important therapeutic and prognostic implications.

  18. Renal graft biopsy assists diagnosis and treatment of renal allograft dysfunction after kidney transplantation: a report of 106 cases.

    Science.gov (United States)

    Han, Yong; Guo, Hui; Cai, Ming; Xiao, Li; Wang, Qiang; Xu, Xiaoguang; Huang, Haiyan; Shi, Bingyi

    2015-01-01

    Acute antibody mediated rejection (AMR) is one of the most important complications after kidney transplantation. Renal graft biopsy is safe and reliable without adverse effects on the patients and transplanted kidneys, which was of great instructive significance in diagnosis and treatment of renal allograft dysfunction after renal transplantation. This paper reported a case series of 106 patients underwent renal allograft biopsies. All biopsies were evaluated according to the Banff 2007 schema. 52 examples were obtained within 1 month after transplantation, and there were another 20 examples in one to two months and other 34 examples in two to three months. Appropriate therapy was applied and clinical outcomes were observed. All patients received renal biopsies and anti-inflammatory and hemostasis treatment without complications. There were 2 cases of hyperacute rejection, and 15 cases of acute AMR. All Paraffin-embedded samples were stained by HE, periodic acid-Schiff (PAS), Masson, and immunohistochemistry (C4d, cd20, cd45RO, SV40). All samples were found C4d immunohistochemical staining positive. Patients with acute AMR were managed by steroid intravenous pulse therapy, Rabbit anti-thymocyte globulin intravenous pulse therapy, anti CD20 monoclonal antibody intravenous therapy and so on. Two cases of hyperacute rejection had renal failure, and received kidney excision; 12 cases in 15 cases of AMR recovered, another 2 cases did not recover with high-level creatine, and other 2 cases of renal allograft received excision.

  19. Repeated Renal Biopsy - A Predictive Tool to Assess the Probability of Renal Flare in Lupus Nephritis.

    Science.gov (United States)

    Piñeiro, Gastón J; Arrizabalaga, Pilar; Solé, Manel; Abellana, Rosa M; Espinosa, Gerard; Cervera, Ricard

    2016-01-01

    How one responds to treatment of lupus nephritis (LN) is based on clinical features, but the activity in renal biopsy (RB) is uncertain. We have described the therapeutic decisions after performing a repeated RB on the assessment of response to intravenous cyclophosphamide (IC) and the possible prognostic role of this repeated RB. Clinical, laboratory and histological features at the initial RB and repeated RB were analyzed in 35 patients. Data in the initial versus the repeated RB were serum creatinine 1.23 ± 1.08 and 0.96 ± 0.45 mg/dl (p < 0.05), glomerular filtration rate <60 ml/min in 12 and 5% patients and proteinuria 4.1 ± 2.8 vs. 0.6 1.1 g/day (p < 0.05). Significant differences were detected in hematuria, nephrotic syndrome and serological immune features. Complete renal remission was reached in 60% (n = 21) at the time of the repeated RB, partial remission in 31.4% (n = 11), and no response IC in 8.6% (n = 3). Nine patients showed proliferative forms in the repeated RB, 3 of them had proteinuria <1 g/day. Just after the repeated RB, 34.3% increased or started a new immunosuppressive therapy, 17.1% remained with the same complementary IST, and 14.3% decreased or stopped it. In the follow-up post repeated RB, 34.5% without active lesions showed a renal flare versus 77.8% with active lesions (p = 0.04). The mean time was 120 and 45 months, respectively. A repeated biopsy in LN distinguishes patients in true remission from those in apparent remission. By doing this, we can identify patients who could benefit from intensified treatment and for whom unnecessary treatment methods can be modified or eliminated. © 2016 S. Karger AG, Basel.

  20. Comparison of Two Core Biopsy Techniques Before and After Laparoscopic Cryoablation of Small Renal Cortical Neoplasms

    Science.gov (United States)

    Truesdale, Matthew D.; Sartori, Samantha; Casazza, Cristin N.; Hruby, Gregory W.; Harik, Lara R.; O’Toole, Kathleen M.; Badani, Ketan K.; Pérez-Lanzac, Alberto

    2011-01-01

    Introduction: Cryoablation is an acceptable treatment option for small renal cortical neoplasms (RCN). Unlike extirpative interventions, intraoperative needle biopsy is the only pathologic data for ablated tumors. It is imperative that sampled tissue accurately captures pathology. We studied the optimal intraoperative needle core biopsy protocol for small RCN during laparoscopic renal cryoablation (LCA). Methods: Patients with RCNbiopsy during LCA. Four biopsy cores were taken per tumor, 2 before and 2 after LCA by using both a standard and modified technique. Standard technique: needle biopsy device was deployed after insertion into the renal tissue at a depth of 5mm. Modified technique: needle biopsy device was deployed 1mm outside of the renal tissue. Biopsies were examined and compared with reference standard pathology. Percentage agreement was calculated across biopsy types (standard vs. modified) and time points (pre- vs. postcryoablation). Logistic regression was used to identify factors impacting biopsy accuracy. Results: Thirty patients with 33 RCNs underwent LCA. The mean patient age was 69.1±8.0yrs, and mean tumor size was 2.3±0.7cm. No significant bleeding resulted from biopsies. A definitive diagnosis was made in 31/33 RCNs (94.0%). Ten tumors (30.3%) were benign, 21 (63.7%) were malignant, and 2 (6.0%) were nondiagnostic. Biopsy length was significantly longer using the standard vs. modified technique with mean lengths of 9.3mm vs. 7.0mm, respectively (P=.02). Highest agreement was seen in preablation biopsies (90.3%). A significant association with agreement was seen for younger age (P=.05) and larger tumor size (P=.02). Conclusions: Younger age and larger tumor size were associated with improved accuracy. Preoperative sampling resulted in superior accuracy and the standard technique resulted in significantly longer cores. Use of preablation standard biopsy technique may result in the most accurate pathologic diagnosis for patients undergoing

  1. Calcineurin inhibitor toxicity in renal allografts: Morphologic clues from protocol biopsies

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    Sharma Alok

    2010-10-01

    Full Text Available Background: Calcineurin inhibitors (cyclosporine and tacrolimus are important constituents of post renal transplant immunosuppression. However, renal toxicity limits their utility. Histological features of calcineurin inhibitor toxicity (CNIT have been the subject of few studies using protocol biopsy samples, and consensus on diagnostic criteria is still evolving. Aims: To analyze the spectrum of histological changes in protocol renal allograft biopsies with evidence of CNIT and identify additional features that are likely to help the pathologist in arriving at a diagnosis. Materials and Methods: One hundred and forty protocol allograft biopsies performed at 1, 6 and 12 months post renal transplant were studied. The defining features of CNIT included: isometric vacuolization of proximal tubular cells, arteriolar hyalinosis with medial/peripheral nodules and striped pattern of tubular atrophy/interstitial fibrosis. Other features such as global glomerulosclerosis, vacuolization of smooth muscle cells of arterioles, tubular microcalcinosis, ischemic shrinkage of glomeruli and hyperplasia of juxtaglomerular apparatus (JGA were also analyzed and graded semiquantitatively. Results: CNIT was seen in 17/140 protocol biopsies (12.1%. In addition to the diagnostic criteria, arteriolar hyalinosis, smooth muscle cell vacuolization of arterioles and hyperplasia of JGA were found to be useful indicators of CNIT. Conclusions: There is a relatively high incidence of CNIT in protocol allograft biopsies. A critical analysis of renal biopsy in adequate number of serial step sections to identify these features is mandatory, as many of these features are subtle and are likely to be missed if not specifically sought.

  2. Renal biopsy findings and clinical indicators of patients with hematuria without overt proteinuria.

    Science.gov (United States)

    Hoshino, Yoshie; Kaga, Toshie; Abe, Yasutomo; Endo, Mariko; Wakai, Sachiko; Tsuchiya, Ken; Nitta, Kosaku

    2015-10-01

    Whether to perform a renal biopsy for isolated hematuria remains a matter of controversy. We performed renal biopsy in hematuria without overt proteinuria patients and reported the proportion of glomerulonephritis, pathological activities, and statistical analysis of indicators associated with glomerulonephritis. Among 203 patients who underwent renal biopsy in Okubo Hospital, Japan, between January 2008 and October 2013, we identified 56 patients who fulfilled the criteria: (1) urine dipstick examination shows equal to or greater than ± blood on three or more visits, (2) proteinuria proteinuria (0.08 [0-0.25] vs. 0 [0-0.23] g/day [g/gCr], p proteinuria was high and the pathological activities were variable. Patients with hematuria without overt proteinuria should continue their medical follow-up and the best timing of biopsy may be controversial for these patients who have multiple risk factors of IgAN.

  3. Analysis of 4931 renal biopsy data in central China from 1994 to 2014.

    Science.gov (United States)

    Xu, Xiu; Ning, Yong; Shang, Weifeng; Li, Menglan; Ku, Ming; Li, Qing; Li, Yueqiang; Dai, Wei; Shao, Jufang; Zeng, Rui; Han, Min; He, Xiaofeng; Yao, Ying; Lv, Yongman; Liu, Xiaocheng; Ge, Shuwang; Xu, Gang

    2016-08-01

    The purpose of this study is to investigate the changing spectrum and clinicopathologic correlation of biopsy-proven renal diseases in central China. We retrospectively analyzed data of 4931 patients who underwent renal biopsy in ten hospitals between September 1994 and December 2014. Among them, 81.55% were primary glomerular diseases (GD), and 13.02% were secondary GD. IgA nephropathy (IgAN) was the most common primary GD (43.45%), followed by focal glomerulonephritis (16.79%), mesangial proliferative glomerulonephritis (MsPGN, 14.35%), and membranous nephropathy (MN, 13.28%). IgAN was leading primary GD in patients under 60 years old, while MN was the leading one over 60 years old. The most frequent secondary GD was lupus nephritis (LN) (47.35%). The prevalence of IgAN, MN and minimal change disease was found to increase significantly (p renal biopsy was proteinuria and hematuria (49.03%), followed by nephrotic syndrome (NS, 20.36%). IgAN was the most common cause in patients with proteinuria and hematuria, chronic-progressive kidney injury, hematuria and acute kidney injury; and MN was the leading cause of NS. Primary GD remained the predominant renal disease in central China. IgAN and LN were the most prevalent histopathologic lesions of primary and secondary GD, respectively. The spectrum of biopsy-proven renal disease had a great change in the past two decades. Proteinuria and hematuria was the main indication for renal biopsy.

  4. Increased oxidative DNA damage seen in renal biopsies adjacent stones in patients with nephrolithiasis.

    Science.gov (United States)

    Kittikowit, Wipawee; Waiwijit, Uraiwan; Boonla, Chanchai; Ruangvejvorachai, Preecha; Pimratana, Chaowat; Predanon, Chagkrapan; Ratchanon, Supoj; Tosukhowong, Piyaratana

    2014-10-01

    Urinary excretion of 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative DNA damage, is significantly higher in nephrolithiasis patients than in healthy individuals, indicating that these patients have higher degree of oxidative stress. In the present study, we investigated 8-OHdG expression in renal biopsies of patients with nephrolithiasis and in renal tubular cells (HK-2 cells) exposed to calcium oxalate monohydrate (COM). We performed immunohistochemical staining for 8-OHdG in renal biopsies adjacent stones obtained from 28 patients with nephrolithiasis. Controls were noncancerous renal tissues from nephrectomies of patients with renal cancer. 8-OHdG was overexpressed in the nucleus of renal tubular cells in patients with nephrolithiasis compared with controls. Only one nephrolithiasis biopsy was negative for 8-OHdG, whereas in 19 cases 8-OHdG was highly expressed. The level of expression of 8-OHdG among patients with calcium oxalate (mostly mixed with calcium phosphate) and uric acid stones was not significantly different. Increased leukocyte infiltration was observed in renal tissues from patients with nephrolithiasis. Exposure of HK-2 cells to COM caused increased intracellular reactive oxygen species and nuclear expression of 8-OHdG. To our knowledge, this is the first report of increased 8-OHdG expression in renal tubular cells of patients with nephrolithiasis. In vitro, COM crystals were capable of inducing oxidative damage of DNA in the proximal renal tubular cells.

  5. Comparison of various needles in renal biopsy : clinical and animal studies

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Hee; Kim, Seung Hyup; Choi, Kuk Myeong; Kim, Hyun Beom; Yeon, Kyung Mo [Seoul National Univ. (Korea, Republic of). Coll. of Medicine

    1998-03-01

    The purpose of this paper is to compare the efficacy of 14 gauge (G) Vim-Silverman needle biopsy with that of 16G automatic gun biopsy for kidneys and to determine the optimal needle size for renal biopsy. We retrospectively reviewed the pathologic and medical records of 119 (110 native, 9 allograft) patients who had undergone 14G Vim-Silverman needle biopsy and 71 (34 native, 37 allograft) who had undergone 16G automatic gun biopsy. The number of retrieved glomeruli and post-biopsy complications were compared between the two groups. Ex vivo renal biopsies of a dog were performed using an automatic gun mounted with 14G-20G needles and the numbers of retrieved glomeruli were compared. Although significantly more glomeruli were retrieved in the 14G Vim-Silverman needle biopsy group, the number retrieved in the 16G automatic gun biopsy group was sufficient for adequate pathologic interpretation. Experimental study suggests that when an 18G automatic gun in used, sufficient glomeruli are retrieved. (author). 16 refs., 4 tabs., 3 figs.

  6. Renal failure due to granulomatous interstitial nephritis in native and allograft renal biopsies: experience from a tertiary care hospital.

    Science.gov (United States)

    Gupta, Pallav; Rana, D S; Bhalla, A K; Gupta, Ashwini; Malik, Manish; Gupta, Anurag; Bhargava, Vinant

    2014-10-01

    Granulomatous interstitial nephritis is a rare cause of renal failure in both native and allograft renal biopsies. Drugs and sarcoidosis are the commonest causes of granulomatous interstitial nephritis as reported in Western countries. Unlike the west, tuberculosis is the commonest cause of granulomatous interstitial nephritis in Indian subcontinent. The etiological factors, clinical course, glomerular and tubulointerstitial changes associated with granulomatous interstitial nephritis have been analyzed in the present study along with the outcome in patients with granulomatous interstitial nephritis.

  7. What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours?

    Science.gov (United States)

    Barwari, K; Kummerlin, I P; ten Kate, F J; Algaba, F; Trias, I; Wijkstra, H; De la Rosette, J J; Laguna, P

    2013-08-01

    Non-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by five pathologists in the ex vivo diagnosis of renal mass. Two ex vivo core biopsies were taken followed by two FNA passes from extirpated tumours. All samples were evaluated by five blinded pathologists. A consensus diagnosis of the surgical specimen was the index for comparison. For each pathologist, the number of non-diagnostic (non-conclusive or undetermined biology and failed biopsies), correct and incorrect scored cases of each technique was assessed. When a non-diagnostic CB or FNA had a correct diagnostic counterpart, this was considered as of added value. Of the 57 assessed tumours, 53 were malignant. CB was non-diagnostic in 4-10 cases (7-17.5%). FNA established the correct diagnosis in 1-7 of these cases. FNA was non-diagnostic in 2-6 cases (3.5-10.5%), and the counterpart CB established the correct diagnosis in 1-6 of these cases. For the 5 pathologists, accuracy of CB and FNA varied between 82.5-93% and 89.5-96.5%, respectively. Combination of both types of biopsy resulted in 55-57 correct results (accuracy 96.5-100%), i.e., an increase in accuracy of 3.5-14%. Combining the result of CB and FNA in renal mass biopsy leads to a higher diagnostic accuracy. Recommendations on which technique used should be adapted to local expertise and logistic possibilities.

  8. Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Abolhasani Maryam

    2012-11-01

    Full Text Available Abstract Introduction Malakoplakia is an uncommon chronic inflammatory condition that has a gross and microscopic appearance resembling that of xanthogranulomatous pyelonephritis. It is characterized by distinctive Michaelis-Gutmann bodies. Malakoplakia can affect any organ system but genitourinary tract involvement is the most common, particularly in immunocompromised individuals. Very rare cases have been reported to present as a unifocal lesion mimicking a renal tumor. Case presentation We report a case of renal malakoplakia in a 55-year-old Iranian man with a past history of recurrent urinary tract infections who presented with left flank pain. An ultrasound study showed a large solid left renal mass, and he underwent a left radical nephrectomy with a clinical diagnosis of a renal tumor. Pathology slides revealed the diffuse infiltration of sheets of Periodic Acid Schiff-positive histiocytes in his renal parenchyma; these cells showed strong immunoreactivity for CD 68. The final diagnosis was renal malakoplakia. Conclusion Renal malakoplakia must be kept in mind for patients presenting with a renal mass and a history of long-term recurrent renal infections or renal failure. The large, rapidly growing nodules of malakoplakia may mimic renal cell carcinoma in imaging studies. In these cases, a true cut needle biopsy may help the correct diagnosis and prevent unnecessary surgery.

  9. Imaging findings of common benign renal tumors in the era of small renal masses: Differential diagnosis from small renal cell carcinoma: Current status and future perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sung Min; Cho, Jeong Yeon [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-02-15

    The prevalence of small renal masses (SRM) has risen, paralleling the increased usage of cross-sectional imaging. A large proportion of these SRMs are not malignant, and do not require invasive treatment such as nephrectomy. Therefore, differentation between early renal cell carcinoma (RCC) and benign SRM is critical to achieve proper management. This article reviews the radiological features of benign SRMs, with focus on two of the most common benign entities, angiomyolipoma and oncocytoma, in terms of their common imaging findings and differential features from RCC. Furthermore, the role of percutaneous biopsy is discussed as imaging is yet imperfect, therefore necessitating biopsy in certain circumstances to confirm the benignity of SRMs.

  10. Percutaneous ultrasound-guided renal biopsy in children: The need for renal biopsy in pediatric patients with persistent asymptomatic microscopic hematuria

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    Mei-Ching Yu

    2014-12-01

    Full Text Available Background: Percutaneous renal biopsy (PRB is essential for the diagnosis, prognosis, and management of children with unknown kidney disease. In this study, the safety and efficacy of PRB is investigated, and also the common etiologies of childhood kidney disease, based on histological findings. In addition, we explored the role of PRBs in the diagnosis of children who presented with persistent asymptomatic hematuria. Methods: By chart review, from July 2005 to July 2009, a total of 99 PRBs were performed on 91 children (43 girls and 48 boys; mean age, 10.9 ± 4.4 years under ultrasound (US guidance, by a doctor, using an automated 18-gauge biopsy needle following the same protocol, at a medical center in northern Taiwan. Results: The accuracy of the histological diagnosis was excellent. The most common post-biopsy complications were perirenal hematoma (11.1% and asymptomatic gross hematuria (3.0%, respectively. Nevertheless, these complications resolved spontaneously, and none had major bleeding episodes. Histological results showed that lupus nephritis, minimal change disease, and IgA nephropathy (IgAN could be the current leading causes of childhood kidney diseases in Taiwan. Conclusions: Automated ultrasound (US-guided PRB is a safe and reliable method of assessing childhood renal disease. A recent study shows that the presence of persistent asymptomatic isolated microhematuria in adolescents is a predictive marker of future end-stage renal disease. Hence, the emphasis of renal biopsy on children with persistent asymptomatic hematuria is beneficial for the early diagnosis of IgAN or other glomerulonephritis (GN, which tends toward progressive kidney disease in adulthood without prompt therapeutic intervention.

  11. Perirenal hemorrhage after renal biopsy - possibility of clinical diagnosis and contribution of computer tomography

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    Monhart, V.; Sobota, J. (Ustredni Vojenska Nemocnice, Prague (Czechoslovakia)); Jaros, M.; Stepankova, Ch. (Karlova Univ., Prague (Czechoslovakia). Lekarska Fakulta Hygienicka)

    1982-10-01

    Evaluation was made of the clinical course after 1257 percutaneous renal biopsies to determine the incidence of hemorrhage into the renal parenchyma or into its surroundings. In 41% of the performed biopsies signs were found which appeared to be connected with the presence of early or past perirenal or intrarenal hemorrhage - pain on the site of biopsy, hematuria, increased body temperature, signs of circulatory failure and a slow-down of intestinal peristalsis. In 13 (92%) of the 14 patients of this group examined after renal biopsy using computer tomograph Somatom 2 Siemens, a perirenal, mostly medium size hematoma was found, only rarely combined with simultaneous incidence of a small intrarenal hematoma. When the type, localization and extension of the proved hematoma were compared with the incidence of clinical signs -pain, increased body temperature and hematuria, no mutual connections could be found. The results of the study prove a high sensitivity of computer tomography in the detection of hemorrhage after renal biopsy. In the studied group, sensitivity was more than twice higher than that showed by clinical diagnosis.

  12. Reno-invasive fungal infection presenting as acute renal failure: importance of renal biopsy for early diagnosis.

    Science.gov (United States)

    Ranjan, Priyadarshi; Chipde, Saurabh Sudhir; Vashistha, Saurabh; Kumari, Neeraj; Kapoor, Rakesh

    2014-11-01

    Renal zygomycosis, caused by invasive fungi, is a rare and potentially fatal infection. The patient usually presents with non-specific symptoms and renal failure. A 34-year-old male non-diabetic and without any predisposing factors for systemic fungal infection presented to the emergency department with diffuse abdominal pain, high-grade fever and acute renal failure with a serum creatinine of 6.5. A computed tomography showed bilateral diffuse globular nephromegaly. A urine smear for fungal examination showed right angle branching hyphae and kidney biopsy showed fungal hyphae within the glomeruli, tubules and interstitium. Although radiological investigations can give us a clue, the definitive diagnosis can only be made by kidney biopsy. A high index of suspicion and timely diagnosis is important for a proper management.

  13. Small renal masses in the era of personalized medicine

    DEFF Research Database (Denmark)

    Conti, Alessandro; Santoni, Matteo; Sotte, Valeria;

    2015-01-01

    Small renal masses (SRMs) represent a heterogeneous group showing a variety of clinical and biological behaviors. The best treatment for SRMs has been the focus of much debate over the past decades. Present strategies include surgery (partial or radical nephrectomy), local treatments (radiofreque......Small renal masses (SRMs) represent a heterogeneous group showing a variety of clinical and biological behaviors. The best treatment for SRMs has been the focus of much debate over the past decades. Present strategies include surgery (partial or radical nephrectomy), local treatments...... to guide the decision-making process in this subpopulation. In this review, we summarized the data on growth kinetics, tumor heterogeneity, and risk of metastasis in patients with SRMs, with focus on the current role of biopsies and imaging in the management of these patients....

  14. Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

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    Smriti Hari

    2016-01-01

    Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates.

  15. Deep procedural sedation by a sedationist team for outpatient pediatric renal biopsies.

    Science.gov (United States)

    Kamat, Pradip P; Ayestaran, Frank W; Gillespie, Scott E; Sanders, Rebecca D; Greenbaum, Larry A; Simon, Harold K; Stockwell, Jana A

    2016-05-01

    To date, no study has analyzed the use of deep PS for pediatric renal biopsies by a dedicated sedation team in an outpatient setting. Retrospective analysis of renal biopsies performed at CHOA from 2009 to 2013. Patient demographics, procedure success, and sedation-related events were analyzed. Logistic regression techniques were applied to identify characteristics associated with procedure safety and success. A total of 174 biopsies from 136 patients, aged 2-21 yr, were reviewed. Of the 174 biopsies, 63 of 174 (36%) were from native, and 111 of 174 (64%) were from transplanted kidneys, respectively. No deaths, allograft losses, or unanticipated hospital admissions occurred. The most commonly utilized interventions during sedation were blow-by oxygen (29.9%) and CPAP (12.1%). Children receiving the combination of F + P had significantly higher biopsy success rates vs. other drug combinations (96.1% vs. 79%; p = 0.014). There was no difference in complication rates regardless of drug combination or biopsy type (transplanted vs. native). The combination of F + P yields a high procedural success rate for outpatient native and transplanted kidney biopsies. We identified a number of sedation-related events that can be easily managed by a well-trained sedationist team.

  16. Renal biopsy in chronic kidney disease: lessons from a large Italian registry.

    Science.gov (United States)

    Zaza, Gianluigi; Bernich, Patrizia; Lupo, Antonio

    2013-01-01

    Renal biopsy procedure in patients with chronic renal failure (CRF) may represent a valid tool to help clinicians in clinical practice. However, the use of this invasive method in CRF is variable and it reflects the hospital biopsy policy. To better define the CRF-related histological patterns and to assess the clinical utility of this procedure in this extensive group, we analyzed biopsy records of 1,185 CRF patients living in a large area of north-east Italy from 1998 to 2010. Data analysis showed that, although the biopsy incidence rate and the histological features were unchanged, the mean age of our CRF patients increased during the study period (R(2) = 0.42, p types were immunoglobulin A nephropathy (22%), focal segmental glomerulosclerosis (12.4%), membranous glomerulonephritis (MGN, 7.5%) and nephroangiosclerosis (7.3%). These forms were also highly frequent in CRF patients with elevated proteinuria and moderate/severe renal damage. Elderly patients were primarily affected by MGN. After biopsy, 49.5% of CRF patients with and 34.1% without nephrotic syndrome received immunosuppression therapy. This study demonstrated that renal biopsy in CRF patients, regardless of age and glomerular filtration rates, is safe and essential to achieve a correct diagnosis and to commence the correct therapy. Additionally, it revealed that, even in patients with severe renal damage, it is possible to perform an accurate histological diagnosis and, interestingly, end-stage kidney disease seems not to be the primary form. Copyright © 2013 S. Karger AG, Basel.

  17. Pediatric Renal Biopsies in India: A Single-Centre Experience of Six Years

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    Kanodia

    2015-06-01

    Full Text Available Background Renal biopsy is a well-established diagnostic modality for the assessment of kidney diseases in children. It can provide diagnostic precision and prognostic value and guide in therapeutic options for many renal diseases. Objectives This report describes the indication, histopathological patterns, and epidemiology of renal diseases in children in India. Patients and Methods This is a single-center study on renal biopsies performed between January 2008 and December 2013 in 346 children (age ≤ 14 years. Results Eleven (3.17% biopsies were inadequate, and 335 biopsies were considered for analysis. The mean age was 7.91 ± 3.04 years with a predominance of males (68.1%. Nephrotic syndrome (46.2% was the most common indication, followed by urinary abnormality (41.19%, acute nephritic syndrome (10.74%, and chronic renal failure (1.79 %. Primary glomerulonephritis (GN was predominant (81.79%, and secondary GN constituted 16.12% of the biopsies. Primary GN included mesangial proliferative GN (MePGN, IgM nephropathy, focal segmental glomerulosclerosis, minimal change disease, IgA nephropathy, membranoproliferative GN, membranous nephropathy, crescentic GN, and post-infectious GN. Secondary GN revealed lupus nephritis, hemolytic uremic syndrome, amyloidosis, and hypertensive nephropathy. Tubulointerstitial nephritis was observed in 2.08%. The most common histological pattern of primary GN was MePGN (20% and in secondary GN it was lupus nephritis (7.76%. Conclusions The present study provides data on the epidemiology of renal diseases in children in India and will be helpful for developing a national registry and devising therapeutic guidelines.

  18. Biopsy-proven renal disease in Ile-Ife, Nigeria: A histopathologic review.

    Science.gov (United States)

    Onwubuya, I M; Adelusola, K A; Sabageh, D; Ezike, K N; Olaofe, O O

    2016-01-01

    Although various patterns of renal diseases have been reported from different renal biopsy registries worldwide, data from Nigeria remain scanty. A 10-year retrospective review of renal biopsies was conducted in our tertiary health care facility. All cases were reclassified based on their light microscopic features after the application of standard histochemical stains. A total of 165 cases were reviewed with a male:female ratio of 1.8:1 and a mean age of 15.4 ± 12.0 years. About 69.7% of the cases were below the age of 16 years, while only 2.4% were older than 50 years. The most common indications for biopsy were nephrotic syndrome (72.1%) and acute renal failure of unknown etiology (11.5%). Overall, glomerulonephritis (80%) was the most common histologic category and occurred only in individuals younger than 50 years old. Minimal change disease (22.9%) and membranoproliferative glomerulonephritis (21.9%) were the most common varieties in children, while membranous glomerulonephritis (30.6%) and focal segmental glomerulosclerosis (27.8%) were the commonest among the adult population. The initial histologic diagnosis was revised in 18 cases while a diagnosis was arrived at in seven cases initially adjudged as inadequate for assessment. This study showed that renal biopsy was predominantly performed in children and adolescents. Although glomerulonephritis was the predominant disease, the predominant histologic patterns varied with the patient age. Despite the scarcity of advanced diagnostic tools in resource-poor environments, routine use of histochemical stains is helpful in the evaluation of renal biopsies.

  19. Twenty-eight-year review of childhood renal diseases from renal biopsy data: A single centre in China.

    Science.gov (United States)

    Jiang, Mengjie; Xiao, Zizheng; Rong, Liping; Xu, Yuanyuan; Chen, Lizhi; Mo, Ying; Sun, Liangzhong; Sun, Wei; Jiang, Xiaoyun

    2016-12-01

    The aim of the present study was to investigate the clinicopathologic characteristics of biopsy-proven childhood renal diseases and to compare the trends and changes during two different time intervals between 1984 and 2011 at the First Affiliated Hospital of Sun Yat-sen University in China. We retrospectively analyzed kidney biopsy data from children with renal diseases and compared the data during two time intervals, namely 1984-1997 and 1998-2011. A total of 1313 children were enrolled in the present study. There were 921 children with primary glomerular disease (PGD) and 312 children with secondary glomerular disease (SGD), accounting for 70.1% and 23.8% of participants, respectively. The major clinical manifestation of PGD was nephrotic syndrome (NS), which accounted for 31.2% of cases, while the main aetiology of SGD was lupus nephritis (40.7%). The main biopsy patterns of PGD were IgA nephritis (27.6%), minimal change disease (24.0%), and mesangial proliferative glomerulonephritis (16.9%). PGD was the major class of disease in both time intervals, but the ratio of PGD decreased over time, while the ratio of SGD and other glomerular diseases increased. PGD was also the major class of disease in each age group; however, the incidence of PGD decreased with increasing age. The incidence patterns of paediatric renal diseases changed over the 28-year period of this study. Our results show that different renal diseases characterize different age intervals. Furthermore, there are several associations between clinical presentation and biopsy features in childhood renal disease. © 2015 Asian Pacific Society of Nephrology.

  20. C4d immunoreactivity of intraoperative zero-hour biopsy in renal allograft.

    Science.gov (United States)

    Lee, C; Park, J H; Suh, J H; Kim, H W; Moon, K C

    2014-12-01

    C4d deposition in the peritubular capillaries is known to be correlated with antibody-mediated rejection (AMR) in renal allografts. An intraoperative zero-hour biopsy during transplantation is considered an indicator to indirectly determine the status of the donor kidney. In this study, we investigated the relationship between C4d immunoreactivity of intraoperative zero-hour biopsy in renal allograft, thought to be due to donor condition, and acute rejection episodes during follow-up. We collected 147 renal transplantation cases examining intraoperative zero-hour biopsy with C4d immunohistochemical staining. All cases were from the Seoul National University Hospital between 2010 and 2011. Of the 147 cases, 24 (16.3%) showed strong C4d staining in the glomeruli, 38 (25.9%) showed weak staining, and the remainder (57.8%) showed negative staining. Nine cases (6.1%) showed positive C4d staining in the arterioles, and the remainder (93.9%) were negative. There were no significant differences between acute T-cell-mediated rejection and acute AMR episodes in the renal allograft specimens during follow-up according to the glomerular or arteriolar C4d immunoreactivity of the intraoperative zero-hour biopsy specimens.

  1. Relation between serological data at the time of biopsy and renal histology in lupus nephritis.

    Science.gov (United States)

    Nossent, J C; Henzen-Logmans, S C; Vroom, T M; Huysen, V; Berden, J H; Swaak, A J

    1991-01-01

    As autoantibodies are thought to participate in the pathogenesis of renal inflammation in systemic lupus erythematosis (SLE) we investigated associations between serological markers of disease activity in SLE and the activity of renal histopathological lesions in thirty-five patients with lupus nephritis (LN). We found the following prevalence of serum auto-antibodies in LN: IgG antinuclear antibodies (ANA) 100%, IgM ANA 69%, IgA ANA 60%, IgG anti-dsDNA 60%, IgM anti-dsDNA 71%, IgA anti-dsDNA 60%, anti-RNP 20%, anti-Sm 14%, anti-SSA 31%, anti-SSB 14%, anti-histone 37%, anti-cardiolipin 80% and antibody to ribosomal protein (anti-P) 6%. No correlation was found between serological parameters and the WHO-classification of biopsies. The activity-index of histological lesion, assessed according to the NIH-renal histology scoring system, correlated with IgM ANA and IgM anti-dsDNA titers. Of all the specific features of histological renal inflammation, glomerular proliferation showed the best overall correlation with serological parameters of disease activity. Anticardiolipin antibodies were correlated with overall disease activity, but not with renal histological activity. Thus, serological markers of disease activity did not adequately reflect the amount of renal inflammation in LN and cannot replace renal biopsy as a diagnostic tool.

  2. Unmasking of complements using proteinase-K in formalin fixed paraffin embedded renal biopsies

    Directory of Open Access Journals (Sweden)

    R Nada

    2016-01-01

    Full Text Available Renal biopsy interpretation requires histopathology, direct immunofluorescence (DIF and electron microscopy. Formalin-fixed, paraffin-embedded tissue (FFPE sent for light microscopy can be used for DIF after antigen retrieval. However, complement staining has not been satisfactory. We standardized DIF using proteinase-K for antigen retrieval in FFPE renal biopsies. A pilot study was conducted on known cases of membranous glomerulonephritis (MGN, membranoproliferative type-1 (MPGN-1, immunoglobulin A nephropathy (IgAN, and anti-glomerular basement disease (anti-GBM. Immunofluorescence panel included fluorescein isothiocyanate (FITC conjugated IgG, IgA, IgM, complements (C3 and C1q, light chains (kappa, lambda and fibrinogen antibodies. After standardization of the technique, 75 renal biopsies and 43 autopsies cases were stained. Out of 43 autopsy cases, immune-complex mediated glomerulonephritis (GN was confirmed in 18 cases (Lupus nephritis-11, IgAN-6, MGN-1, complement-mediated dense deposit disease (DDD-1 and monoclonal diseases in 4 cases (amyloidosis-3, cast nephropathy-1. Immune-mediated injury was excluded in 17 cases (focal segmental glomerulosclerosis -3, crescentic GN-6 [pauci-immune-3, anti-GBM-3], thrombotic microangiopathy-5, atherosclerosis-3. Renal biopsies (n-75 where inadequate or no frozen sample was available; this technique classified 52 mesangiocapillary pattern as MPGN type-1-46, DDD-2 and (C3GN-4. Others were diagnosed as IgAN-3, lupus nephritis-2, MGN-4, diffuse proliferative glomerulonephritis (DPGN-1, Non-IC crescentic GN-1, monoclonal diseases-3. In nine cases, DIF on FFPE tissue could not help in making diagnosis. Proteinase-K enzymatic digestion of FFPE renal biopsies can unmask complements (both C3 and C1q in immune-complexes mediated and complement-mediated diseases. This method showed good results on autopsy tissues archived for as long as 15 years.

  3. Unmasking of complements using proteinase-K in formalin fixed paraffin embedded renal biopsies.

    Science.gov (United States)

    Nada, R; Kumar, A; Kumar, V G; Gupta, K L; Joshi, K

    2016-01-01

    Renal biopsy interpretation requires histopathology, direct immunofluorescence (DIF) and electron microscopy. Formalin-fixed, paraffin-embedded tissue (FFPE) sent for light microscopy can be used for DIF after antigen retrieval. However, complement staining has not been satisfactory. We standardized DIF using proteinase-K for antigen retrieval in FFPE renal biopsies. A pilot study was conducted on known cases of membranous glomerulonephritis (MGN), membranoproliferative type-1 (MPGN-1), immunoglobulin A nephropathy (IgAN), and anti-glomerular basement disease (anti-GBM). Immunofluorescence panel included fluorescein isothiocyanate (FITC) conjugated IgG, IgA, IgM, complements (C3 and C1q), light chains (kappa, lambda) and fibrinogen antibodies. After standardization of the technique, 75 renal biopsies and 43 autopsies cases were stained. Out of 43 autopsy cases, immune-complex mediated glomerulonephritis (GN) was confirmed in 18 cases (Lupus nephritis-11, IgAN-6, MGN-1), complement-mediated dense deposit disease (DDD-1) and monoclonal diseases in 4 cases (amyloidosis-3, cast nephropathy-1). Immune-mediated injury was excluded in 17 cases (focal segmental glomerulosclerosis -3, crescentic GN-6 [pauci-immune-3, anti-GBM-3], thrombotic microangiopathy-5, atherosclerosis-3). Renal biopsies (n-75) where inadequate or no frozen sample was available; this technique classified 52 mesangiocapillary pattern as MPGN type-1-46, DDD-2 and (C3GN-4). Others were diagnosed as IgAN-3, lupus nephritis-2, MGN-4, diffuse proliferative glomerulonephritis (DPGN)-1, Non-IC crescentic GN-1, monoclonal diseases-3. In nine cases, DIF on FFPE tissue could not help in making diagnosis. Proteinase-K enzymatic digestion of FFPE renal biopsies can unmask complements (both C3 and C1q) in immune-complexes mediated and complement-mediated diseases. This method showed good results on autopsy tissues archived for as long as 15 years.

  4. Indications and results of renal biopsy in children: A single-center experience from Morocco

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    Fatima Zohra Souilmi

    2015-01-01

    Full Text Available The contribution of renal biopsy (RB is of major importance in the management of many renal diseases in children. Specific indications for performing biopsy in children include steroid-resistant nephrotic syndrome (NS and secondary nephropathies. The aim of our study was to report the common histological varieties of kidney diseases in children in Morocco. In this retrospective and descriptive study, we included all renal biopsies performed in patients under 16 years in the Department of Pediatrics of Hassan II University Hospital, Fez, Morocco from July 2009 to December 2013. Biopsy samples without glomeruli and those with less than five glomeruli or repeat biopsies on the same patient were excluded from our study. We performed 112 RBs during this period; the average age at the time of RB was 10.05 ± 4 years and the sex-ratio was 1.07. The indications for RB were NS with hematuria and/or renal failure (RF in 32.1%, active urinary sediment in 21.4%, isolated NS in 15.2%, RF in 13.4% and steroid-resistant NS in 10.7% of cases. Primary nephropathies represented 59.8% of cases, with a predominance of minimal change disease (MCD seen in 40.2% of the cases. Secondary nephropathies accounted for 27.7% of the cases, with a predominance of lupus nephritis (11.6%, followed by Henoch-Schonlein purpura nephritis (6.2% of cases and post-streptococcal glomerulonephritis (3.6%. There was one case of hepatitis B virus-associated membranous glomerulonephritis. Chronic glomerulonephritis accounted for 12.5% of the cases. Vascular and tubulo-interstitial nephritis were rare. Our study confirmed that primary glomerular nephropathy was the most common renal disease in children. The most common lesion was MCD. Secondary nephropathies were less frequent, with a predominance of lupus nephritis.

  5. Acute Page kidney following renal allograft biopsy: a complication requiring early recognition and treatment.

    Science.gov (United States)

    Chung, J; Caumartin, Y; Warren, J; Luke, P P W

    2008-06-01

    The acute Page kidney phenomenon occurs as a consequence of external compression of the renal parenchyma leading to renal ischemia and hypertension. Between January 2000 and September 2007, 550 kidney transplants and 518 ultrasound-guided kidney biopsies were performed. During that time, four recipients developed acute oligo-anuria following ultrasound-guided allograft biopsy. Emergent doppler-ultrasounds were performed demonstrating absence of diastolic flow as well as a sub-capsular hematoma of the kidney. Prompt surgical exploration with allograft capsulotomy was performed in all cases. Immediately after capsulotomy, intraoperative Doppler study demonstrated robust return of diastolic flow. Three patients maintained good graft function, and one kidney was lost due to acute antibody-mediated rejection. We conclude that postbiopsy anuria associated with a subcapsular hematoma and acute absence of diastolic flow on doppler ultrasound should be considered pathognomonic of APK. All renal transplant specialists should be able to recognize this complication, because immediate surgical decompression can salvage the allograft.

  6. A histopathological score on baseline biopsies from elderly donors predicts outcome 1 year after renal transplantation

    DEFF Research Database (Denmark)

    Toft, Birgitte G; Federspiel, Birgitte H; Sørensen, Søren S

    2012-01-01

    Kidneys from elderly deceased patients and otherwise marginal donors may be considered for transplantation and a pretransplantation histopathological score for prediction of postoperative outcome is warranted. In a retrospective design, 29 baseline renal needle biopsies from elderly deceased donors...... wall thickness of arteries and/or arterioles. Nineteen renal baseline biopsies from 15 donors (age: 64 ± 10 years) were included and following consensus the histopathological score was 4.3 ± 2.1 (intraclass correlation coefficient: 0.81; confidence interval: 0.66-0.92). The donor organs were used...... for single renal transplantation (recipient age: 47 ± 3 years). Two grafts were lost after the transplantation. In the remaining 17 recipients the 1-year creatinine clearance (54 ± 6 mL/min) correlated to the baseline histopathological score (r(2) = 0.59; p

  7. Biopsy of parotid masses:Review of current techniques

    Institute of Scientific and Technical Information of China (English)

    Sananda Haldar; Joseph D Sinnott; Kemal M Tekeli; Samuel S Turner; David C Howlett

    2016-01-01

    Definitive diagnosis of parotid gland masses is required optimal management planning and for prognosis. There is controversy over whether fine needle aspiration cytology(FNAC) or ultrasound guided core biopsy(USCB) should be the standard for obtaining a biopsy. The aim of this review is to assess the current evidence available to assess the benefits of each technique and also to assess the use of intra-operative frozen section(IOFS). Literature searches were performed using pubmed and google scholar. The literature has been reviewed and the evidence is presented. FNAC is an accepted and widely used technique. It has been shown to have variable diagnostic capabilities depending on centres and experience of staff. USCB has a highly consistent diagnostic accuracy and can help with tumour grading and staging. However, the technique is more invasive and there is a question regarding potential for seeding. Furthermore, USCB is less likely to be offered as part of a one-stop clinic. IOFS has no role as a first line diagnostic technique but may be reserved as an adjunct or for lesions not amenable to percutaneous biopsy. On balance, USCB seems to be the method of choice. The current evidence suggests it has superior diagnostic potential and is safe. With time, USCB is likely to supplant FNAC as the biopsy technique of choice, replicating that which has occurred already in other areas of medicine such a breast practice.

  8. No change in complication rate using spring-loaded gun compared to traditional percutaneous renal allograft biopsy techniques.

    Science.gov (United States)

    Kovalik, E C; Schwab, S J; Gunnells, J C; Bowie, D; Smith, S R

    1996-06-01

    The previous methods to biopsy renal allografts at our institution involved the use of the Franklin-Silverman or Tru-Cut needles. Unfortunately they had a significant rate of post biopsy bleeding secondary to deep penetration when excess force was used to penetrate a tough transplant capsule. Although spring loaded biopsy devices have been widely used for native kidney biopsies over the past three years, the complication rate for renal allograft biopsies has not been sufficiently evaluated. We describe our experience using a disposable spring loaded biopsy device on transplanted renal grafts. Fifty-four biopsies were performed with the device, all under ultrasound guidance. The ASAP automatic biopsy system by Medi-tech was used comprising of a spring loaded gun with a 15 cm long 15 GA needle echogenic tip and 17 mm specimen notch. All patients were ultrasounded immediately post biopsy to look for hematomas. Compared to 55 previous biopsies performed using Tru-Cut needles, we conclude that the ASAP automated biopsy system proved equally effective in obtaining adequate tissue for diagnosis with fewer post-biopsy hematomas compared to traditional biopsy methods.

  9. A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses.

    Science.gov (United States)

    Kasraeian, Sina; Allison, Daniel C; Ahlmann, Elke R; Fedenko, Alexander N; Menendez, Lawrence R

    2010-11-01

    Biopsy tissue can be obtained through a fine needle, a wider coring needle, or through an open surgical incision. Though much literature exists regarding the diagnostic yield of these techniques individually, none compare accuracy of diagnosis in the same mass. We asked how the diagnostic accuracy of fine-needle aspiration, core biopsy, and open surgical biopsy compare in regard to identifying malignancy, establishing the exact diagnosis, and guiding the appropriate treatment of soft tissue masses. We prospectively studied 57 patients with palpable extremity soft tissue masses, performing fine-needle aspiration, followed by core biopsy, followed by surgical biopsy of the same mass. Open surgical biopsy was 100% accurate on all accounts. With regard to determining malignancy, fine-needle aspiration and core biopsy had 79.17% and 79.2% sensitivity, 72.7% and 81.8% specificity, 67.9% and 76% positive predictive value, 82.8% and 84.4% negative predictive value, and an overall accuracy of 75.4% and 80.7%, respectively. In regard to determining exact diagnosis, fine-needle aspiration had a 33.3% accuracy and core biopsy had a 45.6% accuracy. With regard to eventual treatment, fine-needle aspiration was 38.6% accurate and core biopsy was 49.1% accurate. In soft tissue mass diagnosis, core biopsy is more accurate than fine-needle aspiration on all accounts, and open biopsy is more accurate than both in determining malignancy, establishing the exact diagnosis, and the guiding appropriate treatment.

  10. Computer tomography as a means of detecting perirenal bleeding after renal biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Monhart, V.; Sobota, J.; Navratil, J. (Ustredni Vojenska Nemocnice, Prague (Czechoslovakia)); Jaros, M.; Stepankova, C. (Karlova Univ., Prague (Czechoslovakia). Lekarska Fakulta Hygienicka)

    1983-02-18

    Perirenal bleeding was detected in 23 cases, i.e., 85%, of a group of 27 patients examined using computerized tomography, after percutaneous renal biopsy. The computerized tomography tests were made with a Siemens Somatom 2 apparatus at the 2nd and 3rd post-biopsy days except for 1 patient who was not examined until the 8th day. Apart from localization, the size and spread of perirenal bleeding was sought. The predominant finding was a small perirenal hematoma. The simultaneous presence of minute intrarenal hematoma was ascertained in only 3 patients. Asymptomatic course was seen in 30% of the X-ray-proved cases of hemorrhage. The authors were unable to prove any relationship between the size, type and spread of perirenal bleeding and the presence of clinical signs or the number of renal biopsy punctures. Thanks to its non-invasive nature and high sensitivity, computerized tomography is rated as a reliable method for the early detection, and determination of the size, precise localization, age and absorption of hematomas resulting from percutaneous renal biopsy.

  11. Biopsy Induced Arteriovenous Fistula and Venous Stenosis in a Renal Transplant

    Directory of Open Access Journals (Sweden)

    Sridhar R. Allam

    2015-01-01

    Full Text Available Renal transplant vein stenosis is a rare cause of allograft dysfunction. Percutaneous stenting appears to be safe and effective treatment for this condition. A 56-year-old Caucasian female with end stage renal disease received a deceased donor renal transplant. After transplant, her serum creatinine improved to a nadir of 1.2 mg/dL. During the third posttransplant month, her serum creatinine increased to 2.2 mg/dL. Renal transplant biopsy showed BK nephropathy. Mycophenolate was discontinued. Over the next 2 months, her serum creatinine crept up to 6.2 mg/dL. BK viremia improved from 36464 copies/mL to 15398 copies/mL. A renal transplant ultrasound showed lower pole arteriovenous fistula and abnormal waveforms in the renal vein. Carbon dioxide (CO2 angiography demonstrated severe stenosis of the transplant renal vein. Successful coil occlusion of fistula was performed along with angioplasty and deployment of stent in the renal transplant vein. Serum creatinine improved to 1.5 mg/dL after.

  12. Absorption fever characteristics due to percutaneous renal biopsy-related hematoma.

    Science.gov (United States)

    Hu, Tingyang; Liu, Qingquan; Xu, Qin; Liu, Hui; Feng, Yan; Qiu, Wenhui; Huang, Fei; Lv, Yongman

    2016-09-01

    This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00. The onset and duration of fever and the highest body temperature were recorded. Thereafter, we described the time distribution of absorption fever and obtained the curve of fever pattern.Of 2639 patients, PRB complications were observed in 154 (5.8%) patients. Perirenal hematoma was the most common complication, which occurred in 118 (4.5%) of biopsies, including 74 small hematoma cases (thickness ≤3 cm) and 44 large hematoma cases (thickness >3 cm). Major complications were observed in only 6 (0.2%) cases resulting from a large hematoma. Of 118 patients with a perirenal hematoma, absorption fever was observed in 48 cases. Furthermore, large hematomas had a 5.23-fold higher risk for absorption fever than the small ones.Blood pressure, renal insufficiency, and prothrombin time could be risk factors for complications. Fever is common in patients with hematoma because of renal biopsy and is usually noninfectious. Evaluation of patients with post-biopsy fever is necessary to identify any obvious infection sources. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Absorption fevers will resolve in time without specific therapeutic interventions.

  13. Percutaneous renal biopsy of native kidneys: efficiency, safety and risk factors associated with major complications

    Science.gov (United States)

    Torres Muñoz, Abel; Valdez-Ortiz, Rafael; González-Parra, Carlos; Espinoza-Dávila, Elvy; Morales-Buenrostro, Luis E.; Correa-Rotter, Ricardo

    2011-01-01

    Introduction The use of an automated biopsy device and real-time ultrasound (current technology) for percutaneous renal biopsies (PRBs) has improved the likelihood of obtaining adequate tissue for diagnosis and has reduced the complications associated with renal biopsies. Our objective was to evaluate the efficacy and safety of the current PRB procedure and identify possible risk factors for the development of major complications. Material and methods We collected all native kidney PRBs performed with current technology in our institute from January 1998 to April 2008. Studied variables were collected from the patient's chart at the time of the biopsy. Results We analyzed 623 (96.4%) of 646 renal biopsies performed with the current automated procedure guided by real-time ultrasound. Although the effectiveness was 97.6%, there were 110 complications. Fourteen (2.24%) of these complications were major: 9 cases of renal hematoma, 2 cases with macroscopic hematuria (which needed blood transfusion), 1 case of intestinal perforation (which required exploratory laparotomy), 1 nephrectomy and 1 case of a dissecting hematoma. The logistic regression analysis demonstrated the following risk factors for developing major complications: diastolic blood pressure ≥ 90 mmHg, RR 7.6 (95% CI 1.35-43); platelet count ≤ 120×103/µl; RR 7.0 (95% CI 1.9-26.2); and blood urea nitrogen (BUN) ≥ 60 mg/dl, RR 9.27 (95% CI 2.8-30.7). Conclusions The observed efficacy and safety of the current technique in the present study were similar to observations in previous studies. Diastolic blood pressure ≥ 90 mmHg, platelets ≤ 120×103/µl and BUN ≥ 60 mg/dl were independent risk factors for the development of major complications following PRB. PMID:22291827

  14. The Natural History and Predictors for Intervention in Patients with Small Renal Mass Undergoing Active Surveillance

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    Zaher Bahouth

    2015-01-01

    Full Text Available Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47–89. The mean follow-up period was 34 months (12–112. In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15% masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery. Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

  15. Postobstructive pulmonary edema after biopsy of a nasopharyngeal mass.

    Science.gov (United States)

    Mehta, Keyur Kamlesh; Ahmad, Sabina Qureshi; Shah, Vikas; Lee, Haesoon

    2015-01-01

    We describe a case of 17 year-old male with a nasopharyngeal rhabdomyosarcoma who developed postobstructive pulmonary edema (POPE) after removing the endotracheal tube following biopsy. He developed muffled voice, rhinorrhea, dysphagia, odynophagia, and difficulty breathing through nose and weight loss of 20 pounds in the preceding 2 months. A nasopharyngoscopy revealed a fleshy nasopharyngeal mass compressing the soft and hard palate. Head and neck MRI revealed a large mass in the nasopharynx extending into the bilateral choana and oropharynx. Biopsy of the mass was taken under general anesthesia with endotracheal intubation. Immediately after extubation he developed oxygen desaturation, which did not improve with bag mask ventilation with 100% of oxygen, but improved after a dose of succinylcholine. He was re-intubated and pink, frothy fluid was suctioned from the endotracheal tube. Chest radiograph (CXR) was suggestive of an acute pulmonary edema. He improved with mechanical ventilation and intravenous furosemide. His pulmonary edema resolved over the next 24 h. POPE is a rare but serious complication associated with upper airway obstruction. The pathophysiology of POPE involves hemodynamic changes occurring in the lung and the heart during forceful inspiration against a closed airway due to an acute or chronic airway obstruction. This case illustrates the importance of considering the development of POPE with general anesthesia, laryngospasm and removal of endotracheal tube to make prompt diagnosis and to initiate appropriate management.

  16. Postobstructive pulmonary edema after biopsy of a nasopharyngeal mass

    Science.gov (United States)

    Mehta, Keyur Kamlesh; Ahmad, Sabina Qureshi; Shah, Vikas; Lee, Haesoon

    2015-01-01

    We describe a case of 17 year-old male with a nasopharyngeal rhabdomyosarcoma who developed postobstructive pulmonary edema (POPE) after removing the endotracheal tube following biopsy. He developed muffled voice, rhinorrhea, dysphagia, odynophagia, and difficulty breathing through nose and weight loss of 20 pounds in the preceding 2 months. A nasopharyngoscopy revealed a fleshy nasopharyngeal mass compressing the soft and hard palate. Head and neck MRI revealed a large mass in the nasopharynx extending into the bilateral choana and oropharynx. Biopsy of the mass was taken under general anesthesia with endotracheal intubation. Immediately after extubation he developed oxygen desaturation, which did not improve with bag mask ventilation with 100% of oxygen, but improved after a dose of succinylcholine. He was re-intubated and pink, frothy fluid was suctioned from the endotracheal tube. Chest radiograph (CXR) was suggestive of an acute pulmonary edema. He improved with mechanical ventilation and intravenous furosemide. His pulmonary edema resolved over the next 24 h. POPE is a rare but serious complication associated with upper airway obstruction. The pathophysiology of POPE involves hemodynamic changes occurring in the lung and the heart during forceful inspiration against a closed airway due to an acute or chronic airway obstruction. This case illustrates the importance of considering the development of POPE with general anesthesia, laryngospasm and removal of endotracheal tube to make prompt diagnosis and to initiate appropriate management. PMID:26744691

  17. Postobstructive pulmonary edema after biopsy of a nasopharyngeal mass

    Directory of Open Access Journals (Sweden)

    Keyur Kamlesh Mehta

    2015-01-01

    Full Text Available We describe a case of 17 year-old male with a nasopharyngeal rhabdomyosarcoma who developed postobstructive pulmonary edema (POPE after removing the endotracheal tube following biopsy. He developed muffled voice, rhinorrhea, dysphagia, odynophagia, and difficulty breathing through nose and weight loss of 20 pounds in the preceding 2 months. A nasopharyngoscopy revealed a fleshy nasopharyngeal mass compressing the soft and hard palate. Head and neck MRI revealed a large mass in the nasopharynx extending into the bilateral choana and oropharynx. Biopsy of the mass was taken under general anesthesia with endotracheal intubation. Immediately after extubation he developed oxygen desaturation, which did not improve with bag mask ventilation with 100% of oxygen, but improved after a dose of succinylcholine. He was re-intubated and pink, frothy fluid was suctioned from the endotracheal tube. Chest radiograph (CXR was suggestive of an acute pulmonary edema. He improved with mechanical ventilation and intravenous furosemide. His pulmonary edema resolved over the next 24 h. POPE is a rare but serious complication associated with upper airway obstruction. The pathophysiology of POPE involves hemodynamic changes occurring in the lung and the heart during forceful inspiration against a closed airway due to an acute or chronic airway obstruction. This case illustrates the importance of considering the development of POPE with general anesthesia, laryngospasm and removal of endotracheal tube to make prompt diagnosis and to initiate appropriate management.

  18. Effect of Proteinuria and Glomerular Filtration Rate on Renal Outcome in Patients with Biopsy-Proven Benign Nephrosclerosis.

    Science.gov (United States)

    Sumida, Keiichi; Hoshino, Junichi; Ueno, Toshiharu; Mise, Koki; Hayami, Noriko; Suwabe, Tatsuya; Kawada, Masahiro; Imafuku, Aya; Hiramatsu, Rikako; Hasegawa, Eiko; Yamanouchi, Masayuki; Sawa, Naoki; Fujii, Takeshi; Ohashi, Kenichi; Takaichi, Kenmei; Ubara, Yoshifumi

    2016-01-01

    Reduced estimated glomerular filtration rate (eGFR) and proteinuria are risk factors for end-stage renal disease (ESRD), of which benign nephrosclerosis is a common cause. However, few biopsy-based studies have assessed these associations. We performed retrospective cohort study of 182 Japanese patients who underwent renal biopsy from June 1985 through March 2014 and who were diagnosed with benign nephrosclerosis. Competing risk regression analyses were used to investigate the effect of eGFR and proteinuria levels at the time of renal biopsy on the risk for renal events (ESRD or a 50% decline in eGFR from baseline). During a median 5.8-year follow-up, 63 (34.6%) patients experienced renal events. The incidence of renal events increased with lower baseline eGFR and greater baseline proteinuria levels. After adjustment for baseline covariates, lower eGFR levels (subhazard ratios [SHRs], 1.30; 95% confidence interval [CI], 1.01-1.67, per 10 mL/min/1.73 m2) and higher proteinuria levels (SHR, 1.52; 95% CI, 1.23-1.87, per 1.0 g/day) at the time of renal biopsy were associated independently with higher risk for renal events. Lower levels of serum albumin (SHR, 2.07; 95% CI, 1.20-3.55 per 1.0 g/dL) were also associated with renal events. Patients with both eGFR proteinuria ≥0.5 g/day had a 26.7-fold higher risk (95% CI, 3.97-179.4) of renal events than patients with both eGFR ≥60 mL/min/1.73 m2 and proteinuria proteinuria as well as lower serum albumin at the time of renal biopsy are independent risk factors for renal events among patients with biopsy-proven benign nephrosclerosis.

  19. Differential gene expression pattern in biopsies with renal allograft pyelonephritis and allograft rejection

    Science.gov (United States)

    Oghumu, Steve; Nori, Uday; Bracewell, Anna; Zhang, Jianying; Bott, Cherri; Nadasdy, Gyongyi M.; Brodsky, Sergey V.; Pelletier, Ronald; Satoskar, Abhay R.; Nadasdy, Tibor; Satoskar, Anjali A.

    2016-01-01

    Differentiating acute pyelonephritis (APN) from acute rejection (AR) in renal allograft biopsies can sometimes be difficult because of overlapping clinical and histologic features, lack of positive urine cultures, and variable response to antibiotics. We wanted to study differential gene expression between AR and APN using biopsy tissue. Thirty-three biopsies were analyzed using NanoString multiplex platform and PCR (6 transplant baseline biopsies, 8 AR, 15 APN [8 culture positive, 7 culture negative], and 4 native pyelonephritis [NP]). Additional 22 biopsies were tested by PCR to validate the results. CXCL9, CXCL10, CXCL11, and IDO1 were the top differentially expressed genes, upregulated in AR. Lactoferrin (LTF) and CXCL1 were higher in APN and NP. No statistically significant difference in transcript levels was seen between culture-positive and culture-negative APN biopsies. Comparing the overall mRNA signature using Ingenuity pathway analysis, interferon-gamma emerged as the dominant upstream regulator in AR and allograft APN, but not in NP (which clustered separately). Our study suggests that chemokine pathways in graft APN may differ from NP and in fact resemble AR, due to a component of alloreactivity, resulting in variable response to antibiotic treatment. Therefore, cautious addition of steroids might help in resistant cases of graft APN. PMID:27352120

  20. Differential gene expression pattern in biopsies with renal allograft pyelonephritis and allograft rejection.

    Science.gov (United States)

    Oghumu, Steve; Nori, Uday; Bracewell, Anna; Zhang, Jianying; Bott, Cherri; Nadasdy, Gyongyi M; Brodsky, Sergey V; Pelletier, Ronald; Satoskar, Abhay R; Nadasdy, Tibor; Satoskar, Anjali A

    2016-09-01

    Differentiating acute pyelonephritis (APN) from acute rejection (AR) in renal allograft biopsies can sometimes be difficult because of overlapping clinical and histologic features, lack of positive urine cultures,and variable response to antibiotics. We wanted to study differential gene expression between AR and APN using biopsy tissue. Thirty-three biopsies were analyzed using NanoString multiplex platform and PCR (6 transplant baseline biopsies, 8 AR, 15 APN [8 culture positive, 7 culture negative], and 4 native pyelonephritis [NP]). Additional 22 biopsies were tested by PCR to validate the results. CXCL9, CXCL10, CXCL11, and IDO1 were the top differentially expressed genes, upregulated in AR. Lactoferrin (LTF) and CXCL1 were higher in APN and NP. No statistically significant difference in transcript levels was seen between culture-positive and culture-negative APN biopsies. Comparing the overall mRNA signature using Ingenuity pathway analysis, interferon-gamma emerged as the dominant upstream regulator in AR and allograft APN, but not in NP (which clustered separately). Our study suggests that chemokine pathways in graft APN may differ from NP and in fact resemble AR, due to a component of alloreactivity, resulting in variable response to antibiotic treatment. Therefore, cautious addition of steroids might help in resistant cases of graft APN.

  1. Study of patients undergoing renal biopsy for proteinuria in a tertiary care hospital

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    Mr. M. N. Patel; J R Khambholja; Patel, M. B.

    2014-01-01

    Proteinuria is usually a marker of kidney damage1. The excretion of specific types of protein such as albumin or low molecular weight globulins depend on the type of kidney disease that is present2. An analysis of renal biopsy done in 25 such patients at our hospital helped us in better understanding of pathological and clinical associations of different severities of proteinuria. Nephrotic syndrome was the most frequent clinical presentation. Majority of adolescent...

  2. Impact of specimen adequacy on the assessment of renal allograft biopsy specimens.

    Science.gov (United States)

    Cimen, S; Geldenhuys, L; Guler, S; Imamoglu, A; Molinari, M

    2016-01-01

    The Banff classification was introduced to achieve uniformity in the assessment of renal allograft biopsies. The primary aim of this study was to evaluate the impact of specimen adequacy on the Banff classification. All renal allograft biopsies obtained between July 2010 and June 2012 for suspicion of acute rejection were included. Pre-biopsy clinical data on suspected diagnosis and time from renal transplantation were provided to a nephropathologist who was blinded to the original pathological report. Second pathological readings were compared with the original to assess agreement stratified by specimen adequacy. Cohen's kappa test and Fisher's exact test were used for statistical analyses. Forty-nine specimens were reviewed. Among these specimens, 81.6% were classified as adequate, 6.12% as minimal, and 12.24% as unsatisfactory. The agreement analysis among the first and second readings revealed a kappa value of 0.97. Full agreement between readings was found in 75% of the adequate specimens, 66.7 and 50% for minimal and unsatisfactory specimens, respectively. There was no agreement between readings in 5% of the adequate specimens and 16.7% of the unsatisfactory specimens. For the entire sample full agreement was found in 71.4%, partial agreement in 20.4% and no agreement in 8.2% of the specimens. Statistical analysis using Fisher's exact test yielded a P value above 0.25 showing that - probably due to small sample size - the results were not statistically significant. Specimen adequacy may be a determinant of a diagnostic agreement in renal allograft specimen assessment. While additional studies including larger case numbers are required to further delineate the impact of specimen adequacy on the reliability of histopathological assessments, specimen quality must be considered during clinical decision making while dealing with biopsy reports based on minimal or unsatisfactory specimens.

  3. The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies.

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    Avi Z Rosenberg

    Full Text Available In renal biopsy reporting, quantitative measurements, such as glomerular number and percentage of globally sclerotic glomeruli, is central to diagnostic accuracy and prognosis. The aim of this study is to determine the number of glomeruli and percent globally sclerotic in renal biopsies by means of registration of serial tissue sections and manual enumeration, compared to the numbers in pathology reports from routine light microscopic assessment.We reviewed 277 biopsies from the Nephrotic Syndrome Study Network (NEPTUNE digital pathology repository, enumerating 9,379 glomeruli by means of whole slide imaging. Glomerular number and the percentage of globally sclerotic glomeruli are values routinely recorded in the official renal biopsy pathology report from the 25 participating centers. Two general trends in reporting were noted: total number per biopsy or average number per level/section. Both of these approaches were assessed for their accuracy in comparison to the analogous numbers of annotated glomeruli on WSI.The number of glomeruli annotated was consistently higher than those reported (p<0.001; this difference was proportional to the number of glomeruli. In contrast, percent globally sclerotic were similar when calculated on total glomeruli, but greater in FSGS when calculated on average number of glomeruli (p<0.01. The difference in percent globally sclerotic between annotated and those recorded in pathology reports was significant when global sclerosis is greater than 40%.Although glass slides were not available for direct comparison to whole slide image annotation, this study indicates that routine manual light microscopy assessment of number of glomeruli is inaccurate, and the magnitude of this error is proportional to the total number of glomeruli.

  4. The Spectrum of Glomerular Diseases on Renal Biopsy: Data From A Single Tertiary Center In Oman

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    Dawood Al Riyami

    2013-05-01

    Full Text Available Objective: To study the pattern of glomerular disease (GD from the result of renal biopsies at our center.Methods: We conducted a retrospective review of 190 adult native renal biopsy reports from the pathology registry of renal biopsy performed at our hospital between 1992 and 2010.Results: Lupus nephritis was the most common pathology 48/133 (36.1% with a female preponderance. The most common primary glomerular disease was focal segmental glomerulosclerosis (FSGS 26/133(19.5%, followed by membranous glemerulopathy (MGN 13/133 (9.8%, and mesangial proliferative glomerulonephritis 6/133 (4.5%. IgA nephropathy and acute proliferative glomerulonephritis each accounted for 4/133 (3.0%. Membranoproliferative glomerulonephritis accounted for 3/133 (2.3%. Focal proliferative and cresentic glomerulonephritis each accounted for 2/133 (1.5%. Vasculitis was not common and there was no report of anti-GBM disease.Conclusion: Among the secondary glomerular diseases, lupus nephritis was the commonest condition with a female preponderance. Among the primary glomerular diseases, FSGS was the commonest. These results are consistent with global trend. IgA nephropathy is not common as the case in the Caucasian population. Vasculitis was not common and there was no report of anti-GBM disease.

  5. Reliability of whole slide images as a diagnostic modality for renal allograft biopsies.

    Science.gov (United States)

    Jen, Kuang-Yu; Olson, Jean L; Brodsky, Sergey; Zhou, Xin J; Nadasdy, Tibor; Laszik, Zoltan G

    2013-05-01

    The use of digital whole slide images (WSI) in the field of pathology has become feasible for routine diagnostic purposes and has become more prevalent in recent years. This type of technology offers many advantages but must show the same degree of diagnostic reliability as conventional glass slides. Several studies have examined this issue in various settings and indicate that WSI are a reliable method for diagnostic pathology. Since transplant pathology is a highly specialized field that requires not only accurate but rapid diagnostic evaluation of biopsy materials, this field may greatly benefit from the use of WSI. In this study, we assessed the reliability of using WSI compared to conventional glass slides in renal allograft biopsies. We examined morphologic features and diagnostic categories defined by the Banff 07 Classification of Renal Allograft Pathology as well as additional morphologic features not included in this classification scheme. We found that intraobserver scores, when comparing the use of glass slides versus WSI, showed substantial agreement for both morphologic features (κ = 0.68) and acute rejection diagnostic categories (κ = 0.74). Furthermore, interobserver reliability was comparable for morphologic features (κ = 0.44 [glass] vs 0.42 [WSI]) and acute rejection diagnostic categories (κ = 0.49 [glass] vs 0.51 [WSI]). These data indicate that WSI are as reliable as glass slides for the evaluation of renal allograft biopsies.

  6. Study of patients undergoing renal biopsy for proteinuria in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    M N Patel

    2014-01-01

    Full Text Available Proteinuria is usually a marker of kidney damage1. The excretion of specific types of protein such as albumin or low molecular weight globulins depend on the type of kidney disease that is present2. An analysis of renal biopsy done in 25 such patients at our hospital helped us in better understanding of pathological and clinical associations of different severities of proteinuria. Nephrotic syndrome was the most frequent clinical presentation. Majority of adolescents (12-19 yrs. and more of males had PGN (Primary Glomerulonephritis with MCD (Minimal Change Disease on the biopsy. More of females in the age group of 20-39 years had SGN (Secondary Glomerulonephritis with varied pathology on biopsy.

  7. Renal Ultrasound, Dialysis Catheter Placement, and Kidney Biopsy Experience of US Nephrology Fellows.

    Science.gov (United States)

    Sachdeva, Mala; Ross, Daniel W; Shah, Hitesh H

    2016-08-01

    Procedures are a key component to the practice of nephrology. The Accreditation Council for Graduate Medical Education (ACGME) requires nephrology fellows to acquire skills and demonstrate competency in the performance of several procedures during fellowship training, including temporary hemodialysis catheter placement, biopsy of native and transplanted kidneys, and various dialytic therapies. It is also required that fellows acquire competency in the interpretation of renal imaging, including renal ultrasound, during their training. To gain a more recent perspective of nephrology fellows' experiences regarding renal ultrasonography, dialysis catheter placement, and kidney biopsies, we carried out a national survey of nephrology fellows in May 2014. A majority of the programs did not offer formal clinical training in renal ultrasonography. In addition, a significant percentage of fellows in adult nephrology may not be acquiring the required procedural skills and competency during fellowship training. In this perspective, we explore some of the reasons for this occurrence and propose some measures that the nephrology training community can take to enhance procedural skills and competency of fellows. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  8. Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass

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    Valary T. Raup

    2015-01-01

    Full Text Available Testicular cancer is the most common malignancy of men aged 15–40. Metastatic spread classically begins with involvement of the retroperitoneal lymph nodes, with metastases to the liver, lung, bone, and brain representing advancing disease. Treatment is based on pathologic analysis of the excised testicle and presence of elevated tumor markers. We report a case of a 34-year-old male presenting with back pain who was found to have a right renal mass with tumor extension into the inferior vena cava. Subsequent biopsy was consistent with seminoma. We review this rare case and discuss the literature regarding its diagnosis and management.

  9. Renography and biopsy-verified acute rejection in renal allotransplanted patients receiving cyclosporin A

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    Thomsen, H.S.; Nielsen, S.L.; Larsen, S.; Lokkegaard, H.

    1987-01-01

    Acute impairment of renal function caused by cyclosporin A can be hard to differentiate from acute rejection. Therefore, kidney function after cadaveric allograft transplantation was repeatedly determined by renography in 42 patients receiving either high dose cyclosporin A (32 patients) or azathioprine and prednisone (10 patients) until a graft biopsy showed either acute rejection or no rejection within the first 5 postoperative weeks. The graft function as judged from the renograms was significantly poorer when cyclosporin A was used than when azathioprine and prednisone were the immunosuppressants. In the azathioprine and prednisone group a biopsy showing acute rejection was always preceded by a deterioration in the renogram. In cyclosporin A treated patients a graft biopsy following an early deterioration in the renogram showed acute rejection in only 56% of the biopsies. It was not possible to identify a time course or a function level of the renogram that could predict rejection in these patients. It is concluded that graft biopsies should be used liberally to diagnose rejection during cyclosporin A treatment if surgical complications after transplantations have been ruled out. Radionuclide studies may offer an invaluable aid in determining a nonnephrotoxic initial dose of the drug.

  10. Role of on-site microscopic evaluation of kidney biopsy for adequacy and allocation of glomeruli: comparison of renal biopsies with and without on-site microscopic evaluation.

    Science.gov (United States)

    Gilani, S M; Ockner, D; Qu, H

    2013-12-01

    Evaluation of kidney core biopsies ideally begins with on-site microscopic examination for adequacy and allocation of tissue for light microscopy (LM), immunofluorescence (IF) and electron microscopy (EM). However, some renal biopsies are not microscopically evaluated by a pathologist at the time of procedure, and are allocated without on-site evaluation. This study compares the actual outcome of these two techniques. We reviewed the reports of patients who underwent kidney biopsy for medical causes in the past two years. Eighty-eight biopsies had on-site microscopic evaluation by pathologists, and 70 biopsies did not undergo on-site evaluation. For biopsies without on-site evaluation, no glomeruli were seen in 5 (7.14%) cases for LM, 11 (15.71%) cases for IF and 6 (8.57%) cases for EM. In cases with on-site evaluation, the absence of glomeruli was identified in 1 (1.13%) case for LM, 3 (3.4%) for IF and 3 (3.4%) for EM. The biopsies with on-site microscopic evaluation had 5.68% of the cases considered as inadequate, while 22% of biopsies without on-site evaluation were considered inadequate. The biopsies with on-site evaluation tended to have more glomeruli obtained during the procedure (p < 0.0005). Without on-site evaluation, the likelihood of getting an inadequate specimen compared to on-site evaluation is nearly four times greater.

  11. Treatable renal disease in children with silent lupus nephritis detected by baseline biopsy: association with serum C3 levels.

    Science.gov (United States)

    Wakiguchi, Hiroyuki; Takei, Syuji; Kubota, Tomohiro; Miyazono, Akinori; Kawano, Yoshifumi

    2017-02-01

    Lupus nephritis is identified in up to 75% of patients with juvenile systemic lupus erythematosus and may present with abnormal urinary findings (overt lupus nephritis) or be apparent only upon renal biopsy (silent lupus nephritis). We investigated whether serum complement levels correlate with renal pathology in pediatric patients with silent lupus nephritis. We performed baseline renal biopsy in 45 children diagnosed with juvenile systemic lupus erythematosus who were admitted to Kagoshima University Hospital between January 2000 and June 2015. Patients were classified as having overt or silent lupus nephritis based on urinary findings at renal biopsy. Silent lupus nephritis was identified in 55.5% (25/45) of cases. Of these, 6 (13.3%) were classified as class III nephritis, according to the International Society of Nephrology/Renal Pathology Society criteria. Decreased serum C3 levels were associated with the renal pathology classification for patients with silent but not with overt lupus nephritis. No differences in serum C4 levels were identified between cases of silent and overt lupus nephritis. Baseline renal biopsy is a critical component of the work-up of juvenile systemic lupus erythematosus as treatable renal pathology may be present in the absence of urinary signs. Serum C3 may be an important marker of the progression of silent lupus nephritis.

  12. Diagnosis of Henoch-Schönlein purpura: renal or skin biopsy?

    Science.gov (United States)

    Davin, Jean-Claude; Weening, Jan J

    2003-12-01

    Henoch-Schönlein purpura (HSP) is a form of systemic vasculitis characterized by vascular wall deposits of predominantly IgA, typically involving small vessels in skin, gut, and glomeruli and associated with purpura, intestinal colic, hematuria, and arthralgia or arthritis. HSP nephritis leads to chronic renal failure in up to 20% of pediatric patients after 20 years of follow-up in selected series. The risk is related to the initial clinical presentation and is maximal (more than 50%) when initial signs are a combination of nephrotic and nephritic syndromes. Although less important, the risk persists for mild renal symptoms or when the patient has apparently completely recovered from the renal disease. Other types of non-IgA-related leukocytoclastic vasculitis may be difficult to discriminate from HSP, thus confounding the diagnosis. The clinical picture of HSP is often incomplete and renal signs can become manifest years after initial signs. When based on clinical signs only, the diagnosis of HSP can therefore be missed, and some patients risk developing silent chronic renal failure after decades without appropriate treatment. Patients can also be overdiagnosed as HSP and thus submitted to unnecessary follow-up. It is therefore important that HSP should be correctly diagnosed from the initial signs. As the finding of IgA deposits in vessel walls associated with the characteristic signs of small-vessel vasculitis is a sine qua non in the diagnosis, a skin biopsy should be performed for histological and immunofluorescence studies in cases of clinical suspicion of HSP. The systematic diagnostic use of a cutaneous biopsy should not only improve the follow-up of patients with HSP but will also allow a reliable epidemiological study of vasculitis in children and a better knowledge of the disease.

  13. Alport syndrome: significance of gingival biopsy in the initial diagnosis and periodontal evaluation after renal transplantation.

    Science.gov (United States)

    Toygar, Hilal Uslu; Toygar, Okan; Guzeldemir, Esra; Cilasun, Ulkem; Nacar, Ahmet; Bal, Nebil

    2009-01-01

    Alport Syndrome (AS) is an important hereditary disorder affecting the glomerular basement membrane. Diagnosis of AS is based on the presence of hematuric nephropathy, renal failure, hearing loss, ocular abnormalities and changes in the glomerular basement membrane of the lamina densa. The aims of this case report were to show the changes in the gingival tissues in a patient with AS under therapy with cyclosporin-A after renal transplantation and to discuss the possible role of type IV collagen in gingival basal lamina as an alternative approach for the diagnosis of AS. A 20-year-old male patient with AS underwent periodontal therapy including a series of gingivectomy surgeries. Gingival samples obtained during the second surgery were examined histopathologically and by transmission electron microscopy for further pathological examination. Gingivectomy procedures have been performed every 6 months over the last 4 years. The excessive and fibrous gingival enlargements resulted in migration of the anterior teeth, but no alveolar bone loss occurred. This is the first report to demonstrate the possible changes in the gingival tissues caused by AS. It is suggested that gingival biopsy can be an initial diagnostic tool instead of renal or skin biopsies. Proper dental and periodontal care and regular visits to the dentist could provide limited gingival hyperplasia to patients with AS.

  14. Application of low-vacuum scanning electron microscopy for renal biopsy specimens.

    Science.gov (United States)

    Miyazaki, Hiroki; Uozaki, Hiroshi; Tojo, Akihiro; Hirashima, Sayuri; Inaga, Sumire; Sakuma, Kei; Morishita, Yasuyuki; Fukayama, Masashi

    2012-09-15

    Low-vacuum scanning electron microscopy (LV-SEM) has been developed which enables the observation of soft, moist, and electrically insulating materials without any pretreatment unlike conventional scanning electron microscopy, in which samples must be solid, dry and usually electrically conductive. The purpose of this study was to assess the usefulness of LV-SEM for renal biopsy specimens. We analyzed 20 renal biopsy samples obtained for diagnostic purposes. The sections were stained with periodic acid methenamine silver to enhance the contrast, and subsequently examined by LV-SEM. LV-SEM showed a precise and fine structure of the glomerulus in both formalin fixed paraffin and glutaraldehyde-osmium tetroxide-fixed epoxy resin sections up to 10,000-fold magnification. The spike formation on the basement membrane was clearly observed in the membranous nephropathy samples. Similarly to transmission electron microscopy, electron dense deposits were observed in the epoxy resin sections of the IgA nephropathy and membranous nephropathy samples. LV-SEM could accurately show various glomerular lesions at high magnification after a simple and rapid processing of the samples. We consider that this is a novel and useful diagnostic tool for renal pathologies.

  15. Identification of Type VI Collagen Synthesizing Cells in Human Diabetic Glomerulosclerosis Using Renal Biopsy Sections

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    Mohammed Shawkat Razzaque

    1997-01-01

    Full Text Available Although the role of extracellular matrices in the development of glomerulosclerosis has been discussed widely, the cellular origin of type VI collagen in diabetic nephropathy (DN has remained relatively unexplored. This study reports the distribution and cellular origin of type VI collagen in DN. Type VI collagen‐specific oligonucleotide probes and monoclonal antibody were used to assess the relative expression of mRNA for \\alpha1 (VI chain and its translated protein in paraffin‐embedded renal biopsy sections of DN. By immunohistochemistry, compared to the control, increased deposition of type VI collagen was noted in the diffuse and nodular lesions of diabetic glomeruli. For cellular localization of type VI collagen mRNA, paraffin‐embedded renal sections of the control and DN were hybridized in situ with digoxigenin (Dig‐labeled antisense oligo‐DNA probe complementary to a part of \\alpha1 (VI mRNA. In comparison to the control kidney sections, increased numbers of intraglomerular cells (both mesangial and epithelial cells were positive for α1 (VI mRNA in renal biopsy sections of DN. From the results, we conclude that overexpression of type VI collagen by intraglomerular cells with its increased deposition might significantly contribute to the glomerulosclerosis found in DN.

  16. Alport syndrome: significance of gingival biopsy in the initial diagnosis and periodontal evaluation after renal transplantation

    Directory of Open Access Journals (Sweden)

    Hilal Uslu Toygar

    2009-12-01

    Full Text Available Alport Syndrome (AS is an important hereditary disorder affecting the glomerular basement membrane. Diagnosis of AS is based on the presence of hematuric nephropathy, renal failure, hearing loss, ocular abnormalities and changes in the glomerular basement membrane of the lamina densa. The aims of this case report were to show the changes in the gingival tissues in a patient with AS under therapy with cyclosporin-A after renal transplantation and to discuss the possible role of type IV collagen in gingival basal lamina as an alternative approach for the diagnosis of AS. A 20-year-old male patient with AS underwent periodontal therapy including a series of gingivectomy surgeries. Gingival samples obtained during the second surgery were examined histopathologically and by transmission electron microscopy for further pathological examination. Gingivectomy procedures have been performed every 6 months over the last 4 years. The excessive and fibrous gingival enlargements resulted in migration of the anterior teeth, but no alveolar bone loss occurred. This is the first report to demonstrate the possible changes in the gingival tissues caused by AS. It is suggested that gingival biopsy can be an initial diagnostic tool instead of renal or skin biopsies. Proper dental and periodontal care and regular visits to the dentist could provide limited gingival hyperplasia to patients with AS.

  17. Comparison of needles size in pediatric renal biopsy with sono-guided percutaneous-automated gun technique

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    Kim, Jong Chul; Park, Jin Yong [Chungnam National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    To compare the efficacy of a 20-gauge and an 18-gauge needle in sono-guided percutaneous automated gun biopsy for establishing the specific diagnosis of renal parenchymal disease in pediatric kidneys. In 60 pediatric patients with renal parenchymal diseases, percutaneous sono-guided gun biopsy was performed by an experienced radiologist. In two groups of 30 patients, regardless of their age, two needle passes were performed, using alternately an 18-gauge or a 20-gauge biopsy needle. The core of renal tissue thus obtained was examined with light, immunofluorescent or electron microscopy by the renal pathologist. The mean number of intact glomeruli of whole tissue core per biopsy, as seen on the light microscopy, and post-bioptic complications were compared between the two different needle size groups. The number (mean{+-}1 standard deviation) of glomeruli obtained per biopsy was 17{+-}8 in the 18-gauge needle group, and 14{+-}5 in the 20-gauge group. Between two groups, there was no major post-bioptic complication requiring specific treatment, nor a statistically significant difference in the frequency of minor complications. Even though more glomeruli were obtained with an 18-gauge needle, the number obtained with a 20-gauge needle also permitted adequate pathologic examination. Both an 18-gauge and a 20-gauge needle may thus be suitable for renal biopsy in pediatric patients.

  18. Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy.

    Science.gov (United States)

    Bermejo, Sheila; Soler, María José; Gimeno, Javier; Barrios, Clara; Rodríguez, Eva; Mojal, Sergi; Pascual, Julio

    Diabetic renal lesions can only be diagnosed by kidney biopsy. These biopsies have a high prevalence of non-diabetic lesions. The aims of the study were to determine the predictability of non-diabetic nephropathy (NDN) in diabetics and study differences in survival and renal prognosis. In addition, we evaluated histological lesions and the effect of proteinuria on survival and renal prognosis in patients with diabetic nephropathy (DN). A descriptive, retrospective study of kidney biopsies of diabetics between 1990 and 2013 in our centre. 110 patients were included in the study: 87 men (79%), mean age 62 years (50-74), mean serum creatinine 2.6mg/dl (0.9-4.3) and proteinuria 3.5g/24hours (0.5-6.5). 61.8% showed NDN, 34.5% showed DN and 3,6% showed DN+NDN. The most common NDN was IgA nephropathy (13,2%). In the multivariate analysis, creatinine (OR: 1.48, 1.011-2.172, p=0.044), proteinuria/24hours (OR: 0.813, 0.679-0.974, p=0.025), duration of diabetes (OR: 0.992, 0.987-0.998, p=0.004), age (OR: 1.068, 95% CI: 1.010-1.129, p=0.022), and diabetic retinopathy (OR: 0.23, 0.066-0.808, p=0.022) were independently associated with NDN. We did not find any differences in survival or renal prognosis. Concerning patients with DN, increased nodular mesangial expansion (p=0.02) and worse renal prognosis (p=0.004) were observed in nephrotic proteinuria as compared to non-nephrotic proteinuria. We did not find differences in patient survival. The most common cause of NDN was IgA nephropathy. Higher creatinine levels, shorter duration of diabetes, absence of diabetic retinopathy, lower proteinuria, and older age were risk factors for NDN. Patients with DN and nephrotic-range proteinuria had worse renal prognosis. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Lack of benefit of early protocol biopsies in renal transplant patients receiving TAC and MMF: a randomized study.

    Science.gov (United States)

    Rush, D; Arlen, D; Boucher, A; Busque, S; Cockfield, S M; Girardin, C; Knoll, G; Lachance, J-G; Landsberg, D; Shapiro, J; Shoker, A; Yilmaz, S

    2007-11-01

    We conducted a randomized, multicenter study to determine whether treatment of subclinical rejection with increased corticosteroids resulted in beneficial outcomes in renal transplant patients receiving tacrolimus (TAC), mycophenolate mofetil (MMF) and prednisone. One hundred and twenty-one patients were randomized to biopsies at 0,1,2,3 and 6 months (Biopsy arm), and 119 to biopsies at 0 and 6 months only (Control arm). The primary endpoint of the study was the prevalence of the sum of the interstitial and tubular scores (ci + ct)> 2 (Banff) at 6 months. Secondary endpoints included clinical and subclinical rejection and renal function. At 6 months, 34.8% of the Biopsy and 20.5% of the Control arm patients had a ci + ct score >or= 2 (p = 0.07). Between months 0 and 6, clinical rejection episodes were 12 in 10 Biopsy arm patients and 8 in 8 Control arm patients (p = 0.44). Overall prevalence of subclinical rejection in the Biopsy arm was 4.6%. Creatinine clearance at 6 months was 72.9 +/- 21.7 in the Biopsy and 68.90 mL/min +/- 18.35 mL/min in the Control arm patients (p = 0.18). In conclusion, we found no benefit to the procurement of early protocol biopsies in renal transplant patients receiving TAC, MMF and prednisone, at least in the short term. This is likely due to their low prevalence of subclinical rejection.

  20. Expression of prorenin receptor in renal biopsies from patients with IgA nephropathy.

    Science.gov (United States)

    Miyazaki, Nagisa; Murata, Ichijiro; Takemura, Genzou; Okada, Hideshi; Kanamori, Hiromitsu; Matsumoto-Miyazaki, Jun; Yoshida, Gakuro; Izumi, Kumiko; Kashi, Hitomi; Niimi, Kaori; Nishiwaki, Ayuko; Miyazaki, Tatsuhiko; Ohno, Michiya; Ohashi, Hiroshige; Suzuki, Fumiaki; Minatoguchi, Shinya

    2014-01-01

    Prorenin receptor (PRR) has been implicated in the onset and progression of various renal diseases, though its possible association with immunoglobulin A (IgA) nephropathy remains unclear. In the present study, we tried to clarify expression and pathophysiological significance of PRR in IgA nephropathy. We immunohistochemically assessed PRR levels in renal biopsy specimens from 48 patients with IgA nephropathy and evaluated its relevance to the clinical and pathological features of the disease. PRR was detected mainly in renal tubular cells, which was confirmed at the subcellular level using immunoelectron microscopy. The PRR-positive area (%PRR area) correlated with daily urinary protein, which is known to reflect disease severity (r=0.286, P=0.049). PRR levels were weaker in tubular cells bordering areas of severe interstitial fibrosis, where α-smooth muscle actin-positive myofibroblasts were present. We also used immunohistochemical detection of microtubule-associated protein-1 light chain 3 (LC3) and electron microscopy to assess autophagy, a cytoprotective mechanism downstream of PRR. We noted an apparent coincidence between autophagy activation in tubular cells and PRR expression in the same cells. Taken together, our findings suggest that renal expression of PRR in IgA nephropathy may be a compensatory response slowing disease progression by preventing tubular cell death and subsequent fibrosis through activation of cytoprotective autophagic machinery. Further studies using different type of kidney diseases could draw conclusion if the present finding is a generalized observation beyond IgA nephropathy.

  1. USG assisted and USG guided percutaneous renal biopsy at Nepal Medical College Teaching Hospital: a three and half years study.

    Science.gov (United States)

    Tuladhar, A S; Shrestha, A; Pradhan, S; Manandhar, D N; Chhetri Poudyal, P K; Rijal, A; Poudel, P; Maskey, A; Bhoomi, K K

    2014-09-01

    A prospective study was carried out from 2009 to 2013 in the Department of Radiology and Imaging of Nepal Medical College and Teaching Hospital, Attarkhel, Jorpati, Kathmandu, Nepal, in which a total of 75 patients underwent percutaneous renal biopsy with a 16 or 18 gauge needles. This was done blindly by marking a site on the skin, or, whenever there was difficulty with the blind procedure, by direct real time USG guidance. In all cases, the marking in the skin was done by the radiologist and the biopsy was performed by the Nephrologist, with the aid of the radiologist in cases of real-time USG guided renal biopsy. This study was carried out to assess the safety and efficacy of the USG aided, and USG guided renal biopsy, to see for the types and severity of complications arising from renal biopsies to determine the optimal period of observation required after the procedure. All renal biopsies were performed after the patients were admitted to the hospital at least 1 day prior to the procedure. Coagulation profile was done in all patients prior to the procedure. All patients were kept under strict complete bed rest for 24 hours post procedure. The ages of the patients ranged between 14 years to 71 years, with 42 female and 33 male patients. A mean of 21.8 glomeruli was obtained in each specimen, with absent glomerular yield seen in only 3 patients. Minimal change disease was seen in 19 patients, being the most common histopathological diagnosis followed by a spectrum of others. The overall complication rate was 4% and all of these were self-limiting needing no other intervention, or management except for observation and bed rest. Late complications were not seen. Percutaneous renal biopsy with the help of USG is a safe and efficacious procedure with less chance of minor complications.

  2. Xanthogranulomatous pyelonephritis: an uncommon pediatric renal mass

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    Smith, Ethan A.; Dillman, Jonathan R. [University of Michigan Health System, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Styn, Nicholas; Wan, Julian [University of Michigan Health System, C. S. Mott Children' s Hospital, Department of Urology, Ann Arbor, MI (United States); McHugh, Jonathan [University of Michigan Health System, C. S. Mott Children' s Hospital, Department of Pathology, Ann Arbor, MI (United States)

    2010-08-15

    Xanthogranulomatous pyelonephritis (XGP) is a chronic suppurative infectious process that only rarely affects pediatric patients, and most commonly occurs in the setting of a large obstructing calculus. Histologically, XGP is characterized by the presence of chronic inflammation and lipid-laden macrophages. This case report illustrates the radiological, surgical, and pathologic findings in a young patient who presented to our institution for treatment of this uncommon condition. Although rare, xanthogranulomatous pyelonephritis is a clinically important entity that can affect pediatric patients. This condition should be considered in the differential diagnosis for an atypical-appearing renal mass. (orig.)

  3. Metastatic renal cell carcinoma from a native kidney of a renal transplant patient diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA biopsy

    Directory of Open Access Journals (Sweden)

    Yaseen Alastal

    2015-04-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA biopsy sampling of enlarged lymph nodes is increasingly used to diagnose metastatic tumors, especially of the gastrointestinal tract and the lungs. Herein, we describe the diagnosis of metastatic renal cell carcinoma from a native kidney of a 54 year-old male patient, who had a 5-years history of renal transplant, by EUS-FNA of mediastinal and celiac lymph nodes. Histological and immunohistochemical findings confirmed the origin of metastatic tumor. EUS-FNA with proper cytological evaluation can be useful in the diagnosis of metastatic renal cell carcinoma in renal transplant patients. 

  4. Endothelial cell chimerism by fluorescence in situ hybridization in gender mismatched renal allograft biopsies

    Institute of Scientific and Technical Information of China (English)

    BAI Hong-wei; SHI Bing-yi; QIAN Ye-yong; NA Yan-qun; ZENG Xuan; ZHONG Ding-rong; LU Min; ZOU Wan-zhong; WU Shi-fei

    2007-01-01

    Background The blood vessels of a transplanted organ are the interface between donor and recipient. The endothelium in the blood vessels is thought to be the major target for graft rejection. Endothelial cells of a transplanted organ can be of recipient origin after transplantation. In this study, we tested whether endothelial chimerism correlated with the graft rejection and cold ischemia.Methods We studied the biopsy samples from 34 renal transplants of female recipients who received the kidney from a male donor for the presence of endothelial cells of recipient origin. We examined the tissue sections of renal biopsy samples by fluorescence in situ hybridization (FISH) for the presence of endothelial cells containing two X chromosomes using a biotinylated Y chromosome probe and digoxigenin labelled X chromosome probe, and then analyzed the relationship between the endothelial cell chimerism and the rejection and cold ischemia.Results Endothelial chimerism was common and irrespective of rejections (P>0.05). The cold ischemic time of chimerism group was longer than no chimerism group ((14.83±4.03) hours vs (11.27±3.87) hours, P<0.05).Conclusions There is no correlation between the percentage of recipient endothelial cells in vascular endothelial cells and the type of graft rejection. The endothelium damaged by ischemic injury might be repaired by the endothelial cells from the recipient.

  5. The Past, Present, and Future in Management of Small Renal Masses

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    Sarah C. Ha

    2015-01-01

    Full Text Available Management of small renal masses (SRMs is currently evolving due to the increased incidence given the ubiquity of cross-sectional imaging. Diagnosing a mass in the early stages theoretically allows for high rates of cure but simultaneously risks overtreatment. New consensus guidelines and treatment modalities are changing frequently. The multitude of information currently available shall be summarized in this review. This summary will detail the historic surgical treatment of renal cell carcinoma with current innovations, the feasibility and utility of biopsy, the efficacy of ablative techniques, active surveillance, and use of biomarkers. We evaluate how technology may be used in approaching the small renal mass in order to decrease morbidity, while keeping rates of overtreatment to a minimum.

  6. Demonstration of the proliferation marker Ki-67 in renal biopsies: correlation to clinical findings.

    Science.gov (United States)

    Nabokov, A; Waldherr, R; Ritz, E

    1997-07-01

    Assessment of cell proliferation in renal biopsy samples is a potentially promising analytical tool to evaluate disease activity. So far no information is available on the correlation between proliferative activity in different anatomic compartments of the kidney and clinical symptoms. To elucidate this issue, we examined renal biopsy specimens from 20 patients with systemic vasculitis (15 Wegener's granulomatosis, five microscopic polyangiitis), 20 patients with immunoglobulin (Ig) A nephropathy (IgAN), 13 patients with minimal-change disease (MCD), 11 patients with tubulointerstitial nephritis, and five patients with diabetes mellitus. The streptavidin-biotin-peroxidase complex technique was applied to autoclave-pretreated, formalin-fixed, paraffin-embedded tissue sections to label different cell types with the antibody MIB1 directed against the Ki-67 antigen. Proliferation index (PI) was estimated as the number of positively stained nuclei per glomerular cross-section or per square millimeter section area. The interstitial cells were discriminated by additional staining of Ki-67-processed samples with specific immune markers. In patients with vasculitis, PI was considerably elevated in the extracapillary glomerular compartment (0.86), in proximal tubules (6.24), and in the interstitium (8.62). High proliferative activity was also noted in interstitium (3.98) and proximal tubules (1.35) of patients with IgAN. Of particular interest was the increased interstitial proliferative activity (15.0) in diabetic patients. Resident renal cells, but not infiltrating cells, seemed to constitute the majority of the proliferating cell population in the interstitium. In systemic vasculitis, clinical disease activity was significantly correlated to endocapillary (r(s) = 0.58), extracapillary (r(s) = 0.67), proximal tubular (r(s) = 0.67), and interstitial PI (r(s) = 0.61). By multiple linear regression analysis, proximal tubular PI was correlated to the presence of hematuria

  7. Glomerular diseases in a Hispanic population: review of a regional renal biopsy database

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    Luis Fernando Arias

    Full Text Available CONTEXT AND OBJECTIVE: Epidemiological data provide useful information for clinical practice and investigations. This study aimed to determine glomerular disease frequencies in a region of Colombia and it represents the basis for future studies. DESIGN AND SETTING: Single-center retrospective analysis at the University of Antioquia, Colombia. METHODS: All native renal biopsies (July 1998 to December 2007 were reviewed, but only glomerular diseases were analyzed. The diagnosis of each case was based on histological, immunopathological and clinical features. RESULTS: A total of 1,040 biopsies were included. In 302 cases (29.0%, the patient's age was < 15 years. Primary glomerular diseases were diagnosed in 828 biopsies (79.6% and secondary in 212 (20.4%. The most common primary diseases were focal and segmental glomerulosclerosis (FSGS (34.8%, immunoglobulin A (IgA nephropathy (IgAN (11.8%, membranous glomerulonephritis (MGN (10.6%, minimal change disease (MCD (10.6%, crescentic glomerulonephritis (GN (5.6%, and non-IgA mesangial proliferative GN (5.6%. Postinfectious GN represented 10.7% of the diagnoses if included as primary GN. Lupus nephritis corresponded to 17.8% of the entire series. In adults, the order of the most frequent primary diseases was: FSGS, IgAN, MGN, crescentic GN and MCD. In children (< 15 years, the most frequent were: FSGS, postinfectious GN, MCD, non-IgA mesangial proliferative GN, endocapillary diffuse GN and IgAN. CONCLUSIONS: As among Afro-Americans, FSGS is the most frequent type of glomerulopathy in our population, but in our group, there are more cases of IgAN. The reasons for these findings are unclear. This information is an important contribution towards understanding the prevalence of renal diseases in Latin America.

  8. Renal graft survival according to Banff 2013 classification in indication biopsies.

    Science.gov (United States)

    Arias-Cabrales, Carlos; Redondo-Pachón, Dolores; Pérez-Sáez, María José; Gimeno, Javier; Sánchez-Güerri, Ignacio; Bermejo, Sheila; Sierra, Adriana; Burballa, Carla; Mir, Marisa; Crespo, Marta; Pascual, Julio

    The impact of acute rejection in kidney graft survival is well known, but the prognosis of other diagnoses is uncertain. We evaluated the frequency and impact on graft survival of different diagnostic categories according to the Banff 2013 classification in a cohort of renal transplant recipients. Retrospective study of 495 renal biopsies by indication in 322 patients from 1990-2014. Two independent observers reviewed the histological reports, reclassifying according to the Banff 2013 classification. Of 495 biopsies, 28 (5.7%) were not diagnostic. Of the remaining 467, 10.3% were «normal» (category 1), 19.6% antibody-mediated changes (category 2), 5.9% «borderline» changes (category 3), 8.7% T-cell-mediated rejection (category 4), 23.4% interstitial fibrosis/tubular atrophy (IFTA) (category 5) and 26.5% with other diagnoses (category 6). As time after transplantation increases, diagnoses of categories 1, 3 and 4 decrease, while categories 5 and 2 increase. Worse graft survival with category 2 diagnosis was observed (45% at 7.5 years, HR 4.29 graft loss [95% CI, 2.39-7.73]; P≤.001, compared to category 1). Grafts with «unfavourable histology» (chronic antibody-mediated rejection, moderate-severe IFTA) presented worse survival that grafts with «favourable histology» (normal, acute tubular necrosis, mild IFTA). The Banff 2013 classification facilitates a histological diagnosis in 95% of indication biopsies. While diagnostic category 6 is the most common, a change in the predominant histopathology was observed according to time elapsed since transplantation. Antibody-mediated changes are associated with worse graft survival. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis

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    Bruno Moulin

    2012-01-01

    Full Text Available The clinical merit of surveillance kidney graft biopsies remains controversial. A retrospective, multicenter analysis evaluated 12-month surveillance biopsies (SB, 154 patients versus no SB (NSB, 138 patients (11 with diagnostic biopsy in patients >18 months posttransplant with estimated GFR (eGFR ≥30 mL/min. The primary objective was to describe renal function at 18 months post-transplant in patients with or without SB at month 12. Globally, most recipients in both cohorts were at low immunological risk (<10% of patients with PRA ≥30%. The immunosuppressive regimen remained unchanged following more than half of SB that exhibited chronic lesions (18/33, 54.5%. Mean (SD eGFR at month 18 (primary endpoint was 56 (19 mL/min/1.73 m² with SB and 54 (15 mL/min/1.73 m² with NSB (=0.48. In the SB group, slight nonspecific changes were observed in 51 cases, rejection (acute or chronic in 6 cases, CNI-related toxicity in 15 cases, recurrence of initial disease in two cases, and interstitial fibrosis/tubular atrophy (IF/TA in 83 cases (71.6%, of which 35 cases (30.2% were grade II/III lesions. eGFR <50 mL/min/1.73 m² at month 6 predicted IF/TA grade II or III (OR 3.85, 95% CI 1.64, 9.05, <0.002. SB at 12 months posttransplant did not prompt significant modification of immunosuppression, and no renal benefit was observed.

  10. CT imaging of mass-like renal lesions in children

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    Lee, Edward Y. [Children' s Hospital Boston, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2007-09-15

    Mass-like renal lesions in children occur in a diverse spectrum of conditions including benign and malignant neoplasm, infection, infarction, lymphatic malformation, and traumatic injury. Although mass-like renal lesions can sometimes be suspected on plain radiographs and evaluated with US in children, subsequent CT is usually performed for the confirmation of diagnosis and further characterization. The purpose of this pictorial essay was to review the CT imaging findings of both common and uncommon mass-like renal lesions in pediatric patients. Understanding the characteristic CT appearance of mass-like renal lesions in children enables an accurate diagnosis and optimizes patient management. (orig.)

  11. Incidental solid renal mass in a cadaveric donor kidney

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    R M Meyyappan

    2012-01-01

    Full Text Available The number of patients living with end-stage renal disease (ESRD is increasing in our country and demand for renal grafts is ever increasing. Cadaver renal transplantation is being established as a viable supplement to live transplantation. We present a case where a mass lesion was encountered in the donor kidney from a cadaver. Enucleation of the lesion was done and we proceeded with the grafting. Histopathological examination showed a ′Renomedullary interstitial cell tumour′, a rare benign lesion. Post transplant, the renal function recovered well and the patient is asymptomatic. Such incidental renal masses present an ethical dilemma to the operating surgeon.

  12. Biopsy-proven renal involvement and prognosis in 13 hispanic patients with primary Sjögren syndrome.

    Science.gov (United States)

    Carrillo-Pérez, Diego Luis; Tejeda-Maldonado, Javier; Garza-García, Carlos; Soto-Abraham, Virgilia; Hernández-Molina, Gabriela; Molina-Paredes, Giovanni Arnoldo; Uribe-Uribe, Norma O; Morales-Buenrostro, Luis E

    2017-08-29

    The aim of this study was to describe a case series of 13 Hispanic patients with primary Sjögren syndrome (pSS) and biopsy-proven renal involvement. We describe the clinical, serological and histological characteristics as well as the prognosis in a group of patients with pSS and biopsy-proven renal involvement, treated in 2 referral nephrology units in Mexico City. Thirteen patients with pSS underwent kidney biopsy (KB) over a period of 27 years. The median duration from pSS diagnosis to KB was 13.9 months. Seven patients (54%) had glomerulonephritis and 6 patients (46%) had tubulointerstitial nephritis. All patients were treated with corticosteroids and/or immunosuppressants. Eight patients (62%) remained stable or their renal function improved after a median follow-up of 12 months. This case series reflects the broad spectrum of renal involvement in pSS. We observed that in our Hispanic population, glomerular involvement was the most frequent abnormality, mainly membranous glomerulopathy, followed by tubulointerstitial disease. Tubular atrophy and interstitial fibrosis were also common biopsy findings. Treatment with corticosteroids or other immunosuppressive agents appear to slow renal disease progression. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. Transvaginal Ultrasound-Guided Biopsy of Deep Pelvic Masses: How We Do It.

    Science.gov (United States)

    Plett, Sara K; Poder, Liina; Brooks, Rebecca A; Morgan, Tara A

    2016-06-01

    The purpose of this review is to discuss the rationale and indications for transvaginal ultrasound-guided biopsy. Transvaginal ultrasound-guided biopsy can be a helpful tool for diagnosis and treatment planning in the evaluation of pelvic masses, particularly when the anatomy precludes a transabdominal or posterior transgluteal percutaneous biopsy approach. A step-by-step summary of the technique with preprocedure and postprocedure considerations is included. © 2016 by the American Institute of Ultrasound in Medicine.

  14. High-Intensity Focused Ultrasound in Small Renal Masses

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    Jose Rubio Briones

    2008-01-01

    Therapeutic results are controversial and from an clinical view, HIFU must be considered a technique under investigation at present time. Further research is needed to settle its real indications in the management of small renal masses; maybe technical improvements will certainly facilitate its use in the management of small renal masses in the near future.

  15. Influential factors and effect evaluation of the intra-operative puncture biopsy for pancreatic masses

    Institute of Scientific and Technical Information of China (English)

    ZHUANG Yan; YANG Yin-mo; WANG Wei-min; GAO Hong-qiao; WAN Yuan-lian

    2012-01-01

    Background It is a challenge for the surgeons to accurately diagnose the pancreatic masses preoperatively,which decides the choice of surgical managements and subsequently results in different survivor outcomes,operative complications,and mortality rates.The purposes of this study were to evaluate the diagnostic role that intra-operative puncture biopsy may play in pancreatic masses and to explore the relevant factors influencing the diagnosis.Methods A retrospective study was performed on 94 in-patients admitted to Peking University First Hospital for pancreatic masses during the period from June 1994 to December 2007.They all underwent intra-operative puncture biopsy during exploratory laparotomy.The sensitivity and specificity of intra-operative puncture biopsy were calculated and the relevant factors to the diagnosis of biopsy were selected for the statistical analysis.Results The overall sensitivity,specificity,positive predictive value,and negative predictive value of intra-operative puncture biopsy were 76.0%,94.7%,98.3% and 50.0%,respectively.The analysis of bivariate correlations showed that the size of the pancreatic masses (P=-0.000),the number of puncture biopsies (P=0.000),and the presence of pancreatic fibrosis (P=-0.012) had statistic significance for the diagnosis.But the multivariate analysis identified the size of the pancreatic masses (P=0.004) and the number of puncture biopsies (P=0.000) as independent predictive factors for intra-operative puncture biopsy.In addition,as the number of puncture biopsies increased,the sensitivity and specificity of diagnosis was improved (P=0.000).The sensitivity and specificity of intra-operative puncture biopsy were found to be lower for the pancreatic masses less than 25 mm compared with the masses larger than 25 mm (P=0.000).It was noted,however,that even if the masses were less than 25 mm,the sensitivity and specificity could be improved significantly as the number of puncture biopsies reached 3 to 6

  16. Capillary Deposition of Complement C4d and C3d in Chinese Renal Allograft Biopsies

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    Rong Lv

    2015-01-01

    Full Text Available Background. C3d is a product of both the classic and the alternative complement cascades; however, few studies have addressed the role of C3d in renal biopsies and its relationship with long-term graft survival rate is not very clear. Methods. 94 patients with biopsy-proven acute rejection episodes were included in the study. We investigated the associations between histological findings, clinical examinations, and outcome. Results. The overall prevalence for C4dPTC and C3dPTC was 42.6% and 29.8%. There was a significant association between C3dPTC and C4dPTC (P<0.001. C3dPTC and C4dPTC were related with histological types (P=0.024 and P<0.001, resp.. The long-term survival rate for C4dPTC positive transplants was lower than that of C4dPTC negative transplants, but it was not statistic significant in our study (P=0.150. The survival rate of C3dPTC positive group was much lower than the negative group (P=0.014. Patients with double positives for C4dPTC and C3dPTC exhibited the lowest survival rate significantly different from those of the C3dPTC only and C4dPTC only groups (P=0.01 and P=0.0037. Conclusions. This longitudinal cohort study has demonstrated that C3d deposition in the PTC was closely related to renal dysfunction and pathological changes.

  17. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Loffroy, R. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)], E-mail: loffroy.romaric@neuf.fr; Guiu, B.; Lambert, A. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Mousson, C.; Tanter, Y. [Department of Nephrology and Renal Transplantation (France); Martin, L. [Department of Pathology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Cercueil, J.-P.; Krause, D. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)

    2008-06-15

    Aim: To evaluate the outcomes after transcatheter embolization of percutaneous biopsy-related arteriovenous fistulas in renal allografts. Materials and methods: All post-biopsy renal-transplant vascular injuries referred for embolization between June 1999 and October 2006 were reviewed retrospectively. There were six male and six female patients with a mean age of 49.8 years (range 25-67 years); nine patients were symptomatic, three asymptomatic. Colour Doppler ultrasound (CDUS) and angiography showed one intra-renal arteriovenous fistula in 10 patients and two in two patients, combined with a pseudoaneurysm in six patients. Superselective embolization using a single catheter or coaxial microcatheter was performed with 0.035'' coils or 0.018''microcoils, respectively, in all 12 cases. 24-h creatinine clearance values before (the day of biopsy) and after (7-14 days; 3 months) the procedure were compared using the Wilcoxon signed-rank test. Physical examination and CDUS were performed after 1, 6, and 12 months, and yearly thereafter. Mean follow-up was 33.6 months. Results: Complete definitive occlusion of the fistula was achieved consistently with a single procedure. No procedure-related complications occurred. Renal infarction was minor in all patients (0-10% in nine and 10-20% in three). Symptoms resolved completely. Creatinine clearance values obtained before and after embolization were not statistically different (p = 0.168;.889 respectively). No late recurrences were reported. Conclusion: Transcatheter embolization with coaxial or single-catheter techniques was effective and safe for treating post-biopsy arteriovenous fistulas in renal transplants. The loss of renal parenchyma was minimal and no mid-term deterioration of allograft function was noted. The long-term survival of the renal allograft seemed to be not affected by embolization.

  18. Prognostic utility of preimplantation kidney biopsy from deceased older donors in first year post-transplant renal function.

    Science.gov (United States)

    Amenábar, Juan J; Camacho, Jhon A; Gómez-Larrambe, Nerea; Visus, Teresa; Pijoan, José I; González del Tánago, Jaime; Zárraga, Sofía; García-Olaverri, Jorge; Gaínza, Francisco J

    2016-01-01

    Preimplantation renal biopsy provides potentially valuable information about post-transplant renal function. To assess the prognostic value of preimplantation kidney biopsy from older donors in determining 1-year post-transplant estimated glomerular filtration rate MDRD-4 (eGFR). We evaluated a cohort of 124 renal transplant recipients from deceased donors ≥60 years old, performed at our center between March 2008 and May 2012. Biopsies were assessed by applying the score proposed by O'Valle et al. The overall score was stratified into 3 levels: 0-3, 4-5 and 6-8 points. Kidneys scoring > 8 points were discarded. A total of 77% of the donors were ≥70 years. One year post-transplant, mean eGFR (SD) was lower in transplant recipients with 6-8 points (38.5 [14.1] mL/min/1.73m(2)) than in the group scoring 4-5 points (46.3 [15.7] [p=0.03]) and the group scoring 0-3 (49.6 [12.5] [P=.04]). Seven patients (19%) had eGFR renal biopsy were associated with a worse 1-year post-transplant eGFR. Delayed graft function and acute rejection were significant risk factors for 1-year post-transplant low eGFR. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

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    Cunningham, Jane D., E-mail: janecunningham0708@gmail.com; McCusker, Mark W.; Power, Sarah; PearlyTi, Joanna; Thornton, John; Brennan, Paul; Lee, Michael J.; O’Hare, Alan; Looby, Seamus [Beaumont Hospital, Department of Radiology (Ireland)

    2015-04-15

    PurposeTissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.MethodsAll consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neck lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.ResultsSixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.ConclusionsThe use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.

  20. Heterogeneity and renal mass biopsy:a review of its role and reliability

    Institute of Scientific and Technical Information of China (English)

    Jeffrey JTomaszewski; Robert GUzzo; Marc CSmaldone

    2014-01-01

    Increased abdominal imaging has led to an increase in the detection of the incidental small renal mass (SRM). With increasing recognition that the malignant potential of SRMs is heterogeneous, ranging from benign (15%-20%) to aggressive (20%), enthusiasm for more conservative management strategies in the elderly and infirmed, such as active surveillance (AS), have grown considerably. As the management of the SRM evolves to incorporate ablative techniques and AS for low risk disease, the role of renal mass biopsy (RMB) to help guide individualized therapy is evolving. Historically, the role of RMB was limited to the evaluation of suspected metastatic disease, renal abscess, or lymphoma. However, in the contemporary era, the role of biopsy has grown, most notably to identify patients who harbor benign lesions and for whom treatment, particularly the elderly or frail, may be avoided. When performing a RMB to guide initial clinical decision making for small, localized tumors, the most relevant questions are otfen relegated to proof of malignancy and documentation (if possible) of grade. However, signiifcant intratumoral heterogeneity has been identiifed in clear cell renal cell carcinoma (ccRCC) that may lead to an underestimation of the genetic complexity of a tumor when single-biopsy procedures are used. Heterogeneous genomic landscapes and branched parallel evolution of ccRCCs with spatially separated subclones creates an illusion of clonal dominance when assessed by single biopsies and raises important questions regarding how tumors can be optimally sampled and whether future evolutionary tumor branches might be predictable and ultimately targetable. hTis work raises profound questions concerning the genetic landscape of cancer and how tumor heterogeneity may affect, and possibly confound, targeted diagnostic and therapeutic interventions. In this review, we discuss the current role of RMB, the implications of tumor heterogeneity on diagnostic accuracy, and

  1. STUDY ON B7-1 PROTEIN'S EXPRESSION IN BIOPSIES IN RENAL TRANSPLANTATION

    Institute of Scientific and Technical Information of China (English)

    田普训; 刘雅峰; 薛武军; 杜斌

    2002-01-01

    Objective To study the expression of B7-1 protein in biopsies in allograft renal transplantation,and explore the expression patern and the functional role of B7-1 molecule. Methods Renal allograft sample tissue by Tru-cut needle aspiration were taken from 64 paients(42 male,22 female) with renal transplantation, aging from 17 to 58 years old; 64 cases were categorized into six groups: ①acute rejection (AR n=22);②accelerated rejection (AAR n=8);③chronic rejection (CR n=10 );④hyperacute rejection (HR n=4);⑤allograft with stable function (ASF n=10); ⑥health donor kidney (HDK n=10);Immunohistochemical assays(ABC) were used, and comparison B7-1 and HLA-DR expression between tubularand interstitial,the number of interstitial infiltrating lymphocytes. Results ①The sequence of the expression of B7-1 molecule in terms of intensity from the strongest to the weakest in different groups is AR group, AAR group, CR group, HR group,ASF group and HDK group; ②During acute rejection response, a large number of CD4 and CD8 T lymphocytes infiltrate kidney interstitium, accompanied by strong expression of HLA-DR in tubular cell(donor MHC-Ⅱantigen),which is the first signal necessary for T lymphocyte activation. Conclusion The results demonstrate that B7-1 expression of tubular cells as APC actively take part in immunological reactions and play an important role in expanding the immunological reactions.

  2. Computed tomography-guided percutaneous biopsy of pancreatic masses using pneumodissection

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    Chiang Jeng Tyng

    2013-06-01

    Full Text Available Objective To describe the technique of computed tomography-guided percutaneous biopsy of pancreatic tumors with pneumodissection. Materials and Methods In the period from June 2011 to May 2012, seven computed tomography-guided percutaneous biopsies of pancreatic tumors utilizing pneumodissection were performed in the authors' institution. All the procedures were performed with an automatic biopsy gun and coaxial system with Tru-core needles. The biopsy specimens were histologically assessed. Results In all the cases the pancreatic mass could not be directly approached by computed tomography without passing through major organs and structures. The injection of air allowed the displacement of adjacent structures and creation of a safe coaxial needle pathway toward the lesion. Biopsy was successfully performed in all the cases, yielding appropriate specimens for pathological analysis. Conclusion Pneumodissection is a safe, inexpensive and technically easy approach to perform percutaneous biopsy in selected cases where direct access to the pancreatic tumor is not feasible.

  3. Pathologic findings of renal biopsy were a helpful diagnostic clue of stenosis of the iliac segment proximal to the transplant renal artery: a case report.

    Science.gov (United States)

    Aoyama, H; Saigo, K; Hasegawa, M; Akutsu, N; Maruyama, M; Otsuki, K; Matsumoto, I; Kawaguchi, T; Kitamura, H; Asano, T; Kenmochi, T; Itou, T; Matsubara, H

    2014-01-01

    Common iliac artery stenosis after renal transplantation is a rare complication; it can occur in the course of hypertension and renal dysfunction. We report a case of suspected renal allograft rejection with iliac artery stenosis proximal to a transplanted kidney. A 52-year-old man with a history of cadaveric kidney transplantation 26 years previously underwent a second cadaveric kidney transplantation in the left iliac fossa because of graft failure 3 years before. In June 2012, the patient had progressive renal dysfunction. In July, a percutaneous needle biopsy was taken, and it showed no rejection; however, his renal function continued to get worse through September. A percutaneous allograft renal biopsy was performed under ultrasound guidance and showed hyperplasia of the juxtaglomerular apparatus and renin granules. Magnetic resonance angiography was used to evaluate the arteries in the pelvis and showed left common iliac artery stenosis, and a stent was placed. After percutaneous intervention, the patient's ankle brachial pressure index was within the normal range and the allograft function had improved.

  4. Japan Renal Biopsy Registry and Japan Kidney Disease Registry: Committee Report for 2009 and 2010.

    Science.gov (United States)

    Sugiyama, Hitoshi; Yokoyama, Hitoshi; Sato, Hiroshi; Saito, Takao; Kohda, Yukimasa; Nishi, Shinichi; Tsuruya, Kazuhiko; Kiyomoto, Hideyasu; Iida, Hiroyuki; Sasaki, Tamaki; Higuchi, Makoto; Hattori, Motoshi; Oka, Kazumasa; Kagami, Shoji; Kawamura, Tetsuya; Takeda, Tetsuro; Hataya, Hiroshi; Fukasawa, Yuichiro; Fukatsu, Atsushi; Morozumi, Kunio; Yoshikawa, Norishige; Shimizu, Akira; Kitamura, Hiroshi; Yuzawa, Yukio; Matsuo, Seiichi; Kiyohara, Yutaka; Joh, Kensuke; Nagata, Michio; Taguchi, Takashi; Makino, Hirofumi

    2013-04-01

    The Japan Renal Biopsy Registry (J-RBR) was started in 2007 and the Japan Kidney Disease Registry (J-KDR) was then started in 2009 by the Committee for Standardization of Renal Pathological Diagnosis and the Committee for the Kidney Disease Registry of the Japanese Society of Nephrology. The purpose of this report is to describe and summarize the registered data from 2009 and 2010. For the J-KDR, data were collected from 4,016 cases, including 3,336 (83.1 %) by the J-RBR and 680 (16.9 %) other cases from 59 centers in 2009, and from 4,681 cases including 4,106 J-RBR cases (87.7 %) and 575 other cases (12.3 %) from 94 centers in 2010, including the affiliate hospitals. In the J-RBR, 3,165 native kidneys (94.9 %) and 171 renal grafts (5.1 %) and 3,869 native kidneys (94.2 %) and 237 renal grafts (5.8 %) were registered in 2009 and 2010, respectively. Patients younger than 20 years of age comprised 12.1 % of the registered cases, and those 65 years and over comprised 24.5 % of the cases with native kidneys in 2009 and 2010. The most common clinical diagnosis was chronic nephritic syndrome (55.4 % and 50.0 % in 2009 and 2010, respectively), followed by nephrotic syndrome (22.4 % and 27.0 %); the most frequent pathological diagnosis as classified by the pathogenesis was IgA nephropathy (31.6 % and 30.4 %), followed by primary glomerular diseases (except IgA nephropathy) (27.2 % and 28.1 %). Among the primary glomerular diseases (except IgA nephropathy) in the patients with nephrotic syndrome, membranous nephropathy was the most common histopathology in 2009 (40.3 %) and minor glomerular abnormalities (50.0 %) were the most common in 2010 in native kidneys in the J-RBR. Five new secondary and longitudinal research studies by the J-KDR were started in 2009 and one was started in 2010.

  5. Cryoablation of small peripheral renal masses: a retrospective analysis.

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    Schwartz, Bradley F; Rewcastle, John C; Powell, Timothy; Whelan, Christopher; Manny, Ted; Vestal, J Clifton

    2006-07-01

    Renal cryoablation is a minimally invasive, nephron-sparing option that has shown promise in the treatment of patients with solitary small renal lesions suspicious for malignancy. Few large clinical studies have used this promising technology, although intermediate-term data are encouraging. We present a retrospective review and report the outcomes of a large cohort of patients who underwent renal cryotherapy. Patients who were candidates for partial nephrectomy with peripheral lesions chart review was performed only in cases of missing data. From February 2001 to March 2005, 85 consecutive patients with an average age of 67 years and a mean tumor size of 2.6 cm (range, 1.2-4.7 cm; median, 2.5 cm), underwent renal cryoablation; 70 procedures were performed laparoscopically. Mean estimated blood loss was 58 mL, with 2 patients requiring transfusion. Mean hospital stay was 3.0 days (range, 0-14 days; median, 2 days) for the entire cohort and 2.2 days (range, 0-7 days; median, 2 days) for the laparoscopic group. A total of 7 laparoscopic cases were converted to an open approach early in the experience, 2 of which were considered technical failures. Mean follow-up was 10 months (range, 3-36 months). Abnormal postoperative enhancement occurred in 2 patients at 3 months and 12 months. Radical nephrectomy in the first revealed no viable tumor; needle biopsy in the second revealed renal cell carcinoma, which prompted nephrectomy. Intraoperative needle biopsy yielded a 59% malignancy rate. We conclude that renal cryotherapy is a viable option for nephron-sparing surgery in small, peripheral renal lesions. The procedure is well tolerated, may be considered in patients who are not good candidates for open surgical approaches, results in minimal morbidity, and has shown encouraging treatment results. Close posttreatment surveillance is essential. Longer-term follow-up data will be necessary if the long-term durability of renal cryotherapy is to be established.

  6. Cryo-preserved porcine kidneys are feasible for teaching and training renal biopsy: “the bento kidney”

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    Konno Kenjiro

    2012-05-01

    Full Text Available Abstract Background The use of patients as the primary teaching modality for learning procedures is being questioned. While there have been advancements in the technology used for performing needle biopsies in both native and transplanted kidneys, there has been little advancement in teaching and training tools. We have developed a portable ex-vivo kidney, the Bento Kidney, using cryo-preserved porcine kidneys for teaching this procedure. Methods The kidney is thawed, perfused by a pump, covered with skin for realistic haptic feedback, and then used with existing biopsy technology to teach the technique. Results Thirty porcine kidneys were used in this pilot research, and nine were shipped to physicians at a distant facility. Renal biopsy was then performed using a core biopsy needle and ultrasound guidance. There was some leakage of fluid from all kidneys noted. All trainees felt that the model was realistic, and judged at a mean score of 8.7 (SD 0.8 on a scale of 1 (not useful to 10 (very useful. Conclusions This feasibility study demonstrates that cryo-preserved porcine kidneys can be successfully used to teach and train renal biopsy techniques, and provides haptic feedback as well as realistic real-time ultrasound images. Further large scale studies are needed to demonstrate value from the educational point of view for nephrology and transplantation.

  7. A modified triple test for palpable breast masses: the value of ultrasound and core needle biopsy.

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    Wai, Christina J; Al-Mubarak, Ghada; Homer, Marc J; Goldkamp, Allison; Samenfeld-Specht, Marja; Lee, Yoojin; Logvinenko, Tanya; Rothschild, Janice G; Graham, Roger A

    2013-03-01

    The original triple test score (TTS)--clinical examination, mammogram, and fine-needle aspiration (FNA) biopsy--has long been used to evaluate palpable breast masses. We modified the original TTS to include ultrasound (US) and core biopsy to determine their role in evaluating palpable breast masses. A retrospective chart review of 320 female patients was performed. We developed a modified triple test score (mTTS) that included physical examination, mammogram and/or US, and FNA and/or core biopsy. For the examination and imaging score, 1-3 points were given for low, moderate, or high suspicion. Biopsy scores were characterized as benign, atypical, or malignant. Final outcome was determined by open biopsy or follow-up greater than 1 year. Physical examination was 92% accurate (95% confidence interval [CI] 0.89-0.96, p core biopsy changed the scores of 24 patients; only three changed clinical management. For patients with a palpable breast mass and a mTTS score of 3-4, no further assessment is necessary. Those with a mTTS of 8-9 can proceed to definitive therapy. Patients with a mTTS of 5-7 require further assessment. US and/or core biopsy added little to the accuracy or predictive value of the original TTS.

  8. Long-term renal outcomes in a cohort of 1814 Chinese patients with biopsy-proven lupus nephritis.

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    Yang, J; Liang, D; Zhang, H; Liu, Z; Le, W; Zhou, M; Hu, W; Zeng, C; Liu, Z

    2015-12-01

    In the present study, we observed the renal outcomes in a cohort of 1814 Chinese patients with biopsy-proven lupus nephritis (LN) and evaluated the risk factors associated with poor renal prognosis. The 5 -, 10 -, 15 - and 20-year renal survival rates were 93.1%, 87.9%, 81.0% and 68.3%, respectively. Gender, LN duration, mean arterial pressure (MAP), proteinuria, serum creatinine, haemoglobin and pathological classification at the time of biopsy were independent risk factors for end-stage renal disease (ESRD). The long-term renal outcomes of patients with class II LN were unfavorable as opposed to those with class V. Additionally, the time-average proteinuria (TA-Pro) and the time-average mean arterial pressure (TA-MAP) during the follow-up were important risk factors for ESRD, with better predictive values than the baseline proteinuria and MAP. The results underscore the need for proteinuria and blood pressure control during follow-up in patients with LN; proteinuria levels should be controlled at least to < 1.0 g/24 h, and optimally to < 0.5 g/24 h; MAP should not exceed 96.5 mmHg. More attention should be paid to class II LN and emphasis should be placed on recurrence prevention of class II LN.

  9. Analysis of Pathological data of renal biopsy at one single center in China from 1987 to 2012

    Institute of Scientific and Technical Information of China (English)

    Zhang Xueguang; Liu Shuwen; Tang Li; Wu Jie; Chen Pu; Yin Zhong; Li Minxia

    2014-01-01

    Background In China,the prevalence of chronic kidney disease has increased significantly.Many studies shows that the spectrum of kidney disease had changed in recent years.We retrospectively analyzed the pathological types of renal biopsy and its spectrum change at the General Hospital of the Chinese People's Liberation Army from December 1987 to December 2012,in order to offer new supporting evidences for further specifying the distribution of renal pathological types in China.Methods According to the "Revised Protocol for the Histological Typing of Glomerulopathy" (WHO,1995),pathological diagnosis of renal biopsy was classified,detection rate of each pathological type was summarized (i.e.,percentage of total renal biopsy cases),study period was divided at an interval of 5 years,and age-stratified distribution change of main pathological types was analyzed.Results The proportion of pathological types in 11 618 cases of renal biopsy was as follows:primary glomerulonephritis (PGN,70.7%),secondary glomerulonephritis (SGN,20.7%),tubular-interstitial nephropathy (4.0%),hereditary/rare nephropathy (0.3%),end-stage renal disease (0.9%),and unclassified renal disease (3.3%).Among PGN,there was IgA nephropathy (IgAN,37.0%),membranous nephropathy (MN,11.8%),mesangial proliferative glomerulonephritis (MsPGN,8.9%),minimal change disease (MCD,6.6%),and focal segmental glomerulosclerosis (3.9%).Among SGN there was lupus nephritis (LN,5.5%),Henoch-Sch(o)nlein purpura glomerulonephritis (5.3%),hepatitis B virus-associated nephritis (HBVAN,3.03%),diabetic nephropathy (2.2%),and hypertension/malignant hypertension-associated renal damage (1.9%).Pathological data were analyzed from 1987-1992 to 2008-2012 (after age adjustment).Detection rate of IgAN tended to rise (P <0.001).Detection rates of MN and MCD rose significantly (P <0.001),but detection rate of MsPGN dropped significantly (P <0.001).Among SGN,detection rate of HBVAN tended to drop (P

  10. Analysis of pathological data of renal biopsy at one single center in China from 1987 to 2012.

    Science.gov (United States)

    Zhang, Xueguang; Liu, Shuwen; Tang, Li; Wu, Jie; Chen, Pu; Yin, Zhong; Li, Minxia; Xie, Yuansheng; Cai, Guangyan; Wei, Ribao; Qiu, Qiang; Wang, Yuanda; Shi, Suozhu; Chen, Xiangmei

    2014-01-01

    In China, the prevalence of chronic kidney disease has increased significantly. Many studies shows that the spectrum of kidney disease had changed in recent years. We retrospectively analyzed the pathological types of renal biopsy and its spectrum change at the General Hospital of the Chinese People's Liberation Army from December 1987 to December 2012, in order to offer new supporting evidences for further specifying the distribution of renal pathological types in China. According to the "Revised Protocol for the Histological Typing of Glomerulopathy" (WHO, 1995), pathological diagnosis of renal biopsy was classified, detection rate of each pathological type was summarized (i.e., percentage of total renal biopsy cases), study period was divided at an interval of 5 years, and age-stratified distribution change of main pathological types was analyzed. The proportion of pathological types in 11 618 cases of renal biopsy was as follows: primary glomerulonephritis (PGN, 70.7%), secondary glomerulonephritis (SGN, 20.7%), tubular-interstitial nephropathy (4.0%), hereditary/rare nephropathy (0.3%), end-stage renal disease (0.9%), and unclassified renal disease (3.3%). Among PGN, there was IgA nephropathy (IgAN, 37.0%), membranous nephropathy (MN, 11.8%), mesangial proliferative glomerulonephritis (MsPGN, 8.9%), minimal change disease (MCD, 6.6%), and focal segmental glomerulosclerosis (3.9%). Among SGN there was lupus nephritis (LN, 5.5%), Henoch-Schönlein purpura glomerulonephritis (5.3%), hepatitis B virus-associated nephritis (HBVAN, 3.03%), diabetic nephropathy (2.2%), and hypertension/malignant hypertension-associated renal damage (1.9%). Pathological data were analyzed from 1987-1992 to 2008-2012 (after age adjustment). Detection rate of IgAN tended to rise (P < 0.001). Detection rates of MN and MCD rose significantly (P < 0.001), but detection rate of MsPGN dropped significantly (P < 0.001). Among SGN, detection rate of HBVAN tended to drop (P < 0.001). In China

  11. Immuno-histochemistry analysis of Helicobacter pylori antigen in renal biopsy specimens from patients with glomerulonephritis

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    Qian Li

    2013-01-01

    Full Text Available This study was conducted to investigate the relationship between Helicobacter pylori infection and three varieties of glomerulonephritis. Renal biopsy specimens from patients with Henoch Schonlein Purpura nephritis (HSPN; n = 10, membranous nephropathy (MN; n = 9 and lupus nephritis (LN; n = 27 were studied using immuno-histochemical labeling to clarify the etiological significance of H. pylori antigen in this disease. Immuno-histochemical labeling was performed using a mixture of anti-H. pylori-antibody-positive serum from nine volunteers; a mixture of anti-H. pylori-antibody-negative serum from nine volunteers was used as control. Staphylococci protein-A labeled by horseradish peroxidase was used as the second antibody in this study. A total of 34 of the 48 specimens revealed positive reaction with the anti-H. pylori-positive serum and five of the 48 specimens revealed positive reaction with the anti-H. pylori-negative serum. Positive reaction against anti-H. pylori-positive serum was seen in 10/10 patients with HSPN, six of nine patients with MN and 18/27 patients with LN. Statistical analysis showed that the difference of the positive reaction between anti-H. pylori-positive and negative sera was significant (χ 2 = 36.318, P = 0.000. Our study indicates that H. pylori infection may be associated with the development and/or progression of HSPN, MN and LN.

  12. Ischemia-induced glomerular parietal epithelial cells hyperplasia: Commonly misdiagnosed cellular crescent in renal biopsy.

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    Zeng, Yeting; Wang, Xinrui; Xie, Feilai; Zheng, Zhiyong

    2017-08-01

    Ischemic pseudo-cellular crescent (IPCC) that is induced by ischemia and composed of hyperplastic glomerular parietal epithelial cells resembles cellular crescent. In this study, we aimed to assess the clinical and pathological features of IPCC in renal biopsy to avoid over-diagnosis and to determine the diagnostic basis. 4 IPCC cases diagnosed over a 4-year period (2012-2015) were evaluated for the study. Meanwhile, 5 cases of ANCA-associated glomerulonephritis and 5 cases of lupus nephritis (LN) were selected as control. Appropriate clinical data, morphology, and immunohistochemical features of all cases were retrieved. Results showed that the basement membrane of glomerulus with IPCC appeared as a concentric twisted ball, and glomerular cells of the lesion were reduced even entirely absent, and the adjacent afferent arterioles showed sclerosis or luminal stenosis. Furthermore, immune globulin deposition, vasculitis, and fibrinous exudate have not been observed in IPCC. While the cellular crescents showed diverse characteristics in both morphology and immunostaining in the control group. Therefore, these results indicated that IPCC is a sort of ischemic reactive hyperplasia and associated with sclerosis, stenosis, or obstruction of adjacent afferent arterioles, which is clearly different from cellular crescents result from glomerulonephritis. Copyright © 2017 Elsevier GmbH. All rights reserved.

  13. Quantitative and semi-quantitative histopathological examination of renal biopsies in healthy individuals, and associations with kidney function.

    Science.gov (United States)

    Bar, Yael; Barregard, Lars; Sallsten, Gerd; Wallin, Maria; Mölne, Johan

    2016-05-01

    This study assesed the prevalence of histopathological changes in renal biopsies from healthy individuals, and the association with age, sex and smoking. Donor biopsies from 109 subjects were obtained from living kidney donors, and blood and urine samples were collected together with medical history. All biopsies were scored according to the Banff '97 classification with some modifications. The parameters included in this study were tubular atrophy, interstitial fibrosis, glomerulosclerosis, arteriosclerosis, arteriolohyalinosis and a sclerosis score. An alternative scoring system for tubular atrophy was examined (using ≤5% rather than kidney donors around 50 years of age with normal kidney function. We propose that a cut-off of ≤5% yields a better definition of grade 0 tubular atrophy compared with the established cut-off of >0%.

  14. A prospective audit of complications in 100 consecutive pediatric percutaneous renal biopsies done under real-time ultrasound guidance

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    Sinha, R.; Maji, B.; Sarkar, B.; Meur, S.

    2016-01-01

    Despite being a common procedure, percutaneous renal biopsy (PRB) carries the potential for complications. The British Association of Paediatric Nephrologist (BAPN) has published standards for pediatric PRB. As Indian data are scarce, we conducted a prospective audit of 100 consecutive pediatric renal biopsies (60% males) under real-time ultrasound guidance. Nephrotic syndrome was the most common indication for PRB (68%) with minimal change disease (30%) and focal segmental glomerulosclerosis (25%) being the most common histopathological lesions. Gross hematuria was observed in six cases. Major complications was noted in one case, who needed longer hospital stay. The result of the audit demonstrated achievability of BAPN standards. In addition, we also show the usefulness of 16 gauge biopsy needle over 18 gauge biopsy needles (median number of glomeruli 25, range 3–90 vs 13, range 6–46, P = 0.001) without any increase in complications. Being a single center study, we do hope that our results will encourage a wider survey on the current state of pediatric PRB. PMID:27795625

  15. Clinical and Renal Biopsy Findings Predicting Outcome in Renal Thrombotic Microangiopathy: A Large Cohort Study from a Single Institute in China

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    Xiao-Juan YU

    2014-01-01

    Full Text Available Objective. The current study aimed to investigate the spectrum of etiologies and associated disorders of renal biopsy-proven thrombotic microangiopathy (TMA patients. Methods. The clinical, laboratory, and renal histopathological data of patients with renal TMA from 2000 to 2012 in our institute were collected and reviewed. Results. One hundred and nine TMA patients were enrolled in this study. The mean age was 34.0 ± 11.1 years. Seventy patients (64.2% were male and thirty-nine patients (35.8% were female. There were eight patients (7.3% with hemolytic uremic syndrome (HUS. Sixty-one patients (56.0% were secondary to malignant hypertension. Fourteen patients (12.8% were pregnancy-associated TMA. Other associated disorders included 17 patients with connective tissue disorders, 2 patients with hematopoietic stem cell transplantation, 4 patients with Castleman’s disease, 1 patient with cryoglobulinemia, and 2 patients with glomerulopathy. During followup, 8 patients died due to severe infection, 17 patients had doubling of serum creatinine, and 44 had end-stage renal disease. In multivariate analysis, male, elevated serum creatinine, and decreased hemoglobin were independently associated with poor renal outcomes. Conclusions. Renal TMA changes consisted of different disorders with various etiologies. aHUS, pregnancy-associated TMA, and malignant hypertension accounted for the majority of patients in our cohort.

  16. A Prospective Study of Renal Biopsies Performed Over One-year at the Riyadh Armed Forces Hospital

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    Mousa D

    2000-01-01

    Full Text Available A prospective study of all native kidney biopsies performed over one year at the Riyadh Armed Forces Hospital, Riyadh, Saudi Arabia was conducted. During this period, 52 kidney biopsies were performed of which, 49 had adequate tissue. All biopsies were processed for light microscopy, immunofluorescence and electron microscopy. The indications for biopsy included the nephrotic syndrome (n=28; 53.8%, asymptomatic proteinuria (n=12; 21.2%, acute nephritic presentation (n=7; 13.5% and asymptomatic hematuria (n=7; 13.5%. Primary glomerulonephritis (GN, excluding IgA nephropathy (IgAN was seen in 34 of the 49 patients (77.6%. Focal and segmental glomerulosclerosis and mesangial proliferative GN were the most common histological diagnoses (31% and 20.4% respectively. Surprisingly, we found a high prevalence of IgA nephropathy (IgAN of 14.5% in comparison with other studies. The prevalence of mesangiocapillary glomerulonephritis (MCGN was low (2% and can only be explained as incidental. The study patients were followed-up for an average of 26.3 weeks. At the end of the observation period, 50% has unchanged course, 37.5% had improved their renal function and protein excretion, and 12.5% had deteriorated. The prognosis of different GN groups and renal survival rate cannot be assessed or calculated in this study because of the relatively short duration of follow-up. Our study further emphasizes the need for a national GN registry and long-term follow-up, in order to recognize the common patterns of GN, their natural histories, the appropriate line of management, and to try and arrest their progression to end-stage renal disease.

  17. The Value of a Panel of Autoantibodies for Predicting the Activity of Lupus Nephritis at Time of Renal Biopsy

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    Gabriella Moroni

    2015-01-01

    Full Text Available Few studies have correlated serum biomarkers with renal histology, the gold standard for renal activity, in lupus nephritis (LN. We tested a panel of autoantibodies and complement at the time of kidney biopsy and after treatment. Anti-dsDNA, anti-nucleosome, anti-ribosome P, and anti-C1q antibodies and C3/C4 were measured in 107 patients with LN at the time of renal biopsy and after 6–12 months and were correlated with clinical/histological parameters. At multivariate analysis, high titers of anti-C1q antibodies or of anti-dsDNA antibodies (P=0.005, OR = 8.67, CI: 2.03–37.3 were the independent predictors that discriminate proliferative from nonproliferative LN. All the immunological parameters, except anti-ribosome, showed a significant correlation with activity index but not with chronicity index. Only anti-C1q showed a significant correlation with the amount of proteinuria (R=0.2, P=0.03. None of the immunological parameters were predictive of remission at 6 and 12 months. We found that anti-C1q alone or in combination with anti-dsDNA emerged as the most reliable test in differentiating proliferative and nonproliferative LN. Anti-C1q was the only test correlated with the clinical presentation of LN. After treatment, the titre of the autoantibodies was significantly reduced, but none was predictive of remission.

  18. Increased risk of renal biopsy complications in patients with IgA-nephritis.

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    Peters, Björn; Stegmayr, Bernd; Andersson, Yvonne; Hadimeri, Henrik; Mölne, Johan

    2015-12-01

    The aim of this study was to investigate if specific clinical and histological findings can be related to biopsy complications to enable more closely monitoring patients at high risk. Results from 1081 biopsies (994 patients, median age 54.5 years; 896 native and 185 transplant kidney biopsies) were included. Diagnostic quality, morphology, clinical data and complications were prospectively registered. In native kidney biopsies, the most common diagnosis was IgA-nephritis, while in transplant kidney biopsies it was rejection. Patients with IgA-nephritis had a higher risk of major complications (11.7 versus 6.4 %, Odds Ratio (OR) 1.8, Confidence Interval (CI) 1.1-3.2) when compared to patients with other diseases. In native kidney biopsies, patients who experienced major complications had higher degrees of glomerulosclerosis (31 versus 20 %, p = 0.008), whereas in transplant kidney biopsies, patients had higher degrees of interstitial fibrosis (82 versus 33 %, p IgA-nephritis-patients had a higher risk of re-biopsies (4.7 versus 1.3 %, OR 4, CI 1.5-11) than patients with other diseases. Patients with native kidneys who needed re-biopsies were younger (42.6 versus 52.3 years, p = 0.031) and had a higher degree of interstitial fibrosis (63 versus 34 %, p = 0.046). Patients with IgA-nephritis have an increased risk of major biopsy complications. The risk of re-biopsies was higher in younger individuals and in patients with IgA-nephritis.

  19. Interpreting CD56+ and CD163+ infiltrates in early versus late renal transplant biopsies.

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    Shin, Sung; Kim, Young Hoon; Cho, Yong Mee; Park, Yangsoon; Han, Seungbong; Choi, Byung Hyun; Choi, Ji Yoon; Han, Duck Jong

    2015-01-01

    CD56+ and CD163+ cell infiltration in human kidney transplant biopsies have not been fully evaluated. We investigated the association of CD56+ and CD163+ cell infiltration with human kidney transplant biopsies with antibody- or T-cell-mediated rejection (TCMR) and other histologic lesions. One hundred and seventy four clinically indicated transplant biopsies were included in this analysis. Immunohistochemical staining for C4d, CD56 and CD163 was performed. One hundred and seventy four indication biopsies were divided into early (≤1 year posttransplant; n = 49) and late (>1 year posttransplant; n = 125) biopsies. High numbers of CD56+ cells were uncommon in early biopsies except for those with antibody-mediated rejection (AMR) only. On the other hand, high numbers of CD56+ cells were observed in late biopsies diagnosed as TCMR only, AMR only, and TCMR combined with AMR. In early biopsies, both CD56+ and CD163+ infiltrates correlated strongly with interstitial inflammation, tubulitis, and peritubular capillaritis (ptc) scores. The ci and ct scores, however, were correlated only with the number of CD56+ cells. In late biopsies, on the other hand, the number of CD56+ infiltrates was correlated only with ptc, while the number of CD163+ infiltrates was weakly correlated with any histologic lesion. Multivariable analyses showed that chronic active AMR and the number of CD56+ cells/10 HPF were independently associated with death-censored graft failure post-biopsy. The number of CD163+ cells was not correlated with any pathologic lesion and post-biopsy graft failure. CD56+ infiltrates were also associated with interstitial fibrosis and tubular atrophy. Intragraft CD56+ cell infiltrates were significantly associated with AMR and subsequent poor clinical outcomes. © 2015 S. Karger AG, Basel.

  20. Retroperitoneal and transperitoneal laparoscopic cryotherapy for small renal masses.

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    Domínguez, A; Bellido, J A; Muñoz-Rodríguez, J; Abascal-Junquera, J M; Hannaoui, N; Banús, J M

    2015-11-01

    Cryotherapy is a minimally invasive ablative technique that is considered an alternative to conventional surgery for preserving renal function in small renal tumors and in selected cases. We present our results from laparoscopic renal cryotherapy. We retrospectively analyzed 17 renal tumors diagnosed in 16 patients treated with cryotherapy. The patients' mean age was 66 years (43-80). The mean tumor size was 1.8cm (0.7-3.7cm). Cryotherapy with double-freeze cycle was performed laparoscopically in all cases (10 by transperitoneal approach and 7 by retroperitoneal approach). Perioperative biopsies were performed on all patients and were positive for malignancy in 10 cases (59%). The mean stay was 2.8 days. The mean operative time was 162 minutes. Only 1 case reverted to open surgery due to bleeding. One patient required a blood transfusion in the immediate postoperative period. The majority of complications were Clavien-Dindo grades I and II. Some 76.5% of the patients had no complications. After a mean follow-up of 31 months (6-102), 1 patient died from nontumor-related causes, and 12 patients (75%) still show no evidence of local recurrence or progression. One patient had tumor persistence and therefore underwent partial nephrectomy at 6 months. One patient had a metachronous recurrence in the same kidney at 36 months, and another patient had a recurrence at 23 months. Laparoscopic renal cryotherapy is a safe and feasible technique and is a good alternative to surgery for selected renal tumors. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. In vitro comparison of a novel facilitated ultrasound targeting technology vs standard technique for percutaneous renal biopsy.

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    Menhadji, Ashleigh; Nguyen, Vien; Cho, Jane; Chu, Ringo; Osann, Kathyrn; Bucur, Philip; Patel, Puja; Lusch, Achim; McDougall, Elspeth; Landman, Jaime

    2013-09-01

    To improve the understanding of the epidemiology of renal cortical neoplasms through pretreatment biopsy, we evaluated a facilitated ultrasound targeting (FUT) technology. The technology allows a needle to be passed through the transducer probe and guided along a virtual dotted line on the monitor. We compared the FUT with standard percutaneous biopsy (PB) technique. Forty-eight participants with various levels of training were recruited. Participants performed ultrasound-guided biopsies on phantom models using FUT and the standard biopsy technique in a randomized sequence. The phantom models consisted of pimento olives embedded in an opaque mold of Metamucil and Knox gelatin. Patients were given up to 10 attempts to achieve 3 complete specimens from the olives. Patients rated each biopsy technique. Results were stratified by level of experience. The mean time to obtain 3 complete biopsy specimens was significantly faster for FUT compared with the standard technique (140 seconds vs 246 seconds, P = .0001). The mean number of attempts needed to obtain 3 specimens was significantly less with FUT compared with the standard technique (4.3 vs 5.6 attempts, P = .0007). Patients reported that FUT was significantly easier to use compared with the standard technique (P = .0005). No significant order effect was observed. In this in vitro comparison, FUT increased the efficiency and efficacy of PB for users of all experience levels. FUT may allow urologists with limited PB experience to perform the procedure reliably and easily. Clinical evaluation of this technology is actively in progress. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Avaliação de técnicas de biópsia renal em ovinos Evaluation of renal biopsy techniques in sheep

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    Pedro B. Néspoli

    2010-03-01

    Full Text Available Devido à escassez de trabalhos sobre biópsias renais em ovinos foi desenvolvido um estudo comparativo entre três técnicas de biópsia renal nesta espécie. Neste estudo foram utilizadas nove ovelhas (26,64 kg ±4,86 mestiças (Santa Inês em procedimentos seriados, com intervalos consecutivos de uma semana. Foram avaliados os aspectos clínicos, achados de patologia clínica, o peso das amostras renais, a qualidade histológica, o número de glomérulos e a presença de artefatos no corte histológico da técnica de biópsia percutânea cega, da biópsia guiada por ultrassonografia e do procedimento videolaparoscópico. Não foram observadas alterações hematológicas ou bioquímicas relevantes nos animais submetidos às biópsias renais e as manifestações clínicas detectadas foram leves e transitórias, exceto por um caso de obstrução uretral por coágulo sangüíneo. A técnica percutânea cega foi relacionada à maior ocorrência e gravidade de hematúria, com danos mais graves ao tecido renal e com o único caso de obstrução do fluxo urinário. Na técnica videolaparoscópica, o peso médio das amostras foi superior e a hematúria discreta e transitória. Verificou-se relação direta entre a ocorrência de hematúria grave e a presença de epitélio de transição nas amostras e o número de tentativas utilizado para a obtenção dos fragmentos.Due to lack of studies about renal biopsies in sheep, a comparative study was performed for three renal biopsy techniques in this species. In this study, nine crossbred (Santa Inês ewe lamb (26.64 kg ±4,86 were used in serial procedures with one week consecutive intervals. The clinical aspects, clinical pathological findings, renal sample weights, histology quality, number of glomeruli, and the presence of artifacts in the histology slices were evaluated using the techniques of percutaneous blind biopsy, ultrasound guided biopsies and of videolaparoscopic procedure. No relevant

  3. Frame-based stereotactic biopsy of canine brain masses: technique and clinical results in 26 cases

    Directory of Open Access Journals (Sweden)

    John Henry Rossmeisl

    2015-07-01

    Full Text Available This report describes the methodology, diagnostic yield, and adverse events (AE associated with frame-based stereotactic brain biopsies (FBSB obtained from 26 dogs with solitary forebrain lesions. Medical records were reviewed from dogs that underwent FBSB using two stereotactic headframes designed for use in small animals and compatible with computed tomographic (CT and magnetic resonance (MR imaging. Stereotactic plans were generated from MR and CT images using commercial software, and FBSB performed both with (14/26 and without intraoperative image guidance. Records were reviewed for diagnostic yield, defined as the proportion of biopsies producing a specific neuropathological diagnosis, AE associated with FBSB, and risk factors for the development of AE. Postprocedural AE were evaluated in 19/26 dogs that did not proceed to a therapeutic intervention immediately following biopsy. Biopsy targets included intra-axial telencephalic masses (24/26, one intra-axial diencephalic mass, and one extra-axial parasellar mass. The median target volume was 1.99 cm3. No differences in patient, lesion, or outcome variables were observed between the two headframe systems used or between FBSB performed with or without intraoperative CT-guidance. The diagnostic yield of FBSB was 94.6%. Needle placement error was a significant risk factor associated with procurement of non-diagnostic biopsy specimens. Gliomas were diagnosed in 24/26 dogs, and meningioma and granulomatous meningoencephalitis in one dog each. AE directly related to FBSB were observed in a total of 7/26 (27% of dogs. Biopsy associated clinical morbidity, manifesting as seizures and transient neurological deterioration, occurred in 3/19 (16% of dogs. The case fatality rate was 5.2% (1/19 dogs, with death attributable to intracranial hemorrhage. FBSB using the described apparatus was relatively safe and effective at providing neuropathological diagnoses in dogs with focal forebrain lesions.

  4. The Study for Results of Complex Cystic Breast Masses by Biopsy on Ultrasound

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    Kang, Hye Kyoung [Dept. of Radiology, Yangji General Hospital, Kwangju (Korea, Republic of); Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health College, Kwangju (Korea, Republic of)

    2008-06-15

    We examined the roles of Ultrasonography conductors by analyzing the results of tissue biopsy of complex cystic masse under the guidance of breast US. This study was performed to a group of 178 who showed breast US indicating complex cystic masses among 342 patients who were definitely diagnosed by tissue biopsies and operations in our hospital from June 30th, 2003 to June 30th, 2007. The evaluation of tissues around, calcification, the distribution state of blood flow were excluded from the analysis subjects and logic 200 made by GE corporation and gun for core biopsy(Kimal corp., K7/MBD23) were used in this study. The biopsy results of 178 subjects showed FCC (fibrocystic change)(n=56 : 31.4%), Fibrosis (n=41 : 23.0%), Fibroadenoma (n=20 : 11.2%), Epithelial hyperplasia (n=17 : 9.6%), Carcinoma (n=15 : 8.4%), Fibroadipose (n=8 : 4.5%), Sclerosing adenosis (n=7 : 3.9%), Duct ectasia (n=5 : 2.8%), Papiloma (n=5 : 2.8%), and Fat necrosis (n=1 : 0.6%), Hemangioma (n=1 : 0.6%), Abscess (n=1 : 0.6%), Dystrophic calcification(n=1 : 0.6%). The US showed that the results of the tissue biopsy of complex cystic masses were mostly carcinoma(8.4%). Most of them were benign and only 9.6% of epithelial hyperplasia which has high progression rate into malignant tumors epidemically showed malignancy. Most of them were included in the spectrum of fibrous cystic nodule. Even though these results are confirmed, further studies are required. As a result, a nodule which is not certified by US should be right to take the tissue biopsy, but if it's difficult due to patients or another reasons, re-check tests in three months are required. And systemic ultrasonography evaluation should be well recognized to conduct more careful and specific tests.

  5. Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Urbania, Thomas H. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Ave., Box 0628, San Francisco, CA (United States); Kammen, Bamidele F.; Nancarrow, Paul A. [Children' s Hospital and Research Center Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Morrell, Rose Ellen [Children' s Hospital and Research Center Oakland, Department of Nephrology, Oakland, CA (United States)

    2009-02-15

    Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

  6. Laparoscopic microwave ablation and enucleation of small renal masses: preliminary experience.

    Science.gov (United States)

    Muto, Giovanni; Castelli, Emanuele; Migliari, Roberto; D'Urso, Leonardo; Coppola, Pietro; Collura, Devis

    2011-07-01

    Advancements in imaging and laparoscopy have led to the expansion of minimally invasive techniques in the ablation of small renal masses (SRMs). We report the results of a study aimed at assessing the efficacy of thermoablative microwave (MW) effects on SRMs and the haemostatic as well as necrotic MW effects on the parenchyma surrounding the neoplasm. From November 2008 to October 2010, 10 patients with SRMs underwent laparoscopy-guided Tru-Cut biopsy, MW tumour ablation, and enucleation. Mean age was 66 yr (range: 46-84 yr). Mean renal tumour diameter was 2.75 cm (range: 1.3-4.2 cm). MW antennas were applied one to three times depending on tumour volume, location, and shape. After MW thermoablation, laparoscopic enucleation was performed to evaluate the histopathologic and haemostatic effects of MW. The mean MW antenna application time was 14.1 min (range: 4-30 min). Enucleation did not require renal pedicle clamping in any of the cases because no significant bleeding took place. Preablation pathology revealed clear cell renal carcinoma of Fuhrman grade I-II in all cases. Postablation pathology showed extensive coagulative necrosis without skipped tumour areas. No intra- or postoperative complications were reported. Histopathologic effects on SRMs provide consistent proof of principle for future studies.

  7. Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass

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    Jeffrey Forris Beecham Chick, MD, MPH, DABR

    2017-06-01

    Full Text Available Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches. Transbiliary intravascular ultrasound-guided biopsy resulted in a diagnosis of pancreatic adenocarcinoma, allowing the initiation of chemotherapy.

  8. Recurrent renal cell carcinoma manifesting as a large intrathoracic fibrotic mass: A case report

    Science.gov (United States)

    KIM, JI HYUN; JEONG, JAE HOON; PARK, SUNG-HYUN; JEONG, JIN SEON; RYU, YOUNG-JOON; SONG, SEO-YOUNG

    2016-01-01

    Renal cell carcinomas (RCCs) have a strong tendency to metastasize, and the most common sites are the lungs, bones and liver. Late recurrence is another feature of the RCC, with lesions appearing ≥10 years after surgical treatment. However, fibrosis has rarely been associated with the disease. The present study reports a case of recurrent RCC that manifested as a fibrotic mass within the thorax. A 48-year-old man presented with dyspnea that had persisted for 3 days. The patient had undergone a right radical nephrectomy for stage II clear cell carcinoma of the kidney 6 years previously. The patient was a current smoker, with a smoking history of 20 pack-years. Chest radiography showed pleural effusion in the right thorax with an egg-sized mass shadow within the right upper lung (RUL) field. Computed tomography (CT) showed a main mass, 7 cm in diameter, within the RUL, with heterogeneous enhancement and multiple nodules of various sizes in the lungs, suggestive of primary lung cancer or metastatic RCC. A CT-guided percutaneous needle aspiration biopsy was obtained from the main mass, but histology revealed dense fibrous tissue without any malignant cells. Positron emission tomography-CT demonstrated an irregular hypermetabolic RUL mass, with a standardized uptake value (SUV) of 5.0, along the right pleura, and small pulmonary nodules (SUV, 2.0). Ultrasound-guided biopsy was attempted for a smaller hypermetabolic pleural nodule and the result was clear cell adenocarcinoma, consistent with the previous renal histology. The present study describes the case, along with a review of the relevant literature. PMID:27313703

  9. Detection of anti-HLA antibodies with flow cytometry in needle core biopsies of renal transplants recipients with chronic allograft nephropathy.

    Science.gov (United States)

    Martin, Laurent; Guignier, Fredy; Bocrie, Olivier; D'Athis, Philippe; Rageot, David; Rifle, Gérard; Justrabo, Eve; Mousson, Christiane

    2005-05-27

    The aim of this study was to assess the feasibility of detecting anti-HLA antibodies in eluates from needle core biopsies of renal transplants with chronic allograft nephropathy. Two methods of screening, the enzyme-linked immunosorbent assay (ELISA) and flow cytometry (FlowPRA) were compared. Twenty renal transplants with CAN were removed after irreversible graft failure. To assess the feasibility of detecting anti-HLA antibodies in small samples, needle core biopsies were sampled at the same place as surgical samples and at a second cortical area. Antibodies were eluted with an acid elution kit and anti-class I and class II IgG HLA antibodies detected using ELISA and flow cytometry. Flow cytometry was found to be more sensitive than ELISA for detecting anti-HLA antibodies in eluates from renal transplants with CAN (95% vs. 75% of positive cases). Detection of anti-HLA antibodies showed good agreement between surgical samples and needle core biopsies performed at the same place for anti-class I (80% vs. 65%, r=0.724 PHLA antibodies (70% vs. 55%, r=0.827 PHLA antibodies in needle core biopsies sampled at different sites suggests that immunization to class I donor antigen could be underestimated in needle core biopsy samples. These data indicate that anti-HLA antibodies can be detected in needle core biopsies from renal transplants. Provided further evaluation is done, elution might be a complementary method to detect anti-HLA antibodies when they are bound to the transplant.

  10. Profiling microRNA from nephrectomy and biopsy specimens: predictors of progression and survival in clear cell renal cell carcinoma.

    Science.gov (United States)

    Kowalik, Casey G; Palmer, Drew A; Sullivan, Travis B; Teebagy, Patrick A; Dugan, John M; Libertino, John A; Burks, Eric J; Canes, David; Rieger-Christ, Kimberly M

    2017-09-01

    To identify microRNA (miRNA) characteristic of metastatic clear cell renal cell carcinoma (ccRCC) and those indicative of cancer-specific survival (CSS) in nephrectomy and biopsy specimens. We also sought to determine if a miRNA panel could differentiate benign from ccRCC tissue. RNA was isolated from nephrectomy and kidney biopsy specimens (n = 156 and n = 46, respectively). Samples were grouped: benign, non-progressive, and progressive ccRCC. MiRNAs were profiled by microarray and validated by quantitative reverse transcription-polymerase chain reaction. Biomarker signatures were developed to predict cancer status in nephrectomy and biopsy specimens. CSS was examined using Kaplan-Meier and Cox proportional hazards analyses. Microarray analysis revealed 20 differentially expressed miRNAs comparing non-progressive with progressive tumours. A biomarker signature validated in nephrectomy specimens had a sensitivity of 86.7% and a specificity of 92.9% for differentiating benign and ccRCC specimens. A second signature differentiated non-progressive vs progressive ccRCC with a sensitivity of 93.8% and a specificity of 83.3%. These biomarkers also discriminated cancer status in biopsy specimens. Levels of miR-10a-5p, -10b-5p, and -223-3p were associated with CSS. This study identified miRNAs differentially expressed in ccRCC samples; as well as those correlating with CSS. Biomarkers identified in this study have the potential to identify patients who are likely to have progressive ccRCC, and although preliminary, these results may aid in differentiating aggressive and indolent ccRCC based on biopsy specimens. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  11. INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

    Directory of Open Access Journals (Sweden)

    Renata Nobre MOURA

    2014-12-01

    Full Text Available Context Tissue sampling of renal masses is traditionally performed via the percutaneous approach or laparoscopicaly. The utility of endoscopic ultrasound to biopsy renal lesions it remains unclear and few cases have been reported. Objectives To evaluate the feasibility and outcome of endoscopic ultrasound fine needle aspiration of renal tumors. Methods Consecutive subjects undergoing attempted endoscopic ultrasound fine needle aspiration of a kidney mass after evaluation with computerized tomography or magnetic resonance. Results Ten procedures were performed in nine male patients (median age 54.7 years on the right (n = 4 and left kidney (n = 4 and bilaterally (n = 1. Kidney masses (median diameter 55 mm ; range 13-160 mm were located in the upper pole (n = 3, the lower pole (n = 2 and the mesorenal region (n = 3. In two cases, the mass involved more than one kidney region. Surgical resection confirmed renal cell carcinoma in six patients in whom pre-operative endoscopic ultrasound fine needle aspiration demonstrated renal cell carcinoma. No complications were reported. Conclusions Endoscopic ultrasound fine needle aspiration appears as a safe and feasible procedure with good results and minimal morbidity.

  12. Urinary β2-Microglobulin Is a Good Indicator of Proximal Tubule Injury: A Correlative Study with Renal Biopsies

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    Xu Zeng

    2014-01-01

    Full Text Available Objective. After filtration through glomeruli, β2-microglobulin is reabsorbed in proximal tubules. Increased urinary β2-microglobulin indicates proximal tubule injury and measurement of β2-microglobulin in urine is useful to determine the source of renal injury. Kidney injury molecule-1 (KIM-1 has been characterized as a selective proximal tubule injury marker. This study was designed to evaluate the correlation of urinary β2-microglobulin concentration and KIM-1 expression as evidence of proximal tubule injury. Methods. Between 2009 and 2012, 46 patients with urine β2-microglobulin (RenalVysion had follow-up kidney biopsy. Diagnoses included glomerular and tubule-interstitial disease. Immunohistochemical staining for KIM-1 was performed and the intensity was graded from 0 to 3+. Linear regression analysis was applied to correlate the values of urinary β2-microglobulin and KIM-1 staining scores. P < 0.05 was considered statistically significant. Results. Thirty patients had elevated urinary β2-microglobulin. KIM-1 staining was positive in 35 kidney biopsies. There was a significant correlation between urinary β2-microglobulin and KIM-1 staining (P < 0.05. Sensitivity was 86.6%, specificity was 43.7%, positive predictive value was 74.2%, and negative predictive value was 63.6%. Conclusion. Increased urinary β2-microglobulin is significantly correlated with KIM-1 staining in injured proximal tubules. Measurement of urine β2-microglobulin is a sensitive assay for proximal tubule injury.

  13. Analysis of 1224 renal biopsy data%1224例肾活检病理资料分析

    Institute of Scientific and Technical Information of China (English)

    罗晶晶

    2013-01-01

    Objectives Explore our hospital for the past five years the epidemiologieal characteristics of 1224 cases of renal biopsy information and pathological type distribution characteristics.Methods Between January 2008 and December 2012 in the People's Hospital of the Xinjiang Uygur Autonomous Region(Urumqi,China),1224 attempts of percutaneous renal biopsy were performed in renal patients.In this report,the pathologic entities were analyzed retrospectively.Results The age at renal biopsy rang of 4 to 82 years in 1224 patients with renal diseases with a male 661 cases,female 563 cases,primary glomerular diseases (PGD) accounted for 81.70% of the total renal patients biopsied,secondary glomerular nephritis (SGN) 12.17 %,Tubulointerstitial diseases 5.07 % and the associated nephropathy metabolic accounted for 0.82%,renal transplant recipients 0.16%,and unclassified renal diseases 0.08 %.mesangial proliferative lesion (MsPL) was the most frequent patholigic type (30.30 %) of PGD,followed by IgAN (28.00%),membranous nephropathy(MN) (17.50 %),focal segmental glomerulosclerosis (FSGS,10.50 %).Proliferative sclerosing glomerulonerphritis (3.9%),membranoproliferative glomerulonephritis (3.10%),crescentic glomerulonephritis (2.60%),minimal change glomerulopathy(2.50%),endocapillary proliferative glomemlonephritis(1.6%),The most frequent type of SGN was lupusnephritis (LN) (31.54 %),Hypertensive renal damage(27.52%),nephritis of anaphylactoid purpura (13.42%),amyloidosis (11.4%),diabetic renal (7.38%),hepatitis B virus associated nephritis (2.68%),Thrombotic microangiopathy (2.01%).Conclusions In primary glomerular diseases,mesangial proliferative lesion (MsPL) is still the most frequent pathological type.followed by IgAN,and IgANshowed an increasing trend in the incidence.In addition,secondary renal disease gradually increased,In SGN,LN is the most frequent pathological type.Discussion by renal biopsy and clinical pathology,not only

  14. [Application of Immunohistochemistry and Immunofluorescence Staining in Detection of Phospholipase A2 Receptor on Paraffin Section of Renal Biopsy Tissue].

    Science.gov (United States)

    Dong, Hong-rui; Wang, Yan-yan; Wang, Guo-qin; Sun, Li-jun; Cheng, Hong; Chen, Yi-pu

    2015-10-01

    To evaluate the application of immunohistochemistry and fluorescence staining method in the detection of phospholipase A2 receptor (PLA2R) on paraffin section of renal biopsy tissue,and to find an accurate and fast method for the detection of PLA2R in renal tissue. The PLA2R of 193 cases were detected by immunohistochemical staining,and the antigen was repaired by the method of high pressure cooker (HPC) hot repair plus trypsin repair. The 193 samples including 139 cases of idiopathic membranous nephropathy (IMN), 15 cases of membranous lupus nephritis, 8 cases of hepatitis B virus associated membranous nephropathy, 18 cases of IgA nephropathy, and 13 cases of minimal change diseases. To compare the dyeing effects, 22 paraffin sections of renal biopsy tissue of IMN cases with positive PLA2R were stained by using 4 different. of antigen repairing,which included HPC hot repair, HPC hot repair plus trypsin repair, water bath heat repair, and water bath heat repair plus trypsin repair. To compare the dyeing effects, 15 paraffin sections of renal biopsy tissue of IMN cases with positive PLA2R were stained by using 3 different. of antigen repairing,which included water bath heat repair plus trypsin repair, protease K digestion repair, and pepsin digestion repair. In 193 cases, the positive rate of PLA2R in IMN cases was 90.6% (126/139), and the other 54 patients without IMN were negative. Twenty-two IMN patients were positive for PLA2R by using the HPC heat repair plus trypsin repaire or the water bath heat repair plus trypsin repair;while only a few cases of 22 IMN cases were positive by using the HPC hot repair alone or water bath heat repair alone. Fifteen IMN patients were positive for PLA2R by using water bath heat repair plus trypsin repair,protease K digestion repair,and pepsin digestion repair, but the distribution of positive deposits and the background were different. PLA2R immunohistochemical staining can effectively identify IMN and secondary MN. For

  15. The challenging image-guided abdominal mass biopsy: established and emerging techniques 'if you can see it, you can biopsy it'.

    Science.gov (United States)

    Sainani, Nisha I; Arellano, Ronald S; Shyn, Paul B; Gervais, Debra A; Mueller, Peter R; Silverman, Stuart G

    2013-08-01

    Image-guided percutaneous biopsy of abdominal masses is among the most commonly performed procedures in interventional radiology. While most abdominal masses are readily amenable to percutaneous biopsy, some may be technically challenging for a number of reasons. Low lesion conspicuity, small size, overlying or intervening structures, motion, such as that due to respiration, are some of the factors that can influence the ability and ultimately the success of an abdominal biopsy. Various techniques or technologies, such as choice of imaging modality, use of intravenous contrast and anatomic landmarks, patient positioning, organ displacement or trans-organ approach, angling CT gantry, triangulation method, real-time guidance with CT fluoroscopy or ultrasound, sedation or breath-hold, pre-procedural image fusion, electromagnetic tracking, and others, when used singularly or in combination, can overcome these challenges to facilitate needle placement in abdominal masses that otherwise would be considered not amenable to percutaneous biopsy. Familiarity and awareness of these techniques allows the interventional radiologist to expand the use of percutaneous biopsy in clinical practice, and help choose the most appropriate technique for a particular patient.

  16. Genome-wide promoter methylome of small renal masses.

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    Ilsiya Ibragimova

    Full Text Available The majority of renal cell carcinoma (RCC is now incidentally detected and presents as small renal masses (SRMs defined as ≤ 4 cm in size. SRMs are heterogeneous comprising several histological types of RCC each with different biology and behavior, and benign tumors mainly oncocytoma. The varied prognosis of the different types of renal tumor has implications for management options. A key epigenetic alteration involved in the initiation and progression of cancer is aberrant methylation in the promoter region of a gene. The hypermethylation is associated with transcriptional repression and is an important mechanism of inactivation of tumor suppressor genes in neoplastic cells. We have determined the genome-wide promoter methylation profiles of 47 pT1a and 2 pT1b clear cell, papillary or chromophobe RCC, 25 benign renal oncocytoma ≤ 4 cm and 4 normal renal parenchyma specimens by Infinium HumanMethylation27 beadchip technology. We identify gene promoter hypermethylation signatures that distinguish clear cell and papillary from each other, from chromophobe and oncocytoma, and from normal renal cells. Pairwise comparisons revealed genes aberrantly hypermethylated in a tumor type but unmethylated in normal, and often unmethylated in the other renal tumor types. About 0.4% to 1.7% of genes comprised the promoter methylome in SRMs. The Infinium methylation score for representative genes was verified by gold standard technologies. The genes identified as differentially methylated implicate pathways involved in metabolism, tissue response to injury, epithelial to mesenchymal transition (EMT, signal transduction and G-protein coupled receptors (GPCRs, cancer, and stem cell regulation in the biology of RCC. Our findings contribute towards an improved understanding of the development of RCC, the different biology and behavior of histological types, and discovery of molecular subtypes. The differential methylation signatures may have utility in early

  17. Renal graft survival according to Banff 2013 classification in indication biopsies

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    Carlos Arias-Cabrales

    2016-11-01

    Conclusions: The Banff 2013 classification facilitates a histological diagnosis in 95% of indication biopsies. While diagnostic category 6 is the most common, a change in the predominant histopathology was observed according to time elapsed since transplantation. Antibody-mediated changes are associated with worse graft survival.

  18. Internal Carotid Artery Ectasia: The Value of Imaging Studies Prior to Biopsy of a Retropharyngeal Mass

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    Kenneth Chan

    2010-11-01

    Full Text Available The presence of retropharyngeal tissue mass often raises the suspicion of malignancy, especially in elderly patients. This prompts urgent biopsy to investigate tissue histology. We discuss a case where this is contraindicated as the retropharyngeal mass was illustrated by CT scanning and confirmed with MRI to be a tortuous coursing internal carotid artery. An awareness of this unusual anatomical variation and a careful interpretation of imaging studies both at the stage of differential diagnosis and pre-operative screening are essential to avoid damage to important structures, causing unnecessary complications.

  19. The Role of Ultrasound Guided FNAB (Fine Needle Aspiration Biopsy of Nonpalpable Breast Masses

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    M. Haghighi

    2007-05-01

    Full Text Available Background and Objective: Because of the high inci-dence and mortality rate of breast cancers, and high survival rate of patients after detecting masses smaller than 1cm, it is important to do tissue sampling with imaging guidance. Our goal was to determine the role of sonoguided FNAB as a first step to avoid the more invasive and expensive unnecessary core or excisional biopsies. Materials and Methods: This was an observational study. Our cases included the patients referred to our clinic from 1998-2004 to get FNAB for their nonpal-pable breast masses that had been found in imaging and were visible with Ultrasound and classified in cat 3 or 4 BIRads. The number of cases was 500. The in-strument used was ESaote EU4 with 10 MHZ probe. The results of cytological tests were collected and classified into three groups known as: 1-Benign (negative 2-Malignant (positive 3-Indeterminate Our gold standard was excisional biopsy with three years follow up. Results: Sono and mammo guided FNA, core biopsy and needle localization biopsy are three ways to reach nonpalpable breast lesions. According to other studies, the overall accuracy for imaging guided core biopsy is %97 without FP and for FNA is %77 with %5 FP. An inadequate amount of sample is reported in 32% of sonoguided FNAs but in our study, it was not significant. We had normal breast tissue in %2 (n=10 of our cases and they did not develop malig-nancy in three years follow up. The cost of FNA is very low compared with the other two procedures. Also our NPV was %100 and three fourth of our cases had benign pathology (negative for malignancy. Conclusion: According to our results doing FNA as the first step for cat 3 and 4 masses and R/O of malig-nancy in most patients can save money and time. Core biopsy could be reserved only for the other one fourth of patients.

  20. Renal mass dosing and graft function in children transplanted from pediatric donors.

    Science.gov (United States)

    de Petris, L; Faraggiana, Tullio; Rizzoni, Gianfranco

    2002-06-01

    It has been suggested that "renal mass dosing" may affect graft evolution. Between 1993 and 1999, 43 children, aged 4-17 years, received 43 pediatric cadaveric grafts. The ratio between graft volume (calculated by ultrasound within the first 24 h from transplantation, by ellipsoid formula) and the recipient's body surface area (BSA) ranged between 14.1 and 110 ml/m(2). Three groups were identified: group 1, 14-29 ml/m(2) (13 patients); group 2, 30-39 ml/m(2) (16 patients); group 3, 40-110 ml/m(2) (14 patients). As a consequence of the different renal volume increments in the three groups during the first year after transplant, no differences in the absolute renal volume were observed at the end of follow-up. The average follow-up was 38 months (range 12-80). In the 37 routine graft biopsies, performed on average 13 months after transplantation and with more than five glomeruli, maximum mean glomerular diameters were mostly above normal values. There were no significant differences among the three groups. At the end of follow-up, the three groups did not differ in microalbuminuria, proteinuria, glomerular function or in incidence of hypertension. From this retrospective study, we conclude that the very wide range of renal mass dosing did not cause differences in medium-term graft evolution. A longer follow-up will be necessary to ascertain the possible influence of disproportion between pediatric donors and recipients, on a long-term graft outcome.

  1. Percutaneous CT-guided radiofrequency ablation of solitary small renal masses. A single center experience

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    Pieper, C.C.; Fischer, S.; Strunk, H.; Meyer, C.; Thomas, D.; Willinek, W.A.; Schild, H. [Univ. Bonn (Germany). Dept. of Radiology; Hauser, S. [Univ. Bonn (Germany). Dept. of Urology; Nadal, J. [Univ. Bonn (Germany). Inst. for Medical Biometry; Wilhelm, K. [Johanniter Hospital Bonn (Germany). Dept. of Radiology

    2015-07-15

    To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period. Patient records of renal RFAs (07/2003 - 11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests. 38 patients (16 females, mean age 70.0 years [range 52 - 87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95 % of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4 ± 0.8 % and 50.3 ± 1.0 %, respectively (mean follow-up 54.6 months, range 1 - 127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS. There was no difference in survival between patients with benign and malignant tumors. RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression.

  2. Molecular comparison of calcineurin inhibitor-induced fibrogenic responses in protocol renal transplant biopsies

    NARCIS (Netherlands)

    Groningen, Marian C. Roos-van; Scholten, Eduard M.; Lelieveld, Patrick M.; Rowshani, Ajda T.; Baelde, Hans J.; Bajema, Ingeborg M.; Florquin, Sandrine; Bemelman, Frederike J.; de Heer, Emile; de Fijter, Johan W.; Bruijn, Jan A.; Eikmans, Michael

    The calcineurin inhibitor cyclosporine (CsA) induces a fibrogenic response that may lead to scarring of the renal allograft. This study investigated whether tacrolimus, a novel calcineurin inhibitor, exerts fibrogenic effects to a similar extent. Sixty patients were enrolled in a randomized study:

  3. Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Pedrosa, Ivan [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Rafatzand, Khashayar; Robson, Philip; Alsop, David C. [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); Wagner, Andrew A. [Beth Israel Deaconess Medical Center and Harvard Medical School, Surgery, Division of Urology, Boston, MA (United States); Atkins, Michael B. [Beth Israel Deaconess Medical Center and Harvard Medical School, Hematology/Oncology, Boston, MA (United States); Rofsky, Neil M. [University of Texas Southwestern Medical Center, Departments of Radiology, Dallas, TX (United States)

    2012-02-15

    To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function. Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value <0.05 was considered statistically significant. Seventeen renal lesions were evaluated in 11 patients (8 male; mean age = 70 years) (range 57-86). The median eGFR was 24 mL/min/1.73 m{sup 2} (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7). ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation. (orig.)

  4. Fine needle aspiration biopsy: role in diagnosis of pediatric head and neck masses.

    Science.gov (United States)

    Anne, Samantha; Teot, Lisa A; Mandell, David L

    2008-10-01

    To assess the feasibility and role of fine needle aspiration biopsy (FNAB) as a diagnostic tool in children with neck masses. Retrospective chart review. Tertiary care children's hospital. Consecutive series of 71 children with a head and neck mass who underwent FNAB as the primary diagnostic modality. FNAB was performed and interpreted by a pediatric cytopathologist. Rapid on-site analysis was performed to allow immediate assessment of specimen adequacy and to attain a preliminary diagnosis, after which routine cytologic staining was performed. Flow cytometry was performed on cytological specimens when malignancy was suspected, and open biopsy was performed when the cytologic diagnosis was in question. Technical feasibility of FNAB in children, complications, cytopathological diagnoses, accuracy of rapid on-site analysis, need for subsequent diagnostic evaluations, clinical outcomes and follow-up. Mean age was 8.4 years (S.D. 5.3 years), with mean follow-up of 4.1 months (S.D. 9.6 months). FNAB was performed under general anesthesia in 54 cases (76%). There were no technical complications. On-site rapid interpretation was completed in 55 cases, 18/55 confirmed adequacy of specimen only, 37/55 yielded a preliminary diagnosis, and in 34/37 cases, was same as final cytopathologic result. Overall, FNAB biopsy demonstrated 64 benign lesions, 3 malignant diagnoses, 2 follicular thyroid neoplasms, and 2 non-diagnostic specimens. FNAB was the only pathological test performed in 54 (76%) cases. The most common diagnosis was reactive lymphoid hyperplasia (n = 39), followed by benign granulomatous disease (n = 8). Flow cytometry was performed on 7 specimens (non-diagnostic in 5, negative for malignancy in 2). Of the 15 cases with surgical specimens, 3 revealed a pathologic diagnosis different from initial FNAB. There were no cases in which FNAB missed a malignancy, and there were 2 cases where FNAB suggested malignancy, with benign disease subsequently found on open biopsy

  5. Nursing of renal biopsy guided by Color Doppler ultrasound%彩超引导下肾穿刺活检的护理体会

    Institute of Scientific and Technical Information of China (English)

    陈敏

    2011-01-01

    Objective To discuss the nursing strategies of renal biopsy guided by Color Doppler ultrasound. Methods Effective nursing was given to patients during preoperative, intraop-erative and postoperative stages. Results Sixty renal biopsy cases were done with 100% success rate and no serious complications occurred. Conclusion Effective preoperative, intraoperative and postoperative nursing intervention can decrease the incidence of complications of renal biopsy and it is the key to improve the success rate of renal biopsy.%目的 探讨对彩超引导下肾穿刺活检术患者的护理措施.方法 对患者进行术前、术中及术后的有效护理.结果60例患者肾穿刺活检术成功率为100%,无1例严重并发症发生.结论 有效的术前、术中及术后护理干预可以降低肾穿刺术后并发症的发生,是提高肾穿刺活检成功率的关键.

  6. Radiologic Evaluation of Small Renal Masses (II: Posttreatment Management

    Directory of Open Access Journals (Sweden)

    J. Santos

    2008-01-01

    Full Text Available The increase in the detection of small renal masses (SRMs and their best knowledge leads to a change in the therapeutic management of these lesions. The use of a less aggressive surgical technique or even an expectant attitude is the current tendency, in order to preserve as much renal function as possible. Imaging techniques are essential in the followup of these lesions. It allows us to know the postsurgical changes and possible complications due to treatment and the presence of local recurrence and metastases. Furthermore, a close radiological followup of SRM related to ablative treatments is mandatory. The purpose of this article is to reveal the imaging features of complications due to surgical or ablative treatments, local recurrence and metastasis, as well as their followup.

  7. Comparison of diagnostic quality of kidney biopsy obtained using 16g and 18g needles in patients with diffuse renal disease

    Directory of Open Access Journals (Sweden)

    Komal Arora

    2012-01-01

    Full Text Available To determine the diagnostic quality and complication rates of 16G and 18G needles in biopsy of the kidney, we performed renal biopsy using a biopsy gun under ultrasound guidance in 50 patients who were prospectively and evenly assigned to one of the two needle biopsy methods from April 2007 until May 2008. Two cores of renal biopsy specimen were obtained in each case and subjected to histopathological and immunoflourescence (IF examination. Pain associated with the procedure was assessed using a visual analog scale. The number of glomeruli retrieved using the 16G needle ranged from 0 to 30 (mean 9.42 ± 5.5 and those retrieved using 18G needle ranged from 0 to 19 (mean 7.72 ± 4.4, P <0.05. The quality of biopsy was poorer with 18G needle as compared with 16G needles because of a higher amount of fragmentation and crushing artifact. There was no difference in the compli-cation rates between the two needles (2% each. The 16G needle was associated with significantly more pain than the 18G needle. We conclude that our study demonstrates the benefit of the larger 16G needle in providing more tissue and glomeruli, which is more diagnostically useful. However, the use of 16G needle was associated with significantly more pain than the 18G needle, and may be a better compromise for diagnostic usefulness and patient acceptability.

  8. Melatonin ameliorates oxidative stress, inflammation, proteinuria, and progression of renal damage in rats with renal mass reduction.

    Science.gov (United States)

    Quiroz, Yasmir; Ferrebuz, Atilio; Romero, Freddy; Vaziri, Nosratola D; Rodriguez-Iturbe, Bernardo

    2008-02-01

    The progressive deterioration of renal function and structure resulting from renal mass reduction are mediated by a variety of mechanisms, including oxidative stress and inflammation. Melatonin, the major product of the pineal gland, has potent_antioxidant and anti-inflammatory properties, and its production is impaired in chronic renal failure. We therefore investigated if melatonin treatment would modify the course of chronic renal failure in the remnant kidney model. We studied rats followed 12 wk after renal ablation untreated (Nx group, n = 7) and treated with melatonin administered in the drinking water (10 mg/100 ml) (Nx + MEL group, n = 8). Sham-operated rats (n = 10) were used as controls. Melatonin administration increased 13-15 times the endogenous hormone levels. Rats in the Nx + MEL group had reduced oxidative stress (malondialdehyde levels in plasma and in the remnant kidney as well as nitrotyrosine renal abundance) and renal inflammation (p65 nuclear factor-kappaB-positive renal interstitial cells and infiltration of lymphocytes and macrophages). Collagen, alpha-smooth muscle actin, and transforming growth factor-beta renal abundance were all increased in the remnant kidney of the untreated rats and were reduced significantly by melatonin treatment. Deterioration of renal function (plasma creatinine and proteinuria) and structure (glomerulosclerosis and tubulointerstitial damage) resulting from renal ablation were ameliorated significantly with melatonin treatment. In conclusion, melatonin administration improves the course of chronic renal failure in rats with renal mass reduction. Further studies are necessary to define the potential usefulness of this treatment in other animal models and in patients with chronic renal disease.

  9. 超声引导下肾活检的临床应用%Applicable value of ultrasound-guided renal biopsy in diagnosis of kidney diseases

    Institute of Scientific and Technical Information of China (English)

    焦卫平; 王萍; 付文静

    2008-01-01

    Objective To explore the applicable value of ultrasound guidance in percutaneous renal biopsy. Methods 168 patients with kidney diseases underwent ultrasound-guided renal biopsy. Pathological examination was conducted. Predictors of successful rate were assessed by multivariate logistic regression analysis. Results Successful biopsy was achieved in 157 of the 168 patients with a success rate of 93.45%. Satisfying results were obtained from 143 of the 157 samples and normal renal tissues were reported in 14 samples. No serious adverse events were observed in this study. The successful biopsy rate of female patients was 89.16%, significantly lower than that of the male patients (97.65%, P < 0.05). Age,puncture times, thickness of renal cortex, and type of clinical diagnosis were not significantly correlated with the successful rate of biopsy. Conclusion Ultrasound-guided renal biopsy is a kind of safe diagnostic method for kidney disease. The successful rate of renal biopsy in females is lower than that in males.%目的 探讨超声引导下肾穿刺活检术的临床应用.方法 回顾分析了首都医科大学宣武医院168例肾脏病患者在超声引导下行经皮肾脏活检术,对影响穿刺成功率的有关因素运用多因素Logistic回归法进行分析.结果 168例患者中,157例取得足够病理诊断的肾组织样品,其中14例病理证实为正常肾组织,11例未成功.本研究中所有病例未发现严重并发症.穿刺成功率与性别相关(P<0.05),与年龄、穿刺针数、肾实质厚度以及临床诊断类型无关.结论 超声引导下肾穿刺活检术是诊断肾脏疾病的一种安全方法 ,女性患者较男性患者成功率低.

  10. Clinical Evaluation of Automatic Renal Biopsy to Senile Patients with Acute Renal Failure%肾活检在老年急性肾衰竭临床应用的探讨

    Institute of Scientific and Technical Information of China (English)

    陈婷; 许勇芝; 刘华锋; 黄志清; 陶静莉

    2011-01-01

    目的:探讨肾活检术对老年急性肾衰竭的应用价值,提高老年急性肾衰竭的诊治水平.方法:66例不明原因老年急性肾衰竭均行实时超声引导肾自动穿刺活检术,分析其成功率、并发症,总结肾活检后诊断和治疗的修正率.结果:66例肾活检取材均成功;其中取材不良4例(6.1%),取材良好62例(93.9%);3例出现轻度并发症(4.5%),其中肉眼血尿2例,肾周血肿1例,未出现严重并发症;66例中病因误诊19例,26例治疗方案有较大调整.结论:老年急性肾衰竭患者行经皮肾脏穿刺活检术安全且成功率高;相当部分老年急性肾衰竭病因被误诊,对不明原因老年急性肾衰竭应及时行肾活检术,以免延误诊治.%Objective:To evaluate the clinical evaluation of automatic renal biopsy to senile patients with acute renal failure ( ARF ). Methods: The success rate and related complications were analyzed in 66 senile patients with ARF. The clinical diagnosis and therapy after renal biopsy were revised. Results: All patients were technically successful. The qualities of the specimens were as follows:4 cases ( 6. 1% ) failed for histological evaluation, and 62 cases ( 93. 9% ) very well qualified. Complications occurred in 7 cases ( 10. 6% ). Among these complications, gross hematuria in 2 cases, perirenal hematoma in 1 case. No server hemorrhage occurred. According to the renal pathology acquired by biopsy, 19 cases were misdiagnosed, and treatment therapy was changed in 26 cases after biopsy. Conclusion: Ultrasound - guided automated renal biopsy is safe and successful in senile patients with ARF, and its replied renal biopsy was indispensable and very useful to correct diagnosis. ARF in senil patients is often misdiagnosed, renal biopsy is very helpful in differential diagnosis and treatment.

  11. A comparative study on renal biopsy before and after long-term calcineurin inhibitors therapy: an insight for pathogenesis of its toxicity.

    Science.gov (United States)

    Singh, Lavleen; Singh, Geetika; Sharma, Alok; Sinha, Aditi; Bagga, Arvind; Dinda, A K

    2015-01-01

    Calcineurin inhibitors (CNIs) are effective immunosuppressive agents for the successful treatment of childhood steroid-resistant nephrotic syndrome (SRNS). Because these patients require long-term treatment, the identification of early markers of CNI-induced nephrotoxicity (CNIN) is imperative. The monitoring of CNI trough levels, serum creatinine, and glomerular filtration rate is not an accurate marker of CNIN. The present study has been undertaken to identify early markers of CNIN in SRNS patients. Twenty-four pediatric SRNS patients were included with paired renal biopsies, before initiation (time zero biopsy) and at least 1 year after CNI therapy (protocol renal biopsy) with standard dosage. Semiquantitative morphologic grading of the histologic features was done for assessing CNIN. Immunohistochemical markers for oxidative stress (nitrotyrosine [NT]), fibrogenic cytokine (transforming growth factor β1 [TGF-β1]), and endothelial injury (endothelial nitric oxide synthase [eNOS]) were evaluated. In addition, ultrastructural study was done to assess mitochondrial injury in endothelial and tubular epithelial cells. The protocol renal biopsies in comparison with time zero biopsies showed significant increase in glomerulosclerosis, juxtaglomerular apparatus hyperplasia, tubular atrophy, interstitial fibrosis, arteriolar hyalinosis, and smooth muscle vacuolization (P biopsies. Mean mitochondrial injury grade among post-CNI cases in endothelial cells and proximal tubular cells was 2.28 and 1.4, whereas in pre-CNI, it was 0.28 and 0.27, respectively. We propose that immunohistochemical overexpression of NT, eNOS, and TGF-β1 is an early marker of CNIN. Endothelial and proximal tubular mitochondrial injury may play an important role in the pathogenesis of CNIN.

  12. Radiologic Evaluation of Small Renal Masses (I: Pretreatment Management

    Directory of Open Access Journals (Sweden)

    A. Marhuenda

    2008-01-01

    Full Text Available When characterizing a small renal mass (SRM, the main question to be answered is whether the mass represents a surgical or nonsurgical lesion or, in some cases, if followup studies are a reasonable option. Is this a task for a urologist or a radiologist? It is obvious that in the increasing clinical scenario where this decision has to be made, both specialists ought to work together. This paper will focus on the principles, indications, and limitations of ultrasound, CT, and MRI to characterize an SRM in 2008 with a detailed review of relevant literature. Special emphasis has been placed on aspects regarding the bidirectional information between radiologists and urologists needed to achieve the best radiological approach to an SRM.

  13. Utility of Fine-Needle Aspiration Biopsy in the Evaluation of Pediatric Head and Neck Masses.

    Science.gov (United States)

    Huyett, Phillip; Monaco, Sara E; Choi, Sukgi S; Simons, Jeffrey P

    2016-05-01

    Fine-needle aspiration biopsy (FNAB) has a well-established role in the evaluation of an adult head and neck mass (HNM) but remains underused in children. The objectives of this study were to assess the diagnostic accuracy, safety profile, use of anesthesia, and influence on surgical decision making of FNAB of HNM in the pediatric population. Case series with chart review. Tertiary care children's hospital. In total, 257 consecutive patients with HNM who underwent 338 FNABs from July 2007 to July 2014 were reviewed. Patients ranged in age from 0 to 21 years (mean, 9.3 years); lesions ranged in size from 0.3 to 12.5 cm (mean, 2.4cm). Fine-needle aspiration biopsies were performed in the interventional radiology suite, operating room, clinic, or ward. The most common patient final diagnoses included reactive lymphadenopathy (n = 99, 38.5%), benign thyroid colloid nodule (n = 31, 12.1%), malignancies (n = 21, 8.2%), and atypical mycobacterial infection (n = 15, 5.8%). On surgical histopathologic and clinical follow-up, overall sensitivity of FNAB was 94.6% and specificity was 97.7%. The complication rate was 2.1%, and general anesthesia or sedation was used for 73% of FNAB. Surgery occurred only 9 times following the 191 patients with negative FNAB results, indicating that 95.3% of unnecessary surgeries were avoided with the assistance of the FNAB result. Fine-needle aspiration biopsy is an accurate and safe diagnostic tool for guiding management of persistent lymphadenopathy, thyroid nodules, and other HNM in pediatric patients. Negative FNABs can often obviate the need for surgical intervention. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. Application of Electron Microscopy in the Diagnosis for Renal Biopsy%肾活检病理诊断中电镜检查的应用分析

    Institute of Scientific and Technical Information of China (English)

    张鸥

    2016-01-01

    Objective Value of electron microscopy in the diagnosis of renal biopsy is analyzed.Methods Retrospective analyzed 186 renal biopsy diagnosis from January 2012 to December 2015, the results of electron microscopic diagnosis were compared with light microscope and immune of luorescence results, analysed the necessity of Electron microscopy in the diagnosis of renal biopsy.Results There were 10 kinds of pathological changes in 52 cases in renal biopsy, electron microscopy (sem) examination must be conducted to clear the diagnosis, in addition there were 3 kinds of pathological changes in 40 cases and need to be conifrmed by electron microscopic examination.Conclusion Electron microscopy (sem) examination is an essential diagnostic method in renal biopsy pathology diagnosis, is of great signiifcance to avoid misdiagnosis and missed diagnosis, so it has an vital role of renal biopsy diagnosis.%目的:对电镜检查在肾活检病例诊断中的应用价值进行分析。方法选取2012年1月~2015年12月我院186肾活检诊断结果,对其进行回顾性分析,将电镜诊断结果同光镜和免疫荧光结果相比较,分析电镜检查在肾活检病例诊断中的必要性。结果在肾活检病例诊断中10种病变共52例,必须进行电镜检查才能明确诊断,3种病变共40例需要做电镜检查加以证实。结论电镜检查在肾活检病理诊断中是必不可少的诊断方法,对避免误诊、漏诊具有重要意义,具有完善肾活检诊断的重要作用。

  15. 老年肾脏病患者经皮肾穿刺活检术的安全性评估%Safety Evaluation of Renal Biopsy in Elderly Patients with Renal Disease

    Institute of Scientific and Technical Information of China (English)

    高妍婷; 孙燕; 梁衍; 荀利如; 李振江

    2014-01-01

    Objective To evaluate the safety of renal biopsy in elderly patients with renal disease. Methods A prospective observation of complications was performed in 245 elderly patients who received percutaneous renal biopsy with BARD Magnum biopsy gum and BARD MN1820 biopsy needle, and compared with those of 250 non elderly adult patients. Results (1)The renal biopsies were successfully taken in all patients. There were no significant difference in the frequency of puncture, length of the renal tissue and the specimen satisfactory rate between the two groups (P>0.05). (2)No serious complication occurred in all cases. Mild complications such as perirenal hematoma, lumbago and gross hematuria were observed after biopsy, showing no significant differ-ence between the two groups (P>0.05). Perirenal hematoma mostly occurred within 24h and gross hematuria occurred within 8h. (3)Increased frequency of puncture was risk of perirenal hematoma and increased length of the renal tissue was risk of gross hematuria. Conclusions There is no increased incidence of complications after renal biopsy in elderly patients with renal disease when compared with that of non elderly adult patients. To ensure the safety of renal biopsy, the key point is preparing before biopsy fully, improving the operative technique and strengthen monitoring after biopsy especially within 24h.%目的:探讨老年肾脏病患者行经皮肾穿刺活检术的安全性。方法前瞻性观察245例老年肾脏病患者在B超引导下采用BARD Magnum全自动活检枪和巴德活检针(MN1820)行肾活检的并发症并与250例非老年成人对照。结果(1)全部患者均取到肾小球,两组患者穿刺针数、取出肾组织长度及标本满意率均无明显差异(P>0.05)。(2)无一例患者出现严重并发症,观察到的主要并发症是肾周血肿、腰痛和肉眼血尿,老年组和对照组比较均无明显差异(P>0.05)。肾周血肿主要是小

  16. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Hee; Kim, Myung Joon; Lee, Mi Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Se Hwa [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-09-15

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children.

  17. Clinical value of ultrasound- guided percutaneous renal biopsy%超声引导下肾脏穿刺技术的临床应用

    Institute of Scientific and Technical Information of China (English)

    卢学峰; 甄艳华; 杨利霞

    2011-01-01

    目的 观察超声引导下穿刺取肾脏活组织的取材成功率、并发症的发生率,评价其对临床诊断的价值.方法 62例肾疾病患者采用Phlipls - iE33彩色超声诊断仪,在带穿刺导向的线阵探头指引下用自动活检针快速肾活体组织取材,取材分别送检病理光镜、电镜及免疫荧光.结果 62例全部穿刺成功,2例因取材不足无法做出病理诊断,60例均取得正确临床病理诊断,占96.7%.62例患者肾穿刺活检术后出现并发症3例,其中肉眼血尿2例(3.2%),肾周血肿1例(1.6%).结论 超声引导下经皮肾穿刺活检是一种安全有效的方法,成功率高,并发症少.%Objective To observe the achievement ratio of automatic biopsy and complication rate of ultrasound - guided automatic biopsy technique in renal disease,and to evaluate the method of pereutaneous renal biopsy for clinical diagnosis.Methods The clinical and pathological datas of 62 patients who were received renal biopsy were collected.Results All cases were successfully punctured.Two cases were fail to obtain right pathological diagnosis because the tissue was not sufficient for pathology.Biopsy - related complications occurred in 3 patients (4.8 % ),including gross hematuria in 2 patient (3.2%) and perirenal hematoma in 1 patients( 1.6% ).Conclusions We conclude that ultrasound -guided percutaneous renal biopsy technique in renal disease is an useful and effective diagnostic tool,not only safe but also accurate.

  18. Prognostic value of renal biopsy and clinical variables in patients with lupus nephritis and normal serum creatinine

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Starklint, Henrik; Petersen, J;

    1999-01-01

    To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI).......To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI)....

  19. Effect of Health Education on Patients with Renal Biopsy%浅谈健康教育对肾穿刺活检术患者的影响

    Institute of Scientific and Technical Information of China (English)

    刘文雍

    2015-01-01

    肾穿刺活检术是在B超引导下,使用肾活检针经皮穿刺,夹取少许肾组织后,进行光镜、免疫荧光、电镜检查,以明确肾病的病因、病变程度、病理分型,从而指导治疗、判断预后。由于肾穿刺活检术是一种有创检查,因而对护理的要求也较高。通过对患者手术前后的健康教育,能提高患者的依从性,很好地配合了医疗工作,提高穿刺成功率。%Renal biopsy was performed under the guidance of B ultrasound, using renal biopsy needle percutaneous puncture, clip a lit le kidney tissue, light microscopy, immunofluorescence, electron microscopy, to clarify the cause of kidney disease, pathological changes, pathological classification, so as to guide treatment, prognosis. As a result of renal biopsy is a kind of invasive examination, and therefore the requirements of nursing is also higher. Through the health education of patients before and after surgery, can improve the patient's compliance, good with the medical work, improve the success rate of puncture.

  20. 超声引导经皮肾穿刺活检方法的改进%Study on technological improvement by ultrasound-guided percutaneous renal biopsy

    Institute of Scientific and Technical Information of China (English)

    陈伊伦; 陈芬; 胡志强; 王慧萍

    2000-01-01

    目的 改进肾穿刺方法,以减少肾穿刺的并发症,提高标本质量.方法 将100例有肾穿刺适应症的患者随机分成3组,均在B超引导下用穿刺枪取材.A组:定位于右肾下极外侧,略偏近髓质,垂直进针;B组:定位于右肾下极外侧皮质为主的部位,垂直进针;C组:定位于右肾下极外侧,靠近肾外缘处,穿刺时针略向内倾斜,针尖对准肾皮质较厚的部位.结果 每厘米肾组织中肾小球个数C组最多,B组次之,A组最少.穿刺的成功率三组相似.血尿的发生率A组最高,B组次之,C组最小.结论 在应用活检枪的基础上,通过超声仪选择合适的穿刺位点及准确的导向对减少并发症,提高标本质量起决定性的作用.C组的穿刺方法每厘米肾小球个数最多,血尿发生率最低.%Objective To improve the method of percutaneous renal biopsy for decreasing the complications and ameliorating the sample quality.Methods One hundred patients who had an indication of performing the renal biopsy were divided into three groups and vertically punctured under ultrasound-guided by a biopsy gun to obtain a sample from the exterior side of the lower area of the right kidney,near the renal medulla(group A)and the area where the remal cortex was thicker(group B)and near the verge of the kidney,the needle was titled slightIy,aimed the tip Of the needle at the area where the renal eortex was thicker.(group C),respectively.Results The number of gIomeruIus of per centlmetre renal tissue was the most in group C,the medium in guoup B,and the least in group A.The rate of successful puncture was similar in the three groups.The incidence of hematuria occured ofter renal biopsy was the highest in group A,the medium in group B,and the lowest in group C.Conclusions Using a biOpsy gun,selecting a suitable puncture pomt and the accurate direction improving guided by ultrasound instrument are important in decreasing the complications after renal biopsy and improving the

  1. 临床表现为肾功能异常患者肾活检的病理分析及风险评估%Pathological Analysis and Risk Assessment of Renal Biopsy in Patients with Renal Dysfunction

    Institute of Scientific and Technical Information of China (English)

    张磊; 蔡广研; 孙雪峰; 张雪光; 吴镝; 张利; 吴杰; 陈香美

    2011-01-01

    Objective: To analyze renal pathology and complications of renal biopsy in patients with renal dysfunction and its diagnostic value and risk factors. Methods:We retrospectively analyzed clinical data, ultrasound imaging and laboratory data of 311 patients clinically manifestating as renal dysfunction ( acute or chronic ). 1 717 cases with normal renal function over the same period were as control. The pathological results and complications, of renal biopsy as well as the risk factors were analyzed by multivariate analysis method. Results:89 patients with acute renal dysfunction and 222 with chronic renal dysfunction were enrolled. The top three pathological types of acute renal dysfunction were ANCA associated glomerulonephritis, acute tubular necrosis and acute interstitial nephritis. The top three pathological types of chronic renal dysfunction were IgA nephropathy, chronic tubulointerstitial damage and hypertensive nephropathy. Incidence of renal biopsy complications in acute or chronic renal dysfunction were 2.2% and 5.8%, respectively,which were higher than those with normal renal function ( 1.3% ). However, there was no nephrectomy, death or other serious complications. Multivariate analysis showed that glomerular filtration rate was significantly associated with incidence of complications ( P < 0.05 ). Conclusion: Performance of renal biopsy carefully in patients with renal dysfuntcion brings benefit for pathological diagnosis and therapeutic strategy. Glomerular filtration rate is closely related with occurrence of the complications.%目的:通过分析临床表现为肾功能异常患者肾活检的病理构成与并发症发生情况,明确肾活检在肾功能异常中的诊断价值及风险.方法:回顾性分析行肾活检的311例临床表现为肾功能异常(急性或慢性)患者和同期1 717例肾功能正常患者的临床资料、超声影像与实验室检查数据,分析急性或慢性肾功能异常的肾活检病理结果以及

  2. Comparison of the auto-negative pressure generation renal biopsy device with Bard biopsy device in renal biopsy in the elderly%自动负压式与切割式活检枪在老年患者肾穿刺活检中的应用比较

    Institute of Scientific and Technical Information of China (English)

    白培进; 张勇; 林强; 俞国庆; 李俊霞; 陈建

    2014-01-01

    目的 比较自动负压式活检枪与自动切割式活检枪(Bard活检枪)在老年肾脏病患者中的应用效能及术后并发症的发生情况. 方法 对我科行肾穿刺活检282例(自动负压组159例,自动切割组123例)老年肾脏病患者的穿刺组织标本质量和术后并发症的发生情况进行回顾性分析.结果 自动负压组与自动切割组比较,在穿刺成功率(96.9%比95.1%,P>0.05)和术后并发症肾脏周围血肿(29.6%比30.1%,P>0.05)、肉眼血尿(1.9%比1.6%,P>0.05)发生率等方面,差异均无统计学意义;然而在穿刺组织肾小球数[(17.9±11.5)个比(12.6±9.9)个]、肾组织平均长度[(11.5±5.0)mm比(7.8±3.0)mm]、平均宽度[(1.0±0.2)mm比(0.8±0.4)mm]比较,差异均有统计学意义(均P<0.05). 结论 在老年肾脏病患者应用自动负压式肾活检枪与自动切割式活检枪的穿刺成功率与并发症发生率上无明显不同,但自动负压式活检枪的取材较多,更能满足病理诊断的需要.%Objective To compare the efficacy and complications between an auto negative pressure generation biopsy device and Bard biopsy device in renal biopsy in the elderly.Methods A total of 282 patients in our department received renal biopsies with auto negative pressure generation biopsy device (n=159) versus Bard device (n=123).The quality of tissue biopsy specimen and postoperative complications were analyzed retrospectively.Results There were no significant differences in the success rate,incidences of perirenal hematoma and gross hematuria between the two groups (96.9% vs.95.1%,29.6% vs.30.1%,1.9% vs.1.6%,P>0.05).While the average number of glomeruli,the average length and width of kidney tissue specimen were much more,longer or wider by the auto negative pressure generation renal biopsy device than by the Bard device [(17.9± 11.5) vs.(12.6±9.9),(11.5±5.0)mm vs.(7.8±3.0) mm,(1.0±0.2) mm vs.(0.8±0.4) mm,respectively,all P<0

  3. Evaluation of The Value of Core Needle Biopsy in The Diagnosis of a Breast Mass

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    Asieh Sadat Fattahi

    2016-06-01

    Full Text Available Background: Core needle biopsy (CNB with histological findings is regarded as one of the most important diagnostic measures that make preoperative assessment and planning for appropriate treatment possible. The aim of this study was to determine the sensitivity and specificity of core biopsy results in our patients with benign and malignant breast lumps, especially for borderline breast lesions, by using a classification method.Methods: In this study, 116 patients who were referred to the Surgery Clinic of Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran with breast lump and underwent diagnostic procedures such as mammography and ultrasound were selected. Core needle biopsy (Tru-cut #14 or 16 was performed. After that, excisional biopsy was done. The benign, malignant and unspecified samples obtained by core needle biopsy were evaluated with the samples of the surgical and pathological findings. Then, false positive, false negative, sensitivity, specificity, and diagnostic accuracy of the core needle biopsy method were calculated. Also, the National Health Service Breast Screening Program (NHSBSP classification was employed.Results: The mean age of the participants in this study was 39±13.13 years and the mean tumor size was 2.7 cm. An average of 3.35 biopsies was taken from all patients. Most of the pathology samples taken from CNB and excisional biopsy were compatible with invasive ductal carcinoma. Of the B type classifications, B5 was the most frequent in both methods. Borderline lesions B3 and B4 had a change in their category after surgery. About 2.5% of the samples in core biopsy were inadequate. Skin bruising was the most common core biopsy complication reported. While, the most common complication of excisional biopsy was hematoma. Accuracy, sensitivity, specificity, positive and negative predictive values of the core needle biopsy procedure compared with excisional biopsy was 95.5%, 92.6%, 100%, 100%, and 91

  4. Acute Lymphocytic Leukemia with Bilateral Renal Masses Masquerading as Nephroblastomatosis

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    Poonam Thakore

    2015-01-01

    Full Text Available Acute lymphoblastic leukemia (ALL is the most common malignancy in the pediatric patient population. However, renal involvement as the primary manifestation of ALL is rare. We report a case of a 4-year-old boy with bilateral renal lesions resembling nephroblastic rests as the first finding of early stage ALL preceding hematological changes and subsequent classic clinical findings by two weeks. These renal hypodensities completely resolved after one week of induction chemotherapy. This case demonstrates that renal involvement can be the only initial presenting finding of leukemia. Children with lesions resembling nephroblastic rests need appropriate surveillance due to the risk of malignant disease.

  5. Analysis of the association between Mycobacterium tuberculosis infection and Immunoglobulin A nephropathy by early secreted antigenic target 6 detection in renal biopsies: a prospective study.

    Science.gov (United States)

    Li, Sun; Siyuan, Teng; Jiangmin, Feng; Hailong, Wang; Li, Yao; Jianfei, Ma; Lining, Wang

    2017-04-01

    Immunoglobulin A nephropathy (IgAN) is the most frequent cause of primary renal disease, and clarifying the pathogenesis of IgAN is of great importance for its diagnosis and treatment. It is well known that Mycobacterium tuberculosis (MTB) can infect the urinary tract and result in the typical symptoms of cystitis. However, MTB can also affect the kidney more insidiously. Patients may present with glomerular disease, and sometimes with advanced renal failure. This study was to investigate the association between MTB infection and IgA nephropathy (IgAN), and the early diagnosis of MTB-mediated IgAN by means of early secreted antigenic target 6 (ESAT-6) detection in renal biopsies. One hundred and twenty patients were divided into 3 groups: a renal tuberculosis (RTB) group, a glomerulonephritis without MTB infection (GN-TBI) group and a glomerulonephritis with MTB infection (GN+TBI) group. Morning urine samples were collected for MTB culture. Immunohistochemistry for ESAT-6 expression in renal tissues was performed. The incidence rate of IgAN in the GN+TBI group was 66.7%, which was significantly higher than that of the GN-TBI group. In the GN+TBI group, the ESAT-6 expression was positively associated with IgAN incidence. There was a statistical association between the positive expression of ESAT-6 and the incidence of IgAN. The sensitivity and specificity of urine MTB culture in diagnosing renal MTB infection was 23.3% and 100% respectively, while the sensitivity and specificity of ESAT-6 detection was 100% and 91.1% respectively. Compared with urine MTB culture, the sensitivity of ESAT-6 detection was significantly increased. MTB infection might be associated with the occurrence of IgAN, and ESAT-6 detection in renal tissues may be helpful for the early diagnosis of MTB-mediated IgAN.

  6. Small Renal Masses: Incidental Diagnosis, Clinical Symptoms, and Prognostic Factors

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    F. M. Sánchez-Martín

    2008-01-01

    Full Text Available Introduction. The small renal masses (SRMs have increased over the past two decades due to more liberal use of imaging techniques. SRMs have allowed discussions regarding their prognostic, diagnosis, and therapeutic approach. Materials and methods. Clinical presentation, incidental diagnosis, and prognosis factors of SRMs are discussed in this review. Results. SRMs are defined as lesions less than 4 cm in diameter. SRM could be benign, and most malignant SMRs are low stage and low grade. Clinical symptoms like hematuria are very rare, being diagnosed by chance (incidental in most cases. Size, stage, and grade are still the most consistent prognosis factors in (RCC. An enhanced contrast SRM that grows during active surveillance is clearly malignant, and its aggressive potential increases in those greater than 3 cm. Clear cell carcinoma is the most frequent cellular type of malign SRM. Conclusions. Only some SRMs are benign. The great majority of malign SRMs have good prognosis (low stage and grade, no metastasis with open or laparoscopic surgical treatment (nephron sparing techniques. Active surveillance is an accepted attitude in selected cases.

  7. C-arm cone-beam CT virtual navigation-guided percutaneous mediastinal mass biopsy: Diagnostic accuracy and complications

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    Kim, Hyungjin [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Aerospace Medical Group, Air Force Education and Training Command, Jinju (Korea, Republic of); Park, Chang Min; Goo, Jin Mo [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2015-12-15

    To assess the usefulness of C-arm cone-beam computed tomography (CBCT) virtual navigation-guided percutaneous mediastinal mass biopsy in terms of diagnostic accuracy and complication rates. Seventy-eight CBCT virtual navigation-guided percutaneous mediastinal mass biopsies were performed in 75 patients (M:F, 38:37; mean age, 48.55 ± 18.76 years). The procedural details, diagnostic sensitivity, specificity, accuracy and complication rate were investigated. Mean lesion size was 6.80 ± 3.08 cm, skin-to-target distance was 3.67 ± 1.80 cm, core needle biopsy rate was 96.2 % (75/78), needle indwelling time was 9.29 ± 4.34 min, total procedure time was 13.26 ± 5.29 min, number of biopsy specimens obtained was 3.13 ± 1.02, number of CBCTs performed was 3.03 ± 0.68, rate of lesion border discrimination from abutting mediastinal structures on CBCT was 26.9 % (21/78), technical success rate was 100 % (78/78), estimated effective dose was 5.33 ± 4.99 mSv, and the dose area product was 12,723.68 ± 10,665.74 mGy.cm{sup 2}. Among the 78 biopsies, 69 were malignant, 7 were benign and 2 were indeterminate. Diagnostic sensitivity, specificity and accuracy for the diagnosis of malignancies were 97.1 % (67/69), 100 % (7/7) and 97.4 % (74/76), respectively, with a complication rate of 3.85 % (3/78), all of which were small pneumothoraces. CBCT virtual navigation-guided biopsy is a highly accurate and safe procedure for the evaluation of mediastinal lesions. (orig.)

  8. 肾脏小肿瘤诊治进展%The progress of diagnosis and treatment of small renal mass

    Institute of Scientific and Technical Information of China (English)

    刘国栋; 刘晓; 马宝良

    2012-01-01

    The detection rate of small renal mass (SRM) has risen to 48%~66% of renal tumors detected; moreover, the histology of SRMs is generally heterogonous. Therefore, biopsy must be conducted in order to confirm the diagnosis and select proper treatment options. Literatures demonstrate that the nephron sparing methods, including partial nephrectomy, simple tumor enucleation, thermal ablation and high-intensity focused ultrasound, if applied properly, can be as effective as radical nephrectomy in curing SRMs and may preserve more normal renal parenchyma. Therefore, radical nephrectomy is not necessary for the initial treatment of SRMs.%肾脏小肿瘤检出率占肾肿瘤的48%~66%,且在组织学上常为异质性.必须行活检以明确诊断及准确选择治疗和进行治疗后的监测随访.治疗有严密积极观察、保肾单位治疗如肾部分切除、消融治疗、肿瘤剜除术及超声高能聚焦,如病例选择恰当,这些治疗方法 均能达到与根治性肾切除同样的肿瘤学效果,因此肾小肿瘤的初次治疗没有必要选用根治性肾切除.

  9. Arterial Bleeding of a Thyroid Mass After Thyroid Fine- Needle Aspiration Biopsy: A Case Report

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    Park, Chul Hi; Byun, Sung Su; Kim, Jeong Ho; Hwang, Hee Young; Kim, Ha Na; Chung, Dong Jin; Kim, Hyung Sik [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2009-06-15

    Thyroid fine needle aspiration biopsy is a very common procedure that is used to assess thyroid nodules; any complications from this procedure are rather rare. We report here on an unusual case of active bleeding with the formation of a large hematoma from a branch of the superior thyroidal artery, and this was caused by a thyroid fine needle aspiration biopsy. To the best of our knowledge, this is the first report of active arterial bleeding after thyroid fine needle aspiration biopsy. The active bleeding was successfully treated by interventional embolization

  10. 超声引导下经皮肾穿刺活检的临床价值%The Clinical Value of Ultrasound Guided Percutaneous Renal biopsy

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To investigate the clinical value of Ultrasound guided percutaneous renal biopsy. Methods Retrospective analysis of 115 cases of ultrasound guided percutaneous renal biopsy ultrasound positioning points, the puncture success rate, pathological findings and postoperative complications. Results In 115 cases, 1 case without success, the success rate was 99.1%,pathological results of IgA ephropathy and mesangial proliferative glomerulonephritis accounted for 72% of the total, postoperative complications accounted for 1.3% of gross hematuria, perirenal hematoma accounted for 1.7%, accounted for 43% of low back pain. Conclusions Ultrasound guided percutaneous renal puncture biopsy with high success rate, less complications, and is of high clinical value.%  目的探讨超声引导定位经皮肾穿刺活检的临床价值。方法回顾分析115例经超声引导定位经皮肾穿刺活检声像图定位要点,穿刺取材成功率,病理结果及术后并发症。结果115例中,1例未取材成功,取材成功率99.1%,病理结果IgA肾病及系膜增生性肾小球肾炎占总数的72%,术后并发症肉眼血尿占1.3%,肾周血肿占1.7%,腰痛占43%。结论超声引导定位经皮肾穿刺活检取材成功率高,并发症少,具有很高的临床价值。

  11. The effects of continuous quality improvement on renal biopsy nursing%持续质量改进在肾活检护理中的应用

    Institute of Scientific and Technical Information of China (English)

    李霞

    2011-01-01

    Objective To investigate the effects of continuous quality improvement (CQI)on renal biopsy nursing. Methods Eighty - five patients were divided into control group(45 patients) and observed group(40 patients). Control group patients were given ordinary nursing, observed group were given CQI mode nursing. Nursing problems were evaluated in the process of renal biopsy, and the reasons of these problems were analysed, improvement target was enacted. Steps were taken according to the target. Specific measures were laid out, the effect was appraised. Result The nursing effect of the control group is much better than the observed group. Conclusions Continuous quality improvement application on renal biopsy nursing reduced complications, ensured the patients' safety, improved nursing service quality, and reflected people- first service philosophy.%目的 探讨肾活检护理中持续质量改进(CQI)的应用效果.方法 将85例患者分为对照组45例和观察组40例,对照组按常规护理,观察组采用CQI模式进行护理,评估肾活检过程中存在的护理问题并进行分析,制定改进目标,并根据目标采取措施.制定具体实施步骤,并评价措施产生的效果.结果 观察组的护理效果显著优于对照组.结论肾活检护理中采用持续质量改进,减少了肾活检术后并发症,保证患者安全,提高了护理服务质量,体现了以人为本的护理理念.

  12. Effect of reduced renal mass on renal ammonia transporter family, Rh C glycoprotein and Rh B glycoprotein, expression.

    Science.gov (United States)

    Kim, Hye-Young; Baylis, Chris; Verlander, Jill W; Han, Ki-Hwan; Reungjui, Sirirat; Handlogten, Mary E; Weiner, I David

    2007-10-01

    Kidneys can maintain acid-base homeostasis, despite reduced renal mass, through adaptive changes in net acid excretion, of which ammonia excretion is the predominant component. The present study examines whether these adaptations are associated with changes in the ammonia transporter family members, Rh B glycoprotein (Rhbg) and Rh C glycoprotein (Rhcg). We used normal Sprague-Dawley rats and a 5/6 ablation-infarction model of reduced renal mass; control rats underwent sham operation. After 1 wk, glomerular filtration rate, assessed as creatinine clearance, was decreased, serum bicarbonate was slightly increased, and Na(+) and K(+) were unchanged. Total urinary ammonia excretion was unchanged, but urinary ammonia adjusted for creatinine clearance, an index of per nephron ammonia metabolism, increased significantly. Although reduced renal mass did not alter total Rhcg protein expression, both light microscopy and immunohistochemistry with quantitative morphometric analysis demonstrated hypertrophy of both intercalated cells and principal cells in the cortical and outer medullary collecting duct that was associated with increased apical and basolateral Rhcg polarization. Rhbg expression, analyzed using immunoblot analysis, immunohistochemistry, and measurement of cell-specific expression, was unchanged. We conclude that altered subcellular localization of Rhcg contributes to adaptive changes in single-nephron ammonia metabolism and maintenance of acid-base homeostasis in response to reduced renal mass.

  13. Phenolsulfonphthalein test in healthy sheep and in sheep with reductions in functional renal mass.

    Science.gov (United States)

    Filippich, L J; English, P B; Ainscow, J

    1985-03-01

    The phenolsulfonphthalein (PSP) plasma clearance and urinary excretion tests were applied to sheep before and after 50% and 75% reductions in functional renal mass. The PSP determinants found most useful as indicators of renal mass reduction were the 15-minute urinary excretion percentage and the 60-minute (PSP60) plasma concentration. Although both of these determinants could be used to detect renal mass reduction, the 15-minute PSP excretion percentage was the more sensitive. The PSP60 value was influenced by factors other than reduced nephron numbers; the contraction of the PSP volume of distribution that occurred after renal mass reduction was one important influencing factor. Overall, the PSP tests more accurately reflected the volume of blood delivered to the kidney than the proximal tubular secretory capacity.

  14. Suture Granuloma Mimicking Renal Cell Carcinoma: Magnetic Resonance Imaging (MRI and Pathologic Correlation

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    İbrahim İlker Öz

    2014-11-01

    Full Text Available Solid renal masses are generally distinguished with contrast enhancement and intratumoral fatty foci by radiological examinations. The present of enhancement is most important criteria for diagnosis of malignant lesions. Generally, a contrast enhanced solid mass in kidney is accepted as a neoplasm. Foreign body granuloma is an extraordinary cause of enhanced solid renal mass. This case of a renal suture granuloma demonstrated peripheral enhanced exophytic renal mass mimic renal cell carcinoma, and underwent surgery. At the solid renal mass with different radiological features, biopsy is an option to determining the necessity of surgery as well as the surgical approach.

  15. 肾功能异常的肾活检患者临床及病理特点分析%Clinical and pathological characteristics of renal biopsy in patients with renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    王叙芬

    2015-01-01

    目的:研究和分析肾功能异常的肾活检患者临床及病理特点,为疾病的诊断、治疗及预后提供科学的参考依据。方法选取2012年9月至2015年7月收治的22例肾功能异常患者作为观察组,选取同时期收治的18例肾功能正常患者作为对照组,分析和比较两组患者肾活检结果。结果两组患者标本合格率比较无明显差异(P>0.05),观察组患者并发症发生率较对照组更高(P 0.05), the observation group of patients with complication rates higher than the control group (P < 0.05), 22 patients after renal biopsy to correct diagnosis of 9 cases.Conclusion:Abnormal renal patients for renal biopsy operation, is advantageous to the definite pathological type, provide a reference for the diagnosis, treatment and prognosis of diseases, has important clinical value.

  16. Is there a role for body mass index in the assessment of prostate cancer risk on biopsy?

    Science.gov (United States)

    Liang, Yuanyuan; Ketchum, Norma S; Goodman, Phyllis J; Klein, Eric A; Thompson, Ian M

    2014-10-01

    We examine the role of body mass index in the assessment of prostate cancer risk. A total of 3,258 participants who underwent biopsy (including 1,902 men with a diagnosis of prostate cancer) were identified from the Selenium and Vitamin E Cancer Prevention Trial. The associations of body mass index with prostate cancer and high grade prostate cancer were examined using logistic regression, adjusting for age, race, body mass index adjusted prostate specific antigen, digital rectal examination, family history of prostate cancer, biopsy history, prostate specific antigen velocity, and time between study entry and the last biopsy. The prediction models were compared with our previously developed body mass index adjusted Prostate Cancer Prevention Trial prostate cancer risk calculator. Of the study subjects 49.1% were overweight and 29.3% were obese. After adjustment, among men without a known family history of prostate cancer, increased body mass index was not associated with a higher risk of prostate cancer (per one-unit increase in logBMI OR 0.83, p=0.54) but was significantly associated with a higher risk of high grade prostate cancer (ie Gleason score 7 or greater prostate cancer) (OR 2.31, p=0.03). For men with a known family history of prostate cancer the risks of prostate cancer and high grade prostate cancer increased rapidly as body mass index increased (prostate cancer OR 3.73, p=0.02; high grade prostate cancer OR 7.95, p=0.002). The previously developed risk calculator generally underestimated the risks of prostate cancer and high grade prostate cancer. Body mass index provided independently predictive information regarding the risks of prostate cancer and high grade prostate cancer after adjusting for other risk factors. Body mass index, especially in men with a known family history of prostate cancer, should be considered for inclusion in any clinical assessment of prostate cancer risk and recommendations regarding prostate biopsy. Copyright © 2014

  17. Clinical Analysis of Renal Diseases Based on 62 Cases Renal Biopsy Data%62例患者肾活检的临床及病理对比分析

    Institute of Scientific and Technical Information of China (English)

    王淑云; 许艳

    2015-01-01

    Objective Analyze the clinical features and pathological types of biopsy proven kidney diseases.Methods A retrospective and comparison analysis of 62 cases of renal biopsy in patients with clinical and pathological data in our hospital from March 2012 to March 2014.Results In the clinical manifestations, nephrotic syndrome was most commonly seen, followed by chronic glomerulonephritis. The pathology types of nephrotic were membranous nephropathy and IgA nephropathy. Lupus nephritis was most commonly seen in the glomerulonephritis.Conclusion Renal biopsy examination can make a correct diagnosis for patients with renal disease and can provide effective basis for patient treatment.%目的:分析行肾穿刺活检患者的临床特征及病理类型。方法回顾性分析我院2012年3月~2014年3月期间收治的62例肾穿刺活检患者的临床与病理资料,并进行对比分析。结果62例患者临床表现以肾病综合征最多见,其次为慢性肾小球肾炎。病理类型依次为膜性肾病和IgA 肾病;继发性肾小球疾病以狼疮性肾炎最常见。结论应用肾活检检查可以对患者的肾脏疾病做出正确的诊断和判断,同时能够为患者的治疗提供有效的依据。

  18. The characterization of small hypoattenuating renal masses on contrast-enhanced CT☆

    Science.gov (United States)

    Patel, Neesha S.; Poder, Liina; Wang, Zhen J.; Yeh, Benjamin M.; Qayyum, Aliya; Jin, Hua; Coakley, Fergus V.

    2011-01-01

    Purpose To determine if small hypoattenuating renal masses can be characterized as simple cysts or renal cell carcinomas on contrast-enhanced computed tomography (CT). Materials and methods We retrospectively identified 20 small (≤1.5 cm) hypoattenuating renal masses seen on contrast enhanced CT, consisting of 14 simple cysts and six renal cell carcinomas. Three independent readers recorded subjective visual impression (five-point scale from 1=definitely fluid to 5=definitely solid), CT attenuation, border (well circumscribed or ill defined), and shape (ovoid or irregular) for each lesion. Results The overall area under the receiver operator characteristic curves for subjective visual impression, CT attenuation, border, and shape were 0.97, 0.82, 0.59, and 0.55, respectively. Using dichotomized ratings (1–2=cyst and 3–5=carcinoma), subjective impression had a sensitivity and specificity of 100% and 79–100%, respectively, for the diagnosis of renal cell carcinoma. Using a threshold of 50 Hounsfield Units (HU) or more, CT attenuation had a sensitivity and specificity of 100% and 43–64%, respectively. Conclusion Small hypoattenuating renal masses can be characterized with reasonable accuracy by subjective impression and CT attenuation; lesions that appear solid on visual inspection or have an attenuation value of 50 HU or more are likely to be renal cell carcinoma. © 2009 Elsevier Inc. All rights reserved. PMID:19559352

  19. Bone Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  20. Diagnosis of a submucosal mass at the staple line after sigmoid colon cancer resection by endoscopic cuttingmucosa biopsy

    Institute of Scientific and Technical Information of China (English)

    Mitsuaki Morimoto; Koji Koinuma; Alan K Lefor; Hisanaga Horie; Homare Ito; Naohiro Sata; Yoshikazu Hayashi; Keijiro Sunada; Hironori Yamamoto

    2016-01-01

    A 48-year-old man underwent laparoscopic sigmoid colon resection for cancer and surveillance colonoscopy was performed annually thereafter. Five years after the resection, a submucosal mass was found at the anastomotic staple line, 15 cm from the anal verge. Computed tomography scan and endoscopic ultrasound were not consistent with tumor recurrence. Endoscopic mucosa biopsy was performed to obtain a definitive diagnosis. Mucosal incision over the lesion with the cutting needle knife technique revealed a creamy white material, which was completely removed. Histologic examination showed fibrotic tissue without caseous necrosis or tumor cells. No bacteria, including mycobacterium, were found on culture. The patient remains free of recurrence at five years since the resection. Endoscopic biopsy with a cutting mucosal incision is an important technique for evaluation of submucosal lesions after rectal resection.

  1. Computed tomography-guided percutaneous biopsy of pancreatic masses using pneumodissection; Biopsia percutanea de massas pancreaticas guiada por tomografia computadorizada com pneumodisseccao

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang Jeng; Bitencourt, Almir Galvao Vieira; Almeida, Maria Fernanda Arruda; Barbosa, Paula Nicole Vieira; Martins, Eduardo Bruno Lobato; Junior, Joao Paulo Kawaoka Matushita; Chojniak, Rubens, E-mail: chiangjengtyng@gmail.com [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Imagem; Coimbra, Felipe Jose Fernandez [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Cirurgia Abdominal

    2013-05-15

    Objective: to describe the technique of computed tomography-guided percutaneous biopsy of pancreatic tumors with pneumodissection. Materials and methods: in the period from June 2011 to May 2012, seven computed tomography guided percutaneous biopsies of pancreatic tumors utilizing pneumodissection were performed in the authors' institution. All the procedures were performed with an automatic biopsy gun and coaxial system with Tru-core needles. The biopsy specimens were histologically assessed. Results: in all the cases the pancreatic mass could not be directly approached by computed tomography without passing through major organs and structures. The injection of air allowed the displacement of adjacent structures and creation of a safe coaxial needle pathway toward the lesion. Biopsy was successfully performed in all the cases, yielding appropriate specimens for pathological analysis. Conclusion: Pneumodissection is a safe, inexpensive and technically easy approach to perform percutaneous biopsy in selected cases where direct access to the pancreatic tumor is not feasible. (author)

  2. Can we avoid surgery in elderly patients with renal masses by using the Charlson comorbidity index?

    LENUS (Irish Health Repository)

    O'Connor, Kevin M

    2012-02-01

    OBJECTIVE To determine the safety of surveillance for localized contrast-enhancing renal masses in elderly patients whose comorbidities precluded invasive management; to provide an insight into the natural history of small enhancing renal masses; and to aid the clinician in identifying those patients who are most suitable for a non-interventional approach. PATIENTS AND METHODS We conducted a retrospective chart review of 26 consecutive patients (16 men and 10 women), who were followed for > or =1 year, with localized solid enhancing renal masses between 1998 and 2006. These patients were unfit or unwilling to undergo radical or partial nephrectomy. None had their tumours surgically removed. Study variables included age, presentation, tumour size, growth rate, Charlson comorbidity index (CMI) and available pathological data. RESULTS The mean (range) patient age was 78.14 (63-89) year, with a mean follow-up of 28.1 (12-72) months. The mean tumour size was 4.25 (2.5-8.7) cm at diagnosis. The tumour growth rate was 0.44 cm\\/year; among smaller masses (T1a) it was 0.15 cm\\/year, vs 0.64 cm\\/year in the larger masses (T1b and T2). The mean CMI was 2.96. There were 11 deaths overall; 10 patients died from unrelated illnesses. One death was directly attributable to metastatic renal cancer; this patient had an initial tumour diameter of 5.4 cm and a CMI of 6. All patients who died had a CMI of > or =3. CONCLUSIONS Elderly patients with small renal tumours (T1a) and comorbidity scores of > or =3 were more likely to die as a result of their comorbidities rather than the renal tumour. Surveillance of small renal masses appears to be a safe alternative in elderly patients who are poor surgical candidates, where the overall growth rate appears to be slow.

  3. Comprehensive analysis of the mouse renal cortex using two-dimensional HPLC – tandem mass spectrometry

    Directory of Open Access Journals (Sweden)

    Denner Larry

    2008-05-01

    Full Text Available Abstract Background Proteomic methodologies increasingly have been applied to the kidney to map the renal cortical proteome and to identify global changes in renal proteins induced by diseases such as diabetes. While progress has been made in establishing a renal cortical proteome using 1-D or 2-DE and mass spectrometry, the number of proteins definitively identified by mass spectrometry has remained surprisingly small. Low coverage of the renal cortical proteome as well as our interest in diabetes-induced changes in proteins found in the renal cortex prompted us to perform an in-depth proteomic analysis of mouse renal cortical tissue. Results We report a large scale analysis of mouse renal cortical proteome using SCX prefractionation strategy combined with HPLC – tandem mass spectrometry. High-confidence identification of ~2,000 proteins, including cytoplasmic, nuclear, plasma membrane, extracellular and unknown/unclassified proteins, was obtained by separating tryptic peptides of renal cortical proteins into 60 fractions by SCX prior to LC-MS/MS. The identified proteins represented the renal cortical proteome with no discernible bias due to protein physicochemical properties, subcellular distribution, biological processes, or molecular function. The highest ranked molecular functions were characteristic of tubular epithelium, and included binding, catalytic activity, transporter activity, structural molecule activity, and carrier activity. Comparison of this renal cortical proteome with published human urinary proteomes demonstrated enrichment of renal extracellular, plasma membrane, and lysosomal proteins in the urine, with a lack of intracellular proteins. Comparison of the most abundant proteins based on normalized spectral abundance factor (NSAF in this dataset versus a published glomerular proteome indicated enrichment of mitochondrial proteins in the former and cytoskeletal proteins in the latter. Conclusion A whole tissue extract of

  4. The clinical pathological analysis of the 237 cases of the renal biopsy%237例肾组织活检的临床病理分析

    Institute of Scientific and Technical Information of China (English)

    黄芬芬; 谢小行

    2011-01-01

    Objective: Retrospective analysis of 237 cases of renal biopsy and pathological types and clinical characteristics, relationship between the two. Methods: 237 renal biopsy patients in routine clinical features, immunopathology, light microscopy, electron microscopy of changes made pathological diagnosis. Results: The primary glomerular disease accounted for 78.1 %, mainly IgA nephropathy, mesangial proliferative glomerulone-phritis, membranous nephropathy, minimal change disease and so on. Secondary glomerulonephritis, 19.8%, mainly lupus nephritis, purpura nephritis. The average age of onset was 37. 12 years. Discussion. Primary is the more common type of kidney disease, IgA nephropathy is the main, secondary nephropathy, lupus nephritis based. The majority of patients with chronic nephritis syndrome presents a variety of pathological manifestations. Renal biopsy is of great significance.%目的:旨在通过回顾分析237例肾活检的病理类型与临床诊断,对两者的相关性进行研究总结.方法:分析237例行肾活检病人的临床诊断、免疫病理、光镜、电镜的改变,做出病理诊断.结果:原发性肾小球疾病占78.1%,主是IgA肾病、系膜增生性肾小球肾炎、膜性肾病、微小病变等.继发性肾小球肾炎占19.8%,主是狼疮性肾炎、紫疲性肾炎等.发病年龄平均为37.12岁.讨论:原发性肾病是较常见的类型,以IgA肾病为主,继发性肾病则以狼疮性肾炎为主;绝大多数的慢性肾炎综合征患者的病理表现呈现出多样化的特征,这使得肾活检意义重大.

  5. Inferior vena cava aneurysm in an infant presenting with a renal mass.

    Science.gov (United States)

    Unzueta-Roch, José L; García-Abós, Miriam; Sirvent-Cerdá, Sara; de Prada, Inmaculada; Martínez de Azagra, Amelia; Ollero, Jose M; Madero-López, Luis

    2014-10-01

    Aneurysm of the inferior vena cava is a rare finding in the pediatric population. We report the case of a 5-month-old infant presenting with anemia, hypertension, and dehydration in the emergency room. A renal mass was found with ultrasound and MRI and a renal tumor was first considered. Histopathologic review of the surgical specimen led to the diagnosis of aneurysmal dilatation of the vena cava.

  6. Renal Biopsy and Clinical Pathological Features in 227 Infants%婴幼儿227例肾穿刺及临床病理学特点

    Institute of Scientific and Technical Information of China (English)

    黄丹琳; 易著文; 党西强; 吴小川; 何小解; 曹艳; 莫双红; 何庆南

    2011-01-01

    目的 分析婴幼儿肾脏疾病临床病理的特点及婴幼儿肾穿刺安全进行的方法和意义.方法 对临床诊断为肾脏疾病的227例婴幼儿进行经皮肾穿刺活检,肾脏病理组织分别进行光镜、免疫荧光和电镜观察.光镜标本做苏木精-伊红(HE)、过碘酸雪夫反应(PAS)、六胺银(PASM)和Masson染色,免疫荧光检测其肾组织中的IgG、IgM、IgA、C3、C4、C1q、Fibrin,204例标本同时行电镜检查.结果 所有患儿肾穿刺均获成功,术后无明显并发症.有肾穿刺适应证的227例婴幼儿肾脏疾病中最常见的是肾病综合征(38.3%)、孤立性血尿(37.0%)和急性肾炎综合征(9.3%),继发性肾脏疾病相对较少(5.3%).肾脏病理类型中最常见的是系膜增生性肾小球肾炎(62.6%)、IgA肾病(8.4%)和局灶节段性肾小球硬化(5.7%).87例肾病综合征病理类型最常见的是系膜增生性肾小球肾炎(50例)、微小病变(11例)和局灶节段性肾小球硬化(9例);84例孤立性血尿病理类型最常见的是系膜增生性肾小球肾炎(68例)和IgA肾病(9例).结论 在不盲目扩大适应证的基础上,安全有效地进行婴幼儿肾穿刺,可以提高婴幼儿肾脏疾病的诊治水平.%Objective To analyze the clinical and pathological features of children under 3 years with renal disease, and summarize the methods and significance of renal biopsy in infants.Methods Percutaneous renal biopsy was performed on 227 infants who were diagnosed as kidney diseases.The specimens were divided into 3 parts for light microscope, electron microscope and immunofluorescence examination respectively and processed by hematoxylin - eosin ( HE ), periodic acid - schiff( PAS ) , periodic acid - sliver methenamine ( PASM ) , and Masson staining.Immunofluorescence was used to detect the deposition of IgG, IgM, IgA, C3 , C4 , C 1q, and Fibrin in the renal tissues.Altogether 204 of the specimens were examined by electron microscope.Results All the renal

  7. 高原地区B超引导下穿刺枪肾活检穿刺术的护理体会%Clinical epidemiology of renal disease at high altitude area based on renal biopsy data

    Institute of Scientific and Technical Information of China (English)

    唐婷; 龚运兵; 朱美洁; 邓永明; 李川; 李素芝

    2014-01-01

    Objective Between June 2011 and October 2013 in Department of Urokgy,General Hospital of Tibetan Military Command,Lhasa,107 attempts of percutaneous renal biopsy were performed in renal patients.In this report,the pathologic entityes were analyzed retrospectively.Methodology The drawn quality and occurrence of complications in 107 patients were observed.The mean age at renal biopsy was 29.8±12.2(10~66)years.Male 47 cases (43.9 %), female 60 cases ( 56.1 %), 75 cases of Tibetans (accounting for 70.1% ) , Han 31 cases ( 28.9 per cent) , Bai one case (1%). Results (1) drawn quality: 107 patients were taken to the kidney tissue , assembly power 100% , the number of glomerular kidney tissue obtained 30.5 ± 12.9.Qualified drawn only 2 cases, 1.8% ; drawn good 105 cases, accounting for 98.2% ; (2) the occurrence of complications: there was fewer complications, gross hematuria was occurred in 3 patients (2.8% ) , gross hematuria of 2 cases was disappearance in the application of vasopressin,1 patient with secondary epilepsy give up treatment and discharged ; perirenal hematoma incidence rate was 0.9%. Conclusion The Tibetan plateau renal biopsy is safe. Al patients with biopsy specimens drawn are satisfactory. And no case arises severe renal biopsy complications.%目的:了解我国西藏高原地区慢性肾脏病的肾活检的取材质量及并发症发生情况,探讨护理在肾活检过程中的重要性。方法回顾性分析西藏军区总医院2011年6月至2013年10月因肾脏疾病行肾活检的107例患者取材质量及并发症发生情况,对患者进行肾活检全程护理。结果本组患者行肾活检时平均年龄29.8±12.2(10~66)岁,男性47例(占43.9%),女性60例(占56.1%),藏族75例(占70.1%),汉族31例(占28.9%),白族1例(占1%)。本院无一例肾活检严重并发症。结论有效的护理干预对于安全顺利完成肾活检起到至关重要的作用。施行有效术前、术中、术

  8. Higher body mass index increases the risk for biopsy-mediated detection of prostate cancer in Chinese men.

    Directory of Open Access Journals (Sweden)

    Meng-Bo Hu

    Full Text Available To investigate the relationship between body mass index (BMI and prostate cancer (PCa risk at biopsy in Chinese men.We retrospectively reviewed the records of 1,807 consecutive men who underwent initial multicore (≥10 prostate biopsy under transrectal ultrasound guidance between Dec 2004 and Feb 2014. BMI was categorised based on the Asian classification of obesity as follows: <18.5 (underweight, 18.5-22.9 (normal weight, 23-24.9 (overweight, 25-29.9 (moderately obese, and ≥30 kg/m2 (severely obese. The odds ratios (OR of each BMI category for risk of PCa and high-grade prostate cancer (HGPCa, Gleason score ≥4+3 detection were estimated in crude, age-adjusted and multivariate-adjusted models. Prevalence ratios and accuracies of PSA predicted PCa were also estimated across BMI groups.In total, PCa was detected by biopsy in 750 (45.4% men, and HGPCa was detected in 419 (25.4% men. Compared with men of normal weight, underweight men and obese men were older and had higher prostate specific antigen levels. The risk of overall PCa detection via biopsy presented an obvious U-shaped relationship with BMI in crude analysis. Overall, 50.0%, 37.4%, 45.6% 54.4% and 74.1% of the men in the underweight, normal weight, overweight, moderately obese and severely obese groups, respectively, were diagnosed with PCa via biopsy. In multivariate analysis, obesity was significantly correlated with a higher risk of PCa detection (OR = 1.17, 95%CI 1.10-1.25, P<0.001. However, higher BMI was not correlated with HGPCa detection (OR = 1.03, 95%CI 0.97-1.09, P = 0.29. There were no significant differences in the accuracy of using PSA to predict PCa or HGPCa detection across different BMI categories.Obesity was associated with higher risk of PCa detection in the present Chinese biopsy population. No significant association was detected between obesity and HGPCa.

  9. [OSTEOPOROSIS AND BODY MASS INDEX IN RENAL TRANSPLANT RECIPIENTS].

    Science.gov (United States)

    López Ruiz, María del Carmen; Ortega Martínez, Ana Raquel; Fernández Castillo, Rafael; Esteban de la Rosa, Rafael José; Bravo Soto, Juan Antonio

    2015-08-01

    Introducción y objetivos: tras el trasplante renal es frecuente un aumento de peso, así como un elevado porcentaje de obesidad en estos pacientes. Por otro lado, tras el trasplante se produce una pérdida de la masa ósea, siendo la prevalencia de osteoporosis y fracturas óseas mayor que en la población general. Objetivos: explorar la relación entre el índice de masa corporal y la prevalencia de osteopenia y osteoporosis en una población de trasplantados renales. Material y método: estudio longitudinal prospectivo sobre una muestra de 306 trasplantados renales. Se exploraron las relaciones entre el peso y el índice de masa corporal con la prevalencia de osteopenia y osteoporosis a nivel femoral y lumbar en el momento del trasplante y a los 12 meses del mismo. Resultados: se halló una alta prevalencia de sobrepeso (35,6%) y obesidad (14,1%) tras el trasplante renal y al año del mismo (42,2% y 24,2%, respectivamente). Se hallaron diferencias estadísticamente significativas (p = 0,049) entre el peso en el momento del trasplante y la presencia de osteopenia u osteoporosis al año del mismo a nivel lumbar, siendo el peso medio más elevado entre los pacientes con osteoporosis. La media del IMC fue más elevada (p = 0,028) en los pacientes osteoporóticos (26,59 kg/m2) que en los pacientes con osteopenia (24,23 kg/m2). Conclusiones: nuestros resultados parecen estar en concordancia con recientes estudios realizados en la población general, que muestran el sobrepeso como un posible factor perjudicial para el hueso.

  10. Application of Clinical Nursing Pathway in Renal Biopsy Patients%临床护理路径在肾穿刺病人中的应用

    Institute of Scientific and Technical Information of China (English)

    李五妹

    2012-01-01

    Objective: To establish clinical nursing pathway for renal biopsy patients. Methods : 60 cases were divided into experimental group ( n=30 ) and control group ( n=30 ) at random. The control group of patients received routine nursing according to medical order, while the experimental group took the clinical nursing pathway. The difference between the complication incidence, comfortability and patient's satisfaction of the two groups was observed. Results : The complication incidence of the experimental group decreased significantly and the comfortability and satisfaction were obviously improved compared to the control group. Conclusion: The clinical nursing pathway is fit for renal biopsy patients, which reduce the incidence of complications and increase the comfortability and satisfaction of patients, thus improve the nursing quality.%目的:建立完善的肾穿刺病人的临床护理路径.方法:采用随机抽样法将60例病人分成实验组和对照组,每组30例.对照组病人采用按常规医嘱进行护理,实验组病人采用制定好的临床护理路径进行护理,观察两组病人并发症的发生率、舒适度及病人满意度有无差异.结果:实验组病人并发症的发生率均较对照组明显降低,舒适度及满意度均明显提高.结论:临床护理路径用于肾穿刺病人中,降低并发症发生率,提高舒适度及病人和家属的满意度,从而促进护理质量的提高.

  11. Differential Diagnosis and Analysis of Renal Biopsy for Hematuria Patients%单纯性血尿患者的鉴别诊断及肾穿活检分析

    Institute of Scientific and Technical Information of China (English)

    程晖; 石明; 邱昌建; 刘红燕

    2011-01-01

    Objective: To investigate the importance of hematuria in the renal diseases through differential diagnosis and renal biopsy. Methods: The hematuria has been distinguished by contrast phase microscope and distribution analysis of erythrocyte volumes, then the patients with glomerular hematuria and mixed hematuria underwent renal biopsy. Results: Glomerular hematuria proportion was more than none glomerular hematuria. Renal biopsy indicated that IgA nephropathy was the first cause of isolated renal hematuria. Conclusion: The screening procedures are important for isolated hematuria suspected as renal disease, and renal biopsy is helpful for the final diagnosis and determining the therapeutic schedule.%目的:对单纯血尿患者进行鉴别诊断及肾穿活检,以阐明血尿在肾脏病变中的重要性.方法:相差显微镜和尿红细胞体积曲线进行血尿的鉴别诊断,对肾小球性血尿和混合性血尿的患者进行肾穿活检明确病理改变.结果:肾小球性血尿在单纯性血尿中的比例较非肾小球性血尿高,肾穿刺活检表明IgA肾病是肾性血尿第1位病因.结论:单纯性血尿患者的筛查十分重要,早期筛选出的可疑肾病患者应进行肾活检明确病理性质,有助于制定积极的治疗方案,延缓肾脏病变的进程.

  12. Gum biopsy

    Science.gov (United States)

    Biopsy - gingiva (gums) ... used to close the opening created for the biopsy. ... to eat for a few hours before the biopsy. ... Risks for this procedure include: Bleeding from the biopsy site Infection of the gums Soreness

  13. Skin Biopsy

    Science.gov (United States)

    ... I Help Someone Who's Being Bullied? Volunteering Skin Biopsy KidsHealth > For Teens > Skin Biopsy Print A A ... español Biopsia de piel What Is a Skin Biopsy and Who Would Need One? In a biopsy, ...

  14. Laparoscopic Nephrectomy, Ex Vivo Partial Nephrectomy, and Autotransplantation for the Treatment of Complex Renal Masses

    Directory of Open Access Journals (Sweden)

    Jasmir Gopal Nayak

    2014-01-01

    Full Text Available In the contemporary era of minimally invasive surgery, very few T1/T2 renal lesions are not amenable to nephron-sparing surgery. However, centrally located lesions continue to pose a clinical dilemma. We sought to describe our local experience with three cases of laparoscopic nephrectomy, ex vivo partial nephrectomy, and autotransplantation. Laparoscopic donor nephrectomy was performed followed by immediate renal cooling and perfusion with isotonic solution. Back-table partial nephrectomy, renorrhaphy, and autotransplantation were then performed. Mean warm ischemia (WIT and cold ischemic times (CIT were 2 and 39 minutes, respectively. Average blood loss was 267 mL. All patients preserved their renal function postoperatively. Final pathology confirmed pT1, clear cell renal cell carcinoma with negative margins in all. All are disease free at up to 39 months follow-up with stable renal function. In conclusion, the described approach remains a viable option for the treatment of complex renal masses preserving oncological control and renal function.

  15. Research progress on bed time and position of patients after undergoing renal puncture biopsy%肾穿刺活组织检查术后病人卧床时间及体位的研究进展

    Institute of Scientific and Technical Information of China (English)

    潘凌蕴; 吕桂兰

    2012-01-01

    对肾穿刺活组织检查术后并发症发生的时间窗、不同卧床时间对肾活检术后并发症的影响及不同体位对肾活检术后病人舒适度的影响进行综述,提出肾活检病人术后6h~8h内平卧、12h~15h后下床的安全性,应进一步探讨高危病人肾活检术后卧床及下床时间.%It reviewed the time window of postoperative complications occurrence and influence of different bed time on postoperative complications of renal biopsy, and influence of different positions on the comfort of patients after undergoing renal biopsy. It put forward the security of renal biopsy patients with the supine in 6 h~8 h after operation,and out of bed in 12 h~15 h after operation, so as to further probe into In bed and out of bed time of high - risk patients after renal biopsy.

  16. Transcriptome Sequencing (RNAseq) Enables Utilization of Formalin-Fixed, Paraffin-Embedded Biopsies with Clear Cell Renal Cell Carcinoma for Exploration of Disease Biology and Biomarker Development.

    Science.gov (United States)

    Eikrem, Oystein; Beisland, Christian; Hjelle, Karin; Flatberg, Arnar; Scherer, Andreas; Landolt, Lea; Skogstrand, Trude; Leh, Sabine; Beisvag, Vidar; Marti, Hans-Peter

    2016-01-01

    Formalin-fixed, paraffin-embedded (FFPE) tissues are an underused resource for molecular analyses. This proof of concept study aimed to compare RNAseq results from FFPE biopsies with the corresponding RNAlater® (Qiagen, Germany) stored samples from clear cell renal cell carcinoma (ccRCC) patients to investigate feasibility of RNAseq in archival tissue. From each of 16 patients undergoing partial or full nephrectomy, four core biopsies, such as two specimens with ccRCC and two specimens of adjacent normal tissue, were obtained with a 16g needle. One normal and one ccRCC tissue specimen per patient was stored either in FFPE or RNAlater®. RNA sequencing libraries were generated applying the new Illumina TruSeq® Access library preparation protocol. Comparative analysis was done using voom/Limma R-package. The analysis of the FFPE and RNAlater® datasets yielded similar numbers of detected genes, differentially expressed transcripts and affected pathways. The FFPE and RNAlater datasets shared 80% (n = 1106) differentially expressed genes. The average expression and the log2 fold changes of these transcripts correlated with R2 = 0.97, and R2 = 0.96, respectively. Among transcripts with the highest fold changes in both datasets were carbonic anhydrase 9 (CA9), neuronal pentraxin-2 (NPTX2) and uromodulin (UMOD) that were confirmed by immunohistochemistry. IPA revealed the presence of gene signatures of cancer and nephrotoxicity, renal damage and immune response. To simulate the feasibility of clinical biomarker studies with FFPE samples, a classifier model was developed for the FFPE dataset: expression data for CA9 alone had an accuracy, specificity and sensitivity of 94%, respectively, and achieved similar performance in the RNAlater dataset. Transforming growth factor-ß1 (TGFB1)-regulated genes, epithelial to mesenchymal transition (EMT) and NOTCH signaling cascade may support novel therapeutic strategies. In conclusion, in this proof of concept study, RNAseq data

  17. Transcriptome Sequencing (RNAseq Enables Utilization of Formalin-Fixed, Paraffin-Embedded Biopsies with Clear Cell Renal Cell Carcinoma for Exploration of Disease Biology and Biomarker Development.

    Directory of Open Access Journals (Sweden)

    Oystein Eikrem

    Full Text Available Formalin-fixed, paraffin-embedded (FFPE tissues are an underused resource for molecular analyses. This proof of concept study aimed to compare RNAseq results from FFPE biopsies with the corresponding RNAlater® (Qiagen, Germany stored samples from clear cell renal cell carcinoma (ccRCC patients to investigate feasibility of RNAseq in archival tissue. From each of 16 patients undergoing partial or full nephrectomy, four core biopsies, such as two specimens with ccRCC and two specimens of adjacent normal tissue, were obtained with a 16g needle. One normal and one ccRCC tissue specimen per patient was stored either in FFPE or RNAlater®. RNA sequencing libraries were generated applying the new Illumina TruSeq® Access library preparation protocol. Comparative analysis was done using voom/Limma R-package. The analysis of the FFPE and RNAlater® datasets yielded similar numbers of detected genes, differentially expressed transcripts and affected pathways. The FFPE and RNAlater datasets shared 80% (n = 1106 differentially expressed genes. The average expression and the log2 fold changes of these transcripts correlated with R2 = 0.97, and R2 = 0.96, respectively. Among transcripts with the highest fold changes in both datasets were carbonic anhydrase 9 (CA9, neuronal pentraxin-2 (NPTX2 and uromodulin (UMOD that were confirmed by immunohistochemistry. IPA revealed the presence of gene signatures of cancer and nephrotoxicity, renal damage and immune response. To simulate the feasibility of clinical biomarker studies with FFPE samples, a classifier model was developed for the FFPE dataset: expression data for CA9 alone had an accuracy, specificity and sensitivity of 94%, respectively, and achieved similar performance in the RNAlater dataset. Transforming growth factor-ß1 (TGFB1-regulated genes, epithelial to mesenchymal transition (EMT and NOTCH signaling cascade may support novel therapeutic strategies. In conclusion, in this proof of concept study

  18. Percutaneous Excision of a Benign Breast Mass Using Ultrasound-guided, Vacuum-assisted Core Biopsy:A Review of 197 Cases with Long Term Follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hoi Soo; Han, Heon; Kim, Sam Soo; Jeon, Yong Hwan; Lee, Ji Won; Kim, Hyoung Rae [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of); Moon, Jin Hee; Lee, Hyun; Koh, Sung Hye [Hallym University College of Medicine, Chuncheon (Korea, Republic of); Kim, Sun Mi [Bundang Seoul National University Hospital, Seoul (Korea, Republic of)

    2010-03-15

    To assess long term results of excising benign masses using ultrasound (US)-guided, vacuum-assisted core biopsy (Mammotome). We enrolled 163 patients (197 masses) receiving US guided excision using vacuum-assisted core biopsy and follow-up sonography in this retrospective study. The masses were category 3 as determined by ultrasound imaging according to the Breast Imaging Reporting and Data System (BI-RADS) (n=145) or pathologically confirmed as benign masses by a previous core-needle biopsy although category 4a and 4b (n = 52). Pathology, the presence of hematoma and residual tissue, as well as scar formation were assessed. We diagnosed 190 (96.5%) benign masses, 4 (2.0%) malignant masses, and 3 (1.5%) high-risk lesions. Most (176 masses, 91.2%) were excised completely as demonstrated by the follow-up ultrasound examination. Scar changes were minimal (68.7%) or moderate (31.3%), with regression in 53%. US-guided excision using vacuum-assisted core biopsy is effective for the removal of benign breast masses. The majority of scars are minimal, with good cosmetic effect. However, subsequent excision should be done for malignant masses or phyllodes tumor because radiologic absence does not guarantee complete removal

  19. Pathologic and clinical analysis on 158 cases of renal biopsy%158例肾活检病理及临床分析

    Institute of Scientific and Technical Information of China (English)

    畅飞; 张莉; 孟梅霞; 安军民; 高明; 傅艳平

    2012-01-01

    目的 回顾性总结158例肾活检的病理结果,分析其病理类型及临床分类特点.方法 总结我院158例肾活检病理资料,分析其病理类型与临床分类特点.结果 158例肾活检中原发性肾小球疾病125例(79.11%),继发性肾小球疾病33例(20.89%).原发性肾小球疾病病理类型最多的是系膜增生型肾炎,第二位是IgA肾病,继发性肾小球疾病以紫癜性肾炎病理类型最多.原发性肾小球疾病临床分布最多的前三位依次是肾病综合征、慢性肾炎、IgA肾病.其中肾病综合征的病理类型主要是系膜增生型和膜性肾病,慢性肾炎的主要病理类型是系膜增生型和肾小球硬化.结论 原发性肾小球疾病是最常见的肾小球疾病,肾活检病理类型以系膜增生型肾炎、IgA肾病最多,临床类型则以肾病综合征、慢性肾炎、IgA肾病最为多见.%Objective To retrospectively summarize the pathological results of 158 cases of renal biopsy, and to analyze the pathological types and clinical classification. Methods The pathological data of 158 cases of renal biopsy were pathology retrospectively analyzed. Results Among the 158 cases, 125 cases (79.11%) were of primary glomerular disease and 33 cases (20.89%) were of secondary glomerular diseases. The most common pathological type of primary glomerular disease was mesangial proliferative glomerulonephritis, the second was IgA nephropathy. The most common pathological type of secondary glomerular diseases was purpura nephritis. The top three primary glomerular diseases with most clinical distribution were nephrotic syndrome, chronic nephritis, IgA nephropathy. The main pathological types of nephrotic syndrome were mesangial proliferative and membranous nephropathy, and the main types of chronic nephritis was mesangial proliferative and glomerular sclerosis. Conclusion Primary glomerular disease is the most common renal disease occurred in China. The most common pathological types of

  20. 1000例肾活检儿童临床与病理分析%The clinical and pathological analysis of 1 000 cases with renal biopsies in children

    Institute of Scientific and Technical Information of China (English)

    冯仕品; 罗苇; 张伟; 谢敏; 王莉; 李莎; 金梅; 杨胜

    2012-01-01

    Objective To explore the clinical and pathological features, and the correlation between clinical and pathological diagnoses in 1 000 children with renal biopsies. Methods In 1 000 children with renal diseases, the renal biopsies were performed using semi automatic biopsy needles under ultrasound guidance. The clinical and renal pathological data were analyzed retrospectively. Results In 96.2% (n = 962) of cases, renal biopsies were obtained successfully. Mild complications occurred in 17% patients (n = 170). Most of clinical manifestations were consistent to pathological diagnosis, but 20 cases were not. Conclusions There was considerable proportion of patients who were misdiagnosed and had excessive treatment or delayed treatment for pediatric renal diseases if diagnosed only by clinical manifestation. The pathological diagnosis provides guidances and significantly improves clinical treatment and prognostic assessment.%目的 探讨肾活检儿童的临床、病理特点及两者之间的关系.方法 回顾性分析1 000例肾脏病患儿临床与肾脏病理资料.结果 1 000例患儿肾活检取材成功962例,成功率96.2%.患儿术后出现轻度并发症170例,并发症发生率为17%.临床表现与病理大部分符合,但有20例临床与病理诊断不符.结论 儿童肾脏病的临床表现轻重与病理改变轻重并不平行,仅凭临床表现进行诊治,有误诊、过度治疗、延误治疗的可能,病理诊断对临床治疗及预后评价具有重要的指导意义.

  1. Fine Needle Aspiration Using Improved Agar Microbiopsy is Highly Concordant With Renal Mass Final Diagnosis and Subclassification

    NARCIS (Netherlands)

    Schieven, Louise W.; Smedts, Frank; Hopman, Anton H.; van der Wijk, Jan; Nijman, Rien J.; de Jong, Igle J.

    2009-01-01

    Purpose: Computerized tomography and ultrasound are usually sufficient for preoperative evaluation of renal masses greater than 5 cm. For renal masses less than 5 cm additional histological evaluation could improve diagnosis and treatment decisions. We investigated the concordance between an improve

  2. Fine Needle Aspiration Using Improved Agar Microbiopsy is Highly Concordant With Renal Mass Final Diagnosis and Subclassification

    NARCIS (Netherlands)

    Schieven, Louise W.; Smedts, Frank; Hopman, Anton H.; van der Wijk, Jan; Nijman, Rien J.; de Jong, Igle J.

    2009-01-01

    Purpose: Computerized tomography and ultrasound are usually sufficient for preoperative evaluation of renal masses greater than 5 cm. For renal masses less than 5 cm additional histological evaluation could improve diagnosis and treatment decisions. We investigated the concordance between an improve

  3. Diagnostic impact of color Doppler ultrasound-guided core biopsy on fine-needle aspiration of anterior mediastinal masses.

    Science.gov (United States)

    Chen, Hung-Jen; Liao, Wei-Chih; Liang, Shinn-Jye; Li, Chia-Hsiang; Tu, Chih-Yen; Hsu, Wu-Huei

    2014-12-01

    Although lymphoma and thymoma are common etiologies of anterior mediastinal masses (AMMs), smaller percentages and numbers of patients with these diseases have been enrolled in previous ultrasound-guided biopsy studies. To date, there has been no study of color Doppler sonographic features to support the differentiation of AMMs. For this retrospective cohort study, a search of the database of the China Medical University Hospital using the clinical coding "ultrasound-guided biopsy" was conducted for the period December 2003 to February 2013. We selected patients diagnosed with AMMs (not cysts) using radiographic records. This search yielded a list of 80 cases. Real-time ultrasound-guided core needle biopsy (CNB) was performed in all but 5 patients without a sufficient safety range. In 89% (67/75) of these ultrasound-guided CNB cases, the diagnostic accuracy achieved subclassification. Fine-needle aspiration cytology achieved subclassification in only 10% of cases. On color Doppler sonography, 71% of lymphomas were characterized as "rich vascular with central/crisscross collocations" and 29% as "avascular or localized/scattered peripheral vessels." However, decreased proportions of "rich vascular with central/crisscross collocations" were found in lung cancer (4% [1/23], odds ratio = 0.018, 95% confidence interval: 0.002-0.154, p Fine-needle aspiration cytology itself cannot aid in the diagnosis. Color Doppler sonographic evaluation of AMMs followed by real-time CNB is a more efficient method. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  4. 西藏高原地区与内地平原地区肾活检病理资料对比%Comparison of the renal disease at the Tibetan plateaus and plain based on renal biopsy data

    Institute of Scientific and Technical Information of China (English)

    周岩; 邓永明; 李川; 龚运兵; 毛志国; 吴俊; 李素芝; 刘志红; 唐政

    2014-01-01

    Objective To compare the characteristics of renal disease based on renal biopsy data between the Tibetan plateaus and the plain.Methods 160 chronic kidney diseases patients underwent renal biopsy from the plain and 80 cases from Tibet plateau were compared by parallel controlled manner.The relationship of renal pathology and clinical signs were also compared.Results (1) The male to female ratio was quite different between Tibet plateau and plain groups (0.60∶1 vs 1.11 ∶ 1,P < 0.01).(2) The distribution of pathological types between two groups was quite different.The main reason of primary renal disease at Tibet plateau was minimal change disease (51.39% vs 14.53%,P < 0.01),but at plain it was IgA nephrology (49.57% vs 6.94%,P < 0.01).Meanwhile,the LN ratio in the secondary glomerulonephritis at the plateau region was significantly lower than those in the plain region (12.6% vs 34.9%,P < 0.05).Conclusions The most common reason of primary glomerular disease in plateau region is minimal change,and the most common clinical manifestation is nephrotic syndrome.IgA nephropathy in the plain is the most frequent primary renal disease.In terms of the secondary renal diseases,allergic purpura nephritis is dominated in the plateau region,whereas LN is frequently found in the plain.%目的 探讨我国西藏高原地区与内地平原地区慢性肾脏病患者肾脏病理类型特点的差异.方法 采用回顾性对照研究,比较西藏高原地区80例与内地平原地区160例肾活检患者的一般情况及病理类型分布特点,以及病理与临床表现的关系.结果 (1)高原组与平原组男女比例存在明显差异(0.60∶1比1.11∶1,P<0.01).(2)两组患者的病理类型分布存在明显差异,高原地区的原发性肾小球肾炎以微小病变为主(51.39%比14.53%,P<0.01),而平原地区则以IgA肾病为主(49.57%比6.94%,P< 0.01),同时继发性肾小球肾炎中狼疮肾炎(LN)比例明显低于平原组(12

  5. Lithium-induced Nephrotoxicity: A Case Report of Renal Cystic Disease Presenting as a Mass Lesion

    Directory of Open Access Journals (Sweden)

    Yvonne McCartney

    2014-11-01

    Full Text Available Lithium is an effective therapeutic agent used in the management of bipolar disorder. However, lithium is also associated with several side effects, including renal toxicity. We present a case of a symptomatic cystic mass lesion in the kidney of a patient who had a history of lithium therapy for the management of bipolar disorder.

  6. [Hepatic fine needle aspiration biopsy. Experience in the study of hepatic masses at the Salvador Zubiran National Institute of Nutrition].

    Science.gov (United States)

    Angeles-Angeles, A; Gamboa-Domínguez, A; Velázquez Fernández, D; Muñoz-Fernández, L

    1994-01-01

    The results of 114 fine-needle aspiration biopsies (FNAB) of the liver performed during six years (1987-1992) at the Departament of Pathology of the Instituto Nacional de la Nutrición Salvador Zubirán are presented. All were done by radiologists under ultrasonographic (three cases) or computerized tomographic guidance (111 cases). In order to determine the diagnostic accuracy, diagnoses made by FNAB were compared with those made by histological examination (coarse biopsies or surgical specimens) and/or by other diagnostic procedures including the clinical follow-up. Six cases were excluded because clinical information was not available. In 92 cases (85.2%) a correct diagnosis was made, in six (5.5%) the sample was inadequate and in 10 (9.3%) the diagnosis made by FNAB was incorrect. The diagnoses made were as follows: hepatocarcinoma 44, metastatic carcinoma 27, inflammatory lesions 12, regeneration 10, normal eight, unclassified carcinoma five, and lymphoma two. The sensitivity was 96.2, specificity 93.1, positive predictive value 97.4, negative predictive value 90.0, accuracy 95.3 and prevalence 73.1. There were three false negative and two false positive for carcinoma. These figures are similar to those found by other authors. No relevant complications were observed. It is concluded that FNAB of the liver is a safe, inexpensive and reliable method in the diagnoses of liver masses.

  7. Is Body Mass Index the Best Adiposity Measure for Prostate Cancer Risk? Results From a Veterans Affairs Biopsy Cohort.

    Science.gov (United States)

    Guerrios-Rivera, Lourdes; Howard, Lauren; Frank, Jennifer; De Hoedt, Amanda; Beverly, Devon; Grant, Delores J; Hoyo, Cathrine; Freedland, Stephen J

    2017-07-01

    To test multiple adiposity measures and prostate cancer (PC) risk in men undergoing prostate biopsy. We hypothesized that body mass index (BMI), body fat, and waist circumference would be highly correlated, and all would be associated with aggressive PC, but not overall risk. A case (483)-control (496) study among men undergoing prostate biopsy from 2007 to 2016 was conducted at the Durham Veterans Affairs Medical Center. Anthropometric and self-reported measurements were taken. Percent body fat was measured. Associations between adiposity measures and PC risk and high-grade PC (Gleason ≥7) were examined using logistic regression. BMI, percent body fat, and waist circumference were highly correlated (ρ ≥ .79) (P BMI (P = .011) was associated with overall PC risk, but percent body fat (P = .16) and waist circumference (P = .19) were not. However, all adiposity measurements were associated with high-grade disease (P BMI, body fat, and waist circumference were all highly correlated and associated with aggressive PC. This study supports the idea that higher adiposity is selectively associated with high-grade PC and reinforces the continued use of self-reported BMI as a measure of obesity in epidemiologic studies of PC. Published by Elsevier Inc.

  8. Body mass index and comorbidity are associated with postoperative renal function after nephrectomy

    Directory of Open Access Journals (Sweden)

    Lael Reinstatler

    2015-08-01

    Full Text Available ABSTRACTPurpose:To explore the association of body mass index (BMI and comorbidity with renal function after nephrectomy.Materials and Methods:We retrospectively analyzed 263 patients submitted to partial or radical nephrectomy from 2000-2013. Variables assessed included BMI, Charlson Comorbidity Index (CCI, race, tobacco use, tumor histology, surgical approach, Fuhrman nuclear grade, and tumor (T classification. Glomerular filtration rate (GFR was estimated using the Cockroft-Gault equation, adjusted for gender. Logistic regression was performed and included all interaction terms.Results:Median follow-up was 19.6 months (IQR 5.2, 53.7. Median preoperative GFR was 86.2mL/min/1.73m2 and median postoperative GFR was 68.4mL/min/1.73m2. BMI (OR 1.07, 95%CI 1.02-1.11, CCI (OR 1.19, 95%CI 1.04-1.37, and radical nephrectomy (OR 3.09, 95%CI 1.51-6.33 were significantly associated with a decline in renal function of ≥25%.Conclusion:BMI and CCI are associated with postoperative decline in renal function after nephrectomy. Additionally, radical nephrectomy is significantly associated with decreasing renal function compared to partial nephrectomy. These findings highlight the importance of assessing patient comorbidity in the decision making process for patients presenting with a renal mass.

  9. Body mass index and comorbidity are associated with postoperative renal function after nephrectomy

    Science.gov (United States)

    Reinstatler, Lael; Klaassen, Zachary; Barrett, Brittani; Terris, Martha K.; Moses, Kelvin A.

    2015-01-01

    ABSTRACT Purpose: To explore the association of body mass index (BMI) and comorbidity with renal function after nephrectomy. Materials and Methods: We retrospectively analyzed 263 patients submitted to partial or radical nephrectomy from 2000-2013. Variables assessed included BMI, Charlson Comorbidity Index (CCI), race, tobacco use, tumor histology, surgical approach, Fuhrman nuclear grade, and tumor (T) classification. Glomerular filtration rate (GFR) was estimated using the Cockroft-Gault equation, adjusted for gender. Logistic regression was performed and included all interaction terms. Results: Median follow-up was 19.6 months (IQR 5.2, 53.7). Median preoperative GFR was 86.2mL/min/1.73m2 and median postoperative GFR was 68.4mL/min/1.73m2. BMI (OR 1.07, 95%CI 1.02-1.11), CCI (OR 1.19, 95%CI 1.04-1.37), and radical nephrectomy (OR 3.09, 95%CI 1.51-6.33) were significantly associated with a decline in renal function of ≥25%. Conclusion: BMI and CCI are associated with postoperative decline in renal function after nephrectomy. Additionally, radical nephrectomy is significantly associated with decreasing renal function compared to partial nephrectomy. These findings highlight the importance of assessing patient comorbidity in the decision making process for patients presenting with a renal mass. PMID:26401862

  10. A comparison of immunohistochemistry and mass spectrometry for determining the amyloid fibril protein from formalin-fixed biopsy tissue.

    Science.gov (United States)

    Gilbertson, Janet A; Theis, Jason D; Vrana, Julie A; Lachmann, Helen; Wechalekar, Ashutosh; Whelan, Carol; Hawkins, Philip N; Dogan, Ahmet; Gillmore, Julian D

    2015-04-01

    Amyloidosis is caused by deposition in tissues of abnormal protein in a characteristic fibrillar form. There are many types of amyloidosis, classified according to the soluble protein precursor from which the amyloid fibrils are derived. Accurate identification of amyloid type is critical in every case since therapy for systemic amyloidosis is type specific. In ∼20-25% cases, however, immunohistochemistry (IHC) fails to prove the amyloid type and further tests are required. Laser microdissection and mass spectrometry (LDMS) is a powerful tool for identifying proteins from formalin-fixed paraffin-embedded tissues. We undertook a blinded comparison of IHC, performed at the UK National Amyloidosis Centre, and LDMS, performed at the Mayo Clinic, in 142 consecutive biopsy specimens from 38 different tissue types. There was 100% concordance between positive IHC and LDMS, and the latter increased diagnostic accuracy from 76% to 94%. LDMS in expert hands is a valuable tool for amyloid diagnosis.

  11. Clinical analysis of 106 cases of renal biopsy guided by ultrasound%超声引导下肾活检106例的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    闫楠; 孙健玮; 毛衡; 白云霞; 石卫杰

    2015-01-01

    目的:探讨超声引导下使用自动活检枪行肾穿刺活检的临床应用价值。方法:收治患者106例,在超声引导下使用自动活检枪行肾穿刺活检,观察效果。结果:106例患者穿刺229针次,取出组织条长度5~20 mm,均符合病理学检查要求。106例患者术后均无严重并发症。结论:彩超引导下自动活检枪行肾穿刺活检操作简便、定位准确、成功率高、创伤小,还可避免严重并发症,对肾病的早期诊断与治疗具有重要意义。%Objective:To explore the clinical application value of renal biopsy with automatic biopsy gun guided by ultrasound. Methods:106 patients were selected.They were given renal biopsy with automatic biopsy gun guided by ultrasound,and we observed the effect.Results:106 patients were punctured for 229 times.The length of the tissue was 5 to 20 mm.They were all in line with the pathological examination requirements.There were no serious complications in 106 patients after operation. Conclusion:Renal biopsy with automatic biopsy gun guided by ultrasound was simple,the localization was accurate,the success rate was high,and the wound was small.I can also avoid the serious complication,and had the vital significance to the early diagnosis and the treatment of kidney disease.

  12. 539例肾活检病理临床分析%The Pathologic Data Analysis of Renal Biopsy in 539 Cases

    Institute of Scientific and Technical Information of China (English)

    谢红萍; 全丽; 黄健; 蒋芬

    2015-01-01

    Objective To explore relationship between the clinical pathological date and pathological types of 539 cases of percutaneous renal biopsy. Methods The clinical pathologic data of 539 percutaneous renal biopsy cases from August 2005 to April 2014 were retrospectively analyzed,and the clinical feature and pathological type were summarized. Results The average age at renal biopsy was 32. 6 ± 13. 2 (13~66) years old in 539 patients (male 285 and female 254, gender ratio was 1. 12:1). 422 cases (78. 29%) were of primary glomerular disease and 106 cases (19. 67%) were of sec-ondary glomerular disease,2 cases(0. 37%) were of tubular—interstitial disease,8 cases (1. 48%) were of end-stagerenal disease. IgA nephropathy was the most patholigical type (32. 23%) of PGD,followed by mesangial proliferative glomerulo-nephritis(27. 01%),minimalchangenephrosis (17. 30%),membranous nephropathy(14. 22),Focal stage sclerosing glo-merulonephritis(5. 92%). Among secondary glomerular disease,the most type was lupus nephritis(52. 83%),followed by hepatitis B virus-associated glomerulonephritis(28. 3%),purpuric glomerulonephritis(13. 21%). Our group also found 2 cases of hepatitis C virus-associated glomerulonephritis,one case of overlap syndrome and one case of mixed connective tis-sue disease. Conclusion Primary glomerular disease is still the most common renal disease,and the most frequent path-ological types of renal biopsy are mesangial proliferative glomerulonephritis and IgA nephropathy. Nearly nine years,SGD is increasing year by year,the most common is lupus nephritis. The incidence of female is much higher than male,hepatitis vi-rus associated glomerulonephritis also increased obviously.%目的:探讨539例经皮肾活检的临床资料和病理类型之间的关系。方法回顾性收集539例经皮肾活检的临床病理资料,总结539例病例的临床特点和病理类型。结果539例肾活检组织中患者年龄13~66岁,平均32.6±13.2岁,男女之比1.12

  13. Observational study of the effect of individual urination training on urination after renal biopsy%个体化排尿训练对肾穿术后排尿效果的研究

    Institute of Scientific and Technical Information of China (English)

    张杰; 张金萍

    2009-01-01

    Objective To investigate the effect of individual urination training before renal biopsy on urination and comfort for patients after renal biopsy. Methods One hundred and sixty for hospitalized patients under renal biopsy were randomly selected as subjects. Study group included 81 patients who were individually trained with urination. Control group included 83 patients who were routinely educated before renal biopsy. The methods of urination and comfort between two groups were compared. Results The percentage of autonomous urination after renal biopsy in patients individually trained with urination was higher than that in control group (P <0. 01 ). The comfort of study group was also superior to that of control group (P < 0. 01). There was statistically significant difference between two groups. Conclusions Individual urination training could effectively promote autonomous urination, reduce urinary retention and improve the comfort for patients under renal biopsy.%目的 研究术前实施个体化排尿训练对肾穿刺术后患者的排尿方式和舒适度的影响.方法 随机抽取164例肾穿刺患者为研究对象,分为研究组81例,实施个体化排尿训练;对照组83例,常规术前宣教,比较两组患者术后的排尿方式和舒适度.结果 术前实施个体化排尿训练组患者术后自行排尿的比例高于对照组,舒适程度也明显高于对照组,差异均有统计学意义(P<0.01).结论 实施个体化排尿训练可有效促进肾穿刺术后患者自行排尿,减少尿潴留的发生,提高患者的舒适度.

  14. Acute renal failure following Bull ant mass envenomation in two dogs.

    Science.gov (United States)

    Abraham, L A; Hinkley, C J; Tatarczuch, L; Holloway, S A

    2004-01-01

    Acute renal failure was diagnosed in a German Short Haired Pointer bitch and a Kelpie cross-bred dog following envenomation by Bull ants. Both dogs had been tethered over a Bull ant nest and had experienced mass envenomation. There was local reaction at the envenomation sites and each dog had experienced vomiting that was poorly controlled by symptomatic therapy. Intensive treatment of renal failure was successful in the German Short Haired Pointer and the bitch remains well 19 months after envenomation. The Kelpie cross-bred deteriorated despite intensive treatment and was euthanased 36 hours after presentation. Necropsy examination revealed haemorrhage and necrosis of the small intestine and myocardium, bilateral nephrosis with tubular necrosis, and patchy haemorrhage of the lung alveoli, pancreas and adrenal cortices. Electron microscopy revealed necrosis of the small intestine and hydropic swelling of proximal renal tubules with necrosis of medullary tubules.

  15. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  16. Nerve biopsy

    Science.gov (United States)

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  17. Biopsy - polyps

    Science.gov (United States)

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  18. Bladder biopsy

    Science.gov (United States)

    Biopsy - bladder ... A bladder biopsy can be done as part of a cystoscopy . Cystoscopy is a telescopic examination of the inside of the ... informed consent form before you have a bladder biopsy. In most cases, you are asked to urinate ...

  19. Synovial biopsy

    Science.gov (United States)

    Biopsy - synovial membrane ... fluid in and out of the area. A biopsy grasper is inserted through the trocar and turned ... Synovial biopsy helps diagnose gout and bacterial infections, or rule out other infections. It can be used to diagnose ...

  20. Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

    Institute of Scientific and Technical Information of China (English)

    Julio Iglesias-Garcia; Enrique Dominguez-Munoz; Antonio Lozano-Leon; Ihab Abdulkader; Jose Larino-Noia; Jose Antunez; Jeronimo Forteza

    2007-01-01

    AIM: To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) material in the differential diagnosis of pancreatic solid masses.METHODS: Sixty-two consecutive patients with pancreatic masses were prospectively studied. EUS was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs (22G needle) were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Materials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study.RESULTS: Length of the core specimen obtained for histological analysis was 6.5 + 5.3 mm (range 1-22 mm).Cytological and histological samples were considered as adequate in 51 (82.3%) and 52 cases (83.9%), respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Contrary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases (90.3%),with a global sensitivity of 84.21%, specificity of 100%and an overall accuracy of 90.32%. The complication rate was 1.6%.CONCLUSION: Adequate pancreatic core specimens for histological examination can be obtained by EUS-guided FNA. This technique is mainly useful for the diagnosis of different types of pancreatic tumours and evaluation of benign diseases.

  1. Metastatic Renal Cell Carcinoma Presenting as a Paranasal Sinus Mass: The Importance of Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Massimo Ralli

    2017-01-01

    Full Text Available Metastases in the paranasal sinuses are rare; renal cell carcinoma is the most common cancer that metastasizes to this region. We present the case of a patient with a 4-month history of a rapidly growing mass of the nasal pyramid following a nasal trauma, associated with spontaneous epistaxis and multiple episodes of hematuria. Cranial CT scan and MRI showed an ethmoid mass extending to the choanal region, the right orbit, and the right frontal sinus with an initial intracranial extension. Patient underwent surgery with a trans-sinusal frontal approach using a bicoronal incision combined with an anterior midfacial degloving; histological exam was compatible with a metastasis of clear cell renal cell carcinoma. Following histological findings, a total body CT scan showed a solitary 6 cm mass in the upper posterior pole of the left kidney identified as the primary tumor. Although rare, metastatic renal cell carcinoma should always be suspected in patients with nasal or paranasal masses, especially if associated with symptoms suggestive of a systemic involvement such as hematuria. A correct early-stage diagnosis of metastatic RCC can considerably improve survival rate in these patients; preoperative differential diagnosis with contrast-enhanced imaging is fundamental for the correct treatment and follow-up strategy.

  2. Endoscopic ultrasound-guided sampling of solid pancreatic masses: 22-gauge aspiration versus 25-gauge biopsy needles.

    Science.gov (United States)

    Yang, Min Jae; Yim, Hyunee; Hwang, Jae Chul; Lee, Dakeun; Kim, Young Bae; Lim, Sun Gyo; Kim, Soon Sun; Kang, Joon Koo; Yoo, Byung Moo; Kim, Jin Hong

    2015-09-29

    Biopsy needles have recently been developed to obtain both cytological and histological specimens during endoscopic ultrasound (EUS). We conducted this study to compare 22-gauge (G) fine needle aspiration (FNA) needles, which have been the most frequently used, and new 25G fine needle biopsy (FNB) needles for EUS-guided sampling of solid pancreatic masses. We conducted a retrospective cohort study of all EUS-guided sampling performed between June 2010 and October 2013. During the study period, 76 patients with pancreatic masses underwent EUS-guided sampling with a 22G FNA needle (n = 38) or a 25G FNB needle (n = 38) for diagnosis. An on-site cytopathologist was not present during the procedure. Technical success, the number of needle passes, cytological diagnostic accuracy, cytological sample quality (conventional smear and liquid-based preparation), histological diagnostic accuracy, and complications were reviewed and compared. There were no significant differences in technical success (100% for both), the mean number of needle passes (5.05 vs. 5.55, P = 0.132), or complications (0% for both) between the 22G FNA group and the 25G FNB group. The 22G FNA and 25G FNB groups exhibited comparable outcomes with respect to cytological diagnostic accuracy (97.4% vs. 89.5%, P = 0.358) and histological diagnostic accuracy (34.2% vs. 52.6%, P = 0.105). In the cytological sample quality analysis, the 25G FNB group exhibited higher scores for the amount of diagnostic cellular material present (22G FNA: 0.92 vs. 25G FNB: 1.32, P = 0.030) and the retention of appropriate architecture (22G FNA: 0.97 vs. 25G FNB: 1.42, P = 0.010) in the liquid-based preparation. The 25G FNB group showed a better histological diagnostic yield for specific tumor discrimination compared with the 22G FNA group (60 % vs. 32.4%, P = 0.018). Use of the 25G FNB needle was technically feasible, safe, efficient, and comparable to use of the standard 22G FNA needle in patients

  3. Effect of chronic antioxidant therapy with superoxide dismutase-mimetic drug, tempol, on progression of renal disease in rats with renal mass reduction.

    Science.gov (United States)

    Quiroz, Yasmir; Ferrebuz, Atilio; Vaziri, Nosratola D; Rodriguez-Iturbe, Bernardo

    2009-01-01

    Oxidative stress and inflammation play a major role in the progression of renal damage and antioxidants are potentially useful therapeutic options in chronic renal disease. We investigated if treatment with tempol, a superoxide dismutase mimetic that has beneficial effects in several experimental models of hypertension and acute kidney injury, ameliorates the chronic renal damage resulting in renal mass reduction. Rats with surgical 5/6 nephrectomy were randomly assigned to receive no treatment (CRF group, n = 10) or tempol, 1 mmol/l in the drinking water (CRF-tempol group, n = 10). Sham-operated rats (n = 10) served as controls. All rats were followed for 12 weeks post-nephrectomy. Tempol treatment reduced plasma malondialdehyde (MDA) levels and halved the number of superoxide-positive cells in the remnant kidney; however, the number of hydrogen peroxide-positive cells increased and the overall renal oxidative stress (MDA and nitrotyrosine abundance) and inflammation (interstitial p65 NF-kappaB, macrophage and lymphocyte infiltration) were unchanged. Proteinuria, renal function and glomerular and tubulointerstitial damage in the remnant kidney were similar in the CRF and CRF-tempol groups. In conclusion, tempol administration, at the dose used in these studies, decreased plasma MDA and heightened superoxide dismutation in the kidney, but was incapable of reducing renal oxidative stress or improving renal function or structure in the remnant kidney model.

  4. Clinical analysis of 50 cases with renal biopsy pathology%肾活检50例病理与临床分析

    Institute of Scientific and Technical Information of China (English)

    张健; 曹美玲; 郝晶晶

    2013-01-01

    Objective To summarize the diagnosis characteristics, kidney biopsy types and clinical symptom and laboratory examination, provide the basis for clinical treatment. Methods a retrospective analysis of our hospital from 2005 to 2011 50 cases of renal biopsy in patients with clinical and pathological data, laboratory examination, comparison analysis. Results the patients aged 15-64 years old, average age is 39.5 years old, including 12 cases of mild mesangial proliferative glomerulonephritis, 3 cases of mild mesangial proliferative IgA nephropathy, 3 cases of focal proliferative sclerosing glomerulonephritis, 2 cases endocapillary proliferative glomerulonephritis, 2 cases with 1 membranous nephropathy, 2 cases of purple patch nephritis secondary IgA nephropathy, moderate mesangial proliferative glomerulonephritis, moderate mesangial proliferative IgA nephropathy, severe mesangial proliferative IgA nephropathy with ischemic hardening, severe mesangial proliferation with renal arteriolar sclerosis, glomerular minor lesion, focal proliferative sclerosing IgA nephropathy with crescent formation, focal proliferative sclerosing IgA nephropathy, lupus nephritis (type IV) capillary hyperplasia, stageⅠ-Ⅱmembranous nephropathy, capillary hyperplasia with mild mesangial proliferative glomerulonephritis, renal damage in patients with essential hypertension with renal arteriolar sclerosis, membranous nephropathy stage II, capillary hyperplasia with IgA deposition, lupus glomerulonephritis type II, capillary Ban Xinyue body formation, hyperplasia, chronic tubulointerstitial disease, small lesions with moderate to severe mesangial proliferation, mild mesangial proliferative IgA nephropathy with ischemic hardening, crescentic glomeruli Moderate mesangial proliferative nephritis, membranous nephropathy, IgA nephropathy with IgM glomerulonephritis, IgM nephropathy with moderate mesangial proliferative glomerulonephritis, mild mesangial proliferation with crescent formation

  5. Endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of pancreatic masses.

    Science.gov (United States)

    Jinga, Mariana; Gheorghe, Cristian; Dumitrescu, Marius; Gheorghe, Liana; Nicolaie, Tudor

    2004-03-01

    Endoscopic ultrasound (EUS) represents a highly sensitive method for the detection of pancreatic masses. When available, EUS-guided fine needle aspiration (FNA) is the best technique for the diagnosis and staging of pancreatic cancer due to its ability to obtain tissue for diagnosis. The standardized indications for pancreatic EUS-FNA comprise the definite diagnosis of malignancy and histopathological confirmation of adenocarcinoma before surgical resection, chemo/radiotherapy, or celiac plexus neurolysis. The technique of performing EUS-FNA is described in detail, from the vizualization of the target lesion and adequate placement of the transducer to allow optimal needle access, to needle penetration and sampling of the targeted lesion. We report a series of 9 patients who underwent EUS-FNA and shortly review the indications, technique, results and impact of EUS-FNA on the management of these patients.

  6. Review of automatic renal biopsy device under Truguide needle guided in 178 patients%使用同轴穿刺引导针肾穿刺活检178例体会

    Institute of Scientific and Technical Information of China (English)

    张晶晶; 刘桂凌; 郝丽; 姜凡; 解翔; 王德光

    2013-01-01

    Automatic renal biopsy device under Truguide needle guided were performed on 178 patients with nephropathy, Renal biopsies were successfully performed totally, and mean numbers of glomerulus were ( 18. 0 ± 1.1) per patient. And there was no prominent incidence of complications. The method has the advantages in easy manipulation, higher successful rate and lower incidence of complications.%在B超实时定位下,使用同轴穿刺引导针对178例患者肾脏穿刺活检,穿刺顺利,平均肾小球(18.0±7.7)个,全部获得成功,无明显并发症.结果 表明在超声实时定位下,使用同轴穿刺引导针行经皮肾穿刺活检是一种安全、有效的方法.

  7. Renal masses measuring under 2 cm: Pathologic outcomes and associations with MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Rosenkrantz, Andrew B., E-mail: Andrew.Rosenkrantz@nyumc.org [Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016 (United States); Wehrli, Natasha E. [Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016 (United States); Melamed, Jonathan [Department of Pathology, 550 First Avenue, New York, NY 10016 (United States); Taneja, Samir S. [Department of Urology, Division of Urologic Oncology, 550 First Avenue, New York, NY 10016 (United States); Shaikh, Mohammed B. [Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016 (United States)

    2014-08-15

    Purpose: To evaluate pathologic outcomes and associations with MRI features in small renal masses measuring up to 20 mm Methods: 86 patients (61 ± 13 years; 45 M/41F) with 92 renal masses measuring up to 20 mm that underwent MRI prior to tissue diagnosis were included. Two radiologists independently evaluated all masses for microscopic lipid, hemorrhage, T2-hyperintensity, T2-homogeneity, cystic/necrotic areas, hypervascularity, enhancement homogeneity, circumscribed margins, and predominantly exophytic location. These MRI features, as well as patient age, gender, and history of RCC, were compared with pathologic findings using Fisher's exact test, unpaired t-test, and multivariate logistic regression. Results: 26.1% (24/92) of masses under 2 cm were benign, only 32.6% (30/92) were clear-cell RCC, and only 7.6% (7/92) were high-grade. Among 16 masses measuring up to 1 cm, only 12.5% (2/16) were clear-cell RCC, and none was high-grade. Within the entire cohort, no MRI or clinical feature showed a significant difference between benign and malignant lesions (p ≥ 0.053). However, for both readers, clear-cell RCC exhibited a significantly higher frequency of T2-hyperintensity, cystic/necrotic areas, and hypervascularity, and a significantly lower frequency of hemorrhage, T2-homogeneity, and enhancement homogeneity (p < 0.001–0.036). Hypervascularity was a significant independent predictor of clear-cell RCC for both readers (p = 0.002–0.007), as was T2-hyperintensity for reader 2 (p = 0.007). Conclusion: A substantial fraction of small renal masses were benign, and when malignant, largely exhibited indolent pathologic characteristics, particularly when measuring under 1 cm Although small benign and malignant masses could not be differentiated on MRI, hypervascularity showed a significant independent association with clear-cell RCC in comparison with other lesions.

  8. The negative predictive value of ultrasound-guided 14-gauge core needle biopsy of breast masses: a validation study of 339 cases.

    Science.gov (United States)

    Zhang, Charlie; Lewis, Darrell R; Nasute, Paola; Hayes, Malcolm; Warren, Linda J; Gordon, Paula B

    2012-10-31

    To determine the negative predictive value of sonographically guided 14-gauge core needle biopsy of breast masses, with detailed analysis of any false-negative cases. We reviewed 669 cases of sonographically guided 14-gauge core needle biopsies that had benign pathologic findings. Given a benign pathology on core biopsy, true-negatives had either benign pathology on surgical excision or at least 2 years of stable imaging and/or clinical follow-up; false-negatives had malignant histology on surgical excision. Follow-up was available for 339 breast lesions; 117 were confirmed to be benign via surgical excision, and 220 were stable after 2 years or more of imaging or clinical follow-up (mean follow-up time 33.1 months, range 24-64 months). The negative predictive value was determined to be 99.4%. There were 2 false-negative cases, giving a false-negative rate of 0.1%. There was no delay in diagnosis in either case because the radiologist noted discordance between imaging and core biopsy pathology, and recommended surgical excision despite the benign core biopsy pathology. Sonographically guided 14-gauge core needle biopsy provides a high negative predictive value in assessing breast lesions. Radiologic/pathologic correlation should be performed to avoid delay in the diagnosis of carcinoma.

  9. 肾穿刺活检病理信息管理系统的研究与应用%Research and application of the information management system of renal biopsy for pathologic diagnosis

    Institute of Scientific and Technical Information of China (English)

    李刚; 孙玉静; 尹小青; 王占明; 肖逸平; 黄志中

    2012-01-01

    在分析肾活检病理诊断医疗用语的基础上,以PowerBuilder 9.0、Visual C++6.0为客户端、以MicroSoft SQL Server 为服务器,介绍了该系统的设计思路及关键技术,初步实现了数据的结构化表达、录入及提高病理图像网络传输效率的方法.临床应用显示,该系统能有效提高临床医师收集、处理肾活检病理信息的效率,并在肾活检科学研究和培训中具有较好应用和推广价值.%A web-based management information system of renal biopsy for pathologic diagnosis was designed based on the analysis of medical terms of renal biopsy for pathologic diagnosis. The client of system was designed by PowerBuilder 9.0 and Visual C + +6.0. The server was set up by using MicroSoft SQL Server. The primary structured data expression and input were implemented. A method for improving the efficiency of network transmission of pathologic images was put forward. Clinical application results show that the system can improve doelors'efficiency of collecting and processing renal biopsy information for pathologic diagnosis, and achieve satisfactory results in research and training of renal biopsy.

  10. 品管圈在减轻患者肾穿刺术前焦虑中的应用%Application of quality control circle(QCC) in patients before renal biopsy

    Institute of Scientific and Technical Information of China (English)

    石敏

    2015-01-01

    目的:探讨品管圈在减轻患者肾穿刺术前焦虑中的应用效果。方法由肾科病区一线护理人员组成品管圈小组,通过头脑风暴,调查分析肾穿刺患者术前焦虑的原因,制定相应的整改措施并组织实施。结果患者肾穿刺术前焦虑由活动前63.3%降低到活动后的23.3%,效果显著( P<0.05);提高了护理人员的创新性、科研性,并提升整个团队的凝聚力和合作力。结论品管圈活动的开展有利于减轻患者肾穿刺术前焦虑。%Objective To investigate the anxiety relieving effect of quality control circle ( QCC ) in patients before renal biopsy.Methods QCC team consisting of nephrology nursing staff, through brainstorming, analyzed the reasons for preoperative anxiety of renal biopsy patients, developed appropriate corrective measures and organized their implementation. Results After the implementation of QCC, the preoperative anxiety incidence of renal biopsy patients decreased from 63.3%to 23.3%, the effect was significant (P<0.05).QCC improved nursing innovation and promoted cohesion and cooperation of the entire team.Conclusions QCC may help reduce the preoperative anxiety of renal biopsy patients.

  11. Cardiac metastasis from a renal cell carcinoma

    OpenAIRE

    AlGhamdi, Abdulaziz; Tam, James

    2006-01-01

    A 59-year-old man developed an episode of syncope while he was driving. This resulted in a motor vehicle accident, and the patient sustained an open fracture of the left femur. Biopsy of the left femur fracture showed a metastastic renal cell carcinoma, and echocardiography revealed a right ventricular mass without contiguous vena caval or right atrial involvement. This is one of the few reported cases of renal cell carcinoma associated with syncope as an initial symptom.

  12. 系统性红斑狼疮患者早期肾病理活检的价值研究%The Research on the Value of Early Renal Biopsy in Patients with Systemic Lupus Erythematosus

    Institute of Scientific and Technical Information of China (English)

    敖晶晶; 贾晓敏; 陈志鸿

    2013-01-01

    Objective:To determine the value of early renal biopsy for SLE patients with renal involvement. Methods:The renal biopsies in 70 patients with LN were retrospectively analyzed. Results:In patients with acute renal failure, 82.4%of patients were Class IV and V LN and 17.6%were Class V. 91%had proliferative LN and 9%had non-proliferative LN. Conclusion:In SLE patients, early renal biopsy maybe helpful in diagnosis and planning treatment.%目的:确定系统性红斑狼疮肾(SLE)患者早期肾活检的价值。方法:回顾性分析70例SLE患者肾穿刺活检结果。结果:在急性肾功能衰竭患者中,82.4%的患者为狼疮肾炎IV型和17.6%的患者为V型。91%的患者为增生性狼疮肾炎,9%的患者为非增生性狼疮肾病。高水平抗双链DNA抗体和低C4水平在增殖性狼疮肾炎更常见(p<0.05)。结论:应积极行肾脏活检穿刺术,从病理学角度明确SLE及狼疮肾炎的诊断并指导治疗。

  13. 肾动脉栓塞治疗6例肾穿刺活检术或肾镜取石术术后大出血%Super-Selective Renal Arterial Embolization in the Treatment of Massive Hemorrhage after Renal Biopsy or Mini-Percutaneous Nephrolithotomy

    Institute of Scientific and Technical Information of China (English)

    徐明林; 许哲; 潘建军

    2012-01-01

    Objective:To evaluate the efficacy of super-selective renal arterial cmboiization in the treatment of massive hemorrhage after renal biopsy or mini-percutaneous ncphrolithotomy. Methods: A total of 6 patients with massive hemorrhage after renal biopsy or mini-percutaneous ncphrolithotomy were treated with super-selective renal arterial cmbolization. Results: The hemorrhage in all 6 cases was under control immediately after the treatment of super-selective renal arterial cmbolization, without late hemorrhage at the lsr week, 2r week and 4n week after the cmbolization. No obvious renal impairment was observed in all cases. Conclusions; Surpcr-sclcctivc renal arterial cmbolization is a good way to treat massive hemorrhage after renal biopsy or mini-pcrcutancous ncphrolithotomy.%目的:探讨超选择性肾动脉栓塞治疗肾穿刺活检术或经皮肾镜取石术术后继发大出血的临床价值.方法:回顾分析6例肾穿刺活检术或经皮肾镜取石术术后并发大出血接受超选择性肾动脉栓塞介入治疗的患者的相关资料.结果:在超选择性肾动脉栓塞治疗后,6例患者的大出血均立即得到控制,且术后1周、2周、4周随访均无迟发性出血.所有患者术后均无明显肾功能损害.结论:超选择性肾动脉栓塞是治疗肾穿刺活检术及经皮肾镜取石术术后继发大出血的首选方法.

  14. 老年患者肾活检的临床及病理对比分析%Clinical and pathological analysis on renal biopsy of elderly patients

    Institute of Scientific and Technical Information of China (English)

    张亚莉; 姜莎莎; 冯婕; 孙吉平; 牛丹; 冯学亮

    2013-01-01

    Objective To study the epidemiology,pathologies and clinical manifestations of renal diseases in elderly patients of different genders in China northwest region.Methods Retrospective analysis was used to evaluate the clinical and pathological informations of patients above 60 years old who underwent renal biopsy and had the integrated data in the past 20 years.Results (1)Among the 559 patients,there were 347 men accounting for 62.1%,and there were 212 women accounting for 37.9% ; the average age was (66.7±5.3)years,the median course of disease was 5.0months when receiving renal biopsy,and 50% cases was (1.3 ~ 12.0)months.(2) Primary glomerulopathy accounted for 69.59%(389/559),secondary glomerulopathy,tubulointerstitial disease and the others accounted for 25.4% (142/559),3.8% (21/559) and 1.3% (7/559),respectively.(3)According to clinical manifestation,nephrotic syndrome was the most common disease(accounting for 60.7%),and then chronic glomerulonephritis accounted for 31.6%.In pathology,membranous nephropathy was the most frequently category accounting for 34.5%,then mesangial proliferative glomerulonephritis accounted for 32.4%.(4) Among secondary glomerulopathy,the frequent diseases were primary polyangitis,diabetic nephropathy,amyloidosis of kidney and lupus nephritis,accounting for 24.7%,19.7 %,13.4 % and 10.6 %,respectively,and the number of women was more than men in lupus nephritis(P<0.05).(5) The common diseases of primary glomerulopathy that would result in renal insufficiency were nephrotic syndrome and chronic glomerulonephritis,accounting for 76.5 % (26/34)and 76.2 % (48/63),respectively,and the common pathological type was both mesangial proliferative glomerulonephritis.The common diseases of secondary glomerulopathy that would result in renal insufficiency were primary small vessel vasculitis and diabetic nephropathy,accounting for 46.3%(19/41)and 34.4%(11/32),respectively.Conclusions (1)the number of men

  15. Clinicopathologic Characteristics of 610 Patients Undergoing Renal Biopsy%肾穿刺活检610例患者的临床病理特点分析

    Institute of Scientific and Technical Information of China (English)

    关金; 生杰

    2015-01-01

    。不同年度各型 SGN 发生率比较,差异无统计学意义( P >0.05)。结论 PGD 中常见IgAN,SGN 中常见乙型肝炎病毒相关性肾炎;10年间 CKD 增长幅度较高的为 MN,为临床预防和治疗提供了参考依据。%Objective To analyze the clinicopathologic characteristics of 610 patients undergoing renal biopsy. Methods A total of 610 patients who underwent renal biopsy in the Second Hospital Affiliated to Dalian Medical University during 2004 to 2014,were selected as study subjects. The definite diagnosis was made based on WHO histologic classification of glomerular disease( 1982 and 1995 ),clinical data,laboratory test results and renal pathology. The prevalence rates of glomerular disease were compared among different gender groups and age groups,and the changes of renal pathology types from 2004 to 2008 and from 2009 to 2014 were analyzed. Results Among 468 cases with primary glomerular disease(PGD),153 cases(32. 7% )had IgA nephropathy( IgAN),131 cases( 28. 0% ) had membranous nephropathy( MN),122 cases (26. 1% )had mesangial proliferative glomerulonephritis nephritis(MsPGN),31 cases(6. 6% )had minimal change disease (MCD),27 cases(5. 8% ) had focal segmental glomerulosclerosis( FSGS),2 cases(0. 4% ) had membranoproliferative glomerulonephritis(MPGN),2 cases(0. 4% )had cresentic glomerulonephritis(CREGN). Among 142 cases with secondary glomerulonephritis(SGN),51 cases(35. 9% ) had hepatitis B virus - associated glomerulonephritis,38 cases(26. 8% ) had lupus nephritis(LN),35 cases(24. 6% ) had henoch - schonlein purpura nephritis( HSPN),6 cases(4. 2% ) had vascular disease - induced renal lesions,5 cases( 3. 5% ) had multiple myeloma - associated renal impairment,3 cases (2. 1% )had obesity - related glomerulopathy,2 cases( 1. 4% ) had renal involvement in Sjogren' s syndrome,1 case (0. 7% )had systemic sclerosis - induced renal impairment,1 case(0. 7% )had scleroderma kidney disease. The prevalence rate of IgAN among male cases was

  16. Endoscopic ultrasound guided fine needle aspiration versus endoscopic ultrasound guided fine needle biopsy in sampling pancreatic masses

    Science.gov (United States)

    Wang, Jing; Zhao, Shulei; Chen, Yong; Jia, Ruzhen; Zhang, Xiaohua

    2017-01-01

    Abstract Background: The comparison between endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for the diagnosis of pancreatic masses is still controversial. Many factors can affect the final results. Methods: Databases, such as PubMed, EMBASE, Cochrane Library, and Science Citation Index updated from 2000 to 2016 were searched to include eligible articles. In the meta-analysis, the main outcome measurements were the diagnostic accuracy, number of needle passes, specimen adequacy, the rate of complications, and technical success. Results: Eight randomized controlled trials (RCTs) were identified, and a total of 921 cases were included in the meta-analysis. The diagnostic accuracy was not significantly different between the FNA and FNB groups. The specimen adequacy was higher in the FNB group compared with the FNA group. The number of needle passes to obtain sufficient tissue was lower in the FNB group. The rate of adverse events and technical success did not significantly differ between the 2 groups. But, the forest plot showed a trend toward lower technical success rate and a trend toward higher diagnostic accuracy in the FNB group, compared with FNA. Conclusion: We provide the evidence that FNB is comparable to FNA in terms of diagnostic accuracy, adverse events, and technical success. FNB gives higher specimen adequacy than that of FNA, despite performance of fewer needle passes. PMID:28700483

  17. Prospective Study for Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using 25- and 22-Gauge Core Biopsy Needles in Solid Pancreatic Masses.

    Directory of Open Access Journals (Sweden)

    Se Woo Park

    Full Text Available Although thicker needles theoretically allow more tissue to be collected, their decreased flexibility can cause mechanical damage to the endoscope, technical failure, and sample blood contamination. The effects of needle gauge on diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB of pancreatic mass lesions remain unknown. This study compared procurement rates of histologic cores obtained from EUS-FNB of pancreatic masses using 25- and 22-gauge core biopsy needles.From March 2014 to July 2014, 66 patients with solid pancreatic mass underwent EUS-FNB with both 25- and 22-gauge core biopsy needles. Among them, 10 patients were excluded and thus 56 patients were eligible for the analyses. Needle sequences were randomly assigned, and two passes were made with each needle, consisting of 10 uniform to-and-fro movements on each pass with 10 mL syringe suction. A pathologist blinded to needle sequence evaluated specimens for the presence of histologic core.The mean patient age was 65.8 ± 9.5 years (range, 44-89 years; 35 patients (62.5% were men. The mean pancreatic mass size was 35.3 ± 17.1 mm (range 14-122.3 mm. Twenty-eight patients (50% had tumors at the pancreas head or uncinate process. There were no significant differences in procurement rates of histologic cores between 25-gauge (49/56, 87.5% and 22-gauge (46/56, 82.1%, P = 0.581 needles or diagnostic accuracy using only histologic cores (98% and 95%. There were no technical failures or procedure-related adverse events.The 25-gauge core biopsy needle could offer acceptable and comparable outcomes regarding diagnostic performance including histologic core procurement rates compared to the 22-gauge core biopsy needle, although the differences were not statistically significant.ClinicalTrials.gov NCT01795066.

  18. Comparison of Trifecta and Pentafecta Outcomes between T1a and T1b Renal Masses following Robot-Assisted Partial Nephrectomy (RAPN with Minimum One Year Follow Up: Can RAPN for T1b Renal Masses Be Feasible?

    Directory of Open Access Journals (Sweden)

    Dae Keun Kim

    Full Text Available To investigate the feasibility of RAPN on T1b renal mass by assessment of Trifecta and Pentafecta rate between T1a and T1b renal mass.We retrospectively reviewed the medical records of 277 cases of RPN performed from 2006 to 2015. Sixty patients with clinically T1b renal masses (> 4 cm and ≤ 7 cm were identified, and from 180 patients with clinically T1a renal mass, 60 patients were matched with T1b renal mass by propensity score. Tumor complexity was investigated according to R.E.N.A.L nephrometry score. "Pentafecta" was defined as achievement of Trifecta (negative surgical margin, no postoperative complications and warm ischemia time of ≤ 25 minutes with addition of over 90% estimated GFR preservation and no chronic kidney disease stage upgrading at 1 year postoperative period. Propensity score matching was performed by OneToManyMTCH. Logistic regression models were used to identify the variables which predict the Trifecta, and Pentafecta ac.Preoperative variables (age, sex, body mass index, ASA score were similar between T1a and T1b after propensity score matching. The median R.E.N.A.L. nephrometry score was 8 vs 9 for T1a and T1b respectively (p<0.001. The median warm ischemia time was 20.1 min vs 26.2 min (p<0.001. Positive surgical margin rate was 5% vs 6.6% (p = 0.729 and overall complication rate of 13.3%. vs 15% (p = 0.793. The rate of achievement of Trifecta rate were 65.3% vs 43.3% (p = 0.017 and Pentafecta rate were 38.3% vs 26.7% (p = 0.172. For achievement of Pentafecta, R.E.N.A.L nephrometry score (HR 0.80; 95% CI (0.67-0.97; p = 0.031 was significant predictor of achieving Pentafecta. Subanalyis to assess the component of R.E.N.A.L nephrometry score, L component (location relative to the polar lines, HR 0.63; 95% CI (0.38-1.03; P = 0.064 was relatively important component for Pentafecta achievement.The rate of Pentafecta after RAPN was comparable between T1a and T1b renal masses. RAPN is a feasible modality with excellent

  19. The clinical study of percutaneous renal biopsy by automatic gun under real time color doppler ultrasound guidance%彩色多普勒超声引导下经皮肾活检术的临床应用

    Institute of Scientific and Technical Information of China (English)

    席春生; 李亚妹; 王谨涵; 关怀; 李芸; 高健; 刘冬梅; 张萌

    2013-01-01

    目的探讨彩色多普勒超声引导下斜角进针经皮肾穿刺活检术的安全性和成功率及其影响因素。方法回顾分析了兰州军区兰州总医院226例经临床诊断的慢性肾脏病患者在彩色多普勒超声引导下用美国BARD MAGNUM自动活检枪斜角进针行经皮肾穿刺活检术,对影响穿刺成功率的有关因素进行分析,并与普通超声引导下经皮肾活检术对比。结果穿刺成功222例,成功率为98.4%,有4例未取得足够病理诊断的肾组织标本,活检标本长度为(10.5±4.5)mm,获取肾小球数目为(16.7±6.3)个。本研究中所有病例均未发现严重并发症。肉眼血尿发生率为0.4%(1/226),肾周血肿发生率0.9%(2/226)。在获取肾小球数目和穿刺成功率与文献报道一致,而术后并发症方面,明显低于文献报道。结论彩色多普勒超声引导下斜角进针经皮肾活检术成功率高,并发症少,值得进一步观察和推广。%Objective To investigate the safety and efficacy of color doppler ultrasound-guided renal biopsy using an automated biopsy gun, analysis the related risk factor. Methods The retrospective analysis method were used. Two hundred twenty-six patients with proveded chronic kidney diseases admited Lanzhou General Hospital were performed renal biopsy using an automated BARD biopsy gun made in America. The successful rate and complications were analyzed, and compared with common ultrasound guidance. Results Adequate renal tissue for histologic diagnosis was obtained by BARD MAGNUM biopsy gun was 98.4% of the patients, the average length of renal tissue sample was(10.5±4.5) milimeter, the average number of glomeruli was(16.7±6.3), the rate of gross hematuria was 0.4%. The total of complication was 0.9%(2/226). Conclusion Ultrasound guided percutanous renal biopsy with BARD MAGNUM automated biopsy gun is a kind of safe and accurate method of performing renal biopsy for kidney disease.

  20. The role of intraoperative ultrasound in small renal mass robotic enucleation

    Directory of Open Access Journals (Sweden)

    Roberta Gunelli

    2016-12-01

    Full Text Available Introduction: As a result of the growing evidence on tumor radical resection in literature, simple enucleation has become one of the best techniques associated to robotic surgery in the treatment of renal neoplasia, as it guarantees minimal invasiveness and the maximum sparing of renal tissue, facilitating the use of reduced or zero ischemia techniques during resection. The use of a robotic ultrasound probe represents a useful tool to detect and define tumor location, especially in poorly exophytic small renal mass. Materials and methods: A total of 22 robotic enucleations were performed on < 3 cm renal neoplasias (PADUA score 18 Pz 6/7 e 4 Pz 8 using a 12-5 MHz robotic ultrasound probe (BK Drop-In 8826. Results: Once kidney had been isolated from the adipose capsule at the site of the neoplasia (2, the exact position of the lesion could be easily identified in all cases (22/22, even for mostly endophytic lesions, thanks to the insertion of the ultrasound probe through the assistant port. Images were produced and visualized by the surgeon using the TilePro feature of the DaVinci surgical system for producing a picture-in-picture image on the console screen. The margins of resection were then marked with cautery, thus allowing for speedy anatomical dissection. This reduced the time of ischemia to 8 min (6-13 and facilitated the enucleation technique when performed without clamping the renal peduncle (6/22. No complications due to the use of the ultrasound probe were observed. Conclusions: The use of an intraoperative robotic ultrasound probe has allowed for easier identification of small, mostly endophytic neoplasias, better anatomical approach, shorter ischemic time, reduced risk of pseudocapsule rupture during dissection, and easier enucleation in cases performed without clamping. It is noteworthy that the use of intraoperative ultrasound probe allows mental reconstruction of the tumor through an accurate 3D vision of the hidden field during

  1. 四川地区肾活检2330例临床病理分析%Analysis of 2 330 cases of renal biopsy in Sichuan area

    Institute of Scientific and Technical Information of China (English)

    张萍; 邹玉蓉; 李贵森; 王蔚; 汪伟; 王莉

    2014-01-01

    Objective To investigate the pathological characteristics as well as their associations with secular trend of the disease of renal biopsies in Sichuan area.Methods The pathological data of 2 330 patients with biopsy-proven glomerular diseases were analyzed retrospectively.Results The male to female ratio was 1∶1.15 in 2 330 patients,and the patients aged 20-40 years old accounted for the highest percentage in renal diseases.Among the 2 330 patients,primary glomerulonephritis (PGN,81.37%)was of the most frequent type,followed by secondary glomerulonephritis (SGN, 15.75%),tubulointerstitial nephritis (TIN,2.15%)and hereditary kidney disease (0.73%).Among PGN,IgA nephropathy was the most frequent pathology type,followed by mesangial proliferative glomerulonephritis (MsPGN),membranous nephropathy (MN),minimal change disease (MCD)and focal segmental glomerulosclerosis (FSGS).Lupus nephritis (LN)was the most common form of SGN,followed by henoch-schonlein purpura nephritis (HSPN),diabetic kidney disease(DKD)and amyloidosis (AL).There were 1015 patients (43.56%)with kidney disease nephrotic syndrome,681 (29.22%)with chronic nephritic syndrome,392 (16.82%)with acute nephritic syndrome,121 (5.29%)with occult glomerulonephritis,72(3.09%)with chronic renal failure and 47(2.02%)with acute renal failure in the clinical classification of 2330 patients.Recently,the incidence of MN was in-creased.Conclusions PGN is the most common histological type in Sichuan area,and young men are more inclined to suffer from it.IgAN and MsPGN are the most common types in PGN,and the inci-dence of MN has been increased.For SGN,LN and HSPN are the most frequent types.%目的:探讨四川地区肾穿刺活检病理类型的分布特点以及疾病谱的变迁。方法回顾性分析2330例肾活检患者的临床病理资料,分析本地区肾脏疾病的临床病理特征。结果2330例肾活检患者中,男女比例为1∶1.15,发病高峰年龄为20~40岁。2330例患

  2. Utility of iodine overlay technique and virtual unenhanced images for the characterization of renal masses by dual-energy CT.

    Science.gov (United States)

    Song, Kyoung Doo; Kim, Chan Kyo; Park, Byung Kwan; Kim, Bohyun

    2011-12-01

    The objective of our study was to assess the utility of dual-energy CT for characterizing renal masses using iodine overlay techniques and virtual unenhanced images and to measure the potential radiation dose reduction for two-phase kidney CT compared with a standard three-phase protocol. Sixty patients with suspected renal masses underwent dual-energy CT including true unenhanced, dual-energy corticomedullary, and dual-energy late nephrographic phase imaging. Iodine overlay and virtual unenhanced images were derived from the corticomedullary and late nephrographic phases, respectively. The CT numbers of renal masses were calculated using the iodine overlay images superimposed on the virtual unenhanced images. The overall imaging quality of the true unenhanced images and of the virtual unenhanced images was also evaluated. The effective radiation doses for dual-energy CT and for true unenhanced imaging were calculated. For overlay or enhancement values on iodine overlay images, 36 simple cysts and 10 hemorrhagic cysts had an attenuation value of less than 20 HU, whereas 21 renal cell carcinomas showed an attenuation value of 20 HU or greater. Eleven angiomyolipomas contained macroscopic fat tissue. All renal masses were accurately classified on the basis of dual-energy CT. The imaging quality of the virtual unenhanced images from the corticomedullary and late nephrographic phases was inferior to the image quality of the true unenhanced images (p overlay techniques and virtual unenhanced images may be useful for characterizing renal masses.

  3. Tongue biopsy

    Science.gov (United States)

    Biopsy - tongue ... A tongue biopsy can be done using a needle. You will get numbing medicine at the place where the ... provider will gently stick the needle into the tongue and remove a tiny piece of tissue. Some ...

  4. Needle Biopsy

    Science.gov (United States)

    ... for a day or two During the needle biopsy Your health care team will position you in ... if you're feeling uncomfortable. After the needle biopsy Once your doctor has collected enough cells or ...

  5. Steerable real-time sonographically guided needle biopsy.

    Science.gov (United States)

    Buonocore, E; Skipper, G J

    1981-02-01

    A method for dynamic real-time ultrasonic guidance for percutaneous needle biopsy has been successful in obtaining cytologic and histologic specimens from abdominal masses. The system depends on a real-time ultrasonic transducer that has been rigidly attached to a laterally placed steerable needle holder. Using simple trigonometric functions, a chart has been derived that gives the exact angulation and needle length to produce quick, reliable, guided needle placements. Examples of successful renal, hepatobiliary, and retroperitoneal biopsies are presented. Advantages of this technique include speed, accuracy, low cost, three-dimensional format, and the omission of contrast media and radiation.

  6. Análise de 95 biópsias renais de pacientes com nefrite lúpica: correlação clínico-histológica e fatores associados a insuficiência renal crônica Analysis of 95 renal biopsies from patients with lupus nephritis: clinical and histological correlation and chronic renal failure associated factors

    Directory of Open Access Journals (Sweden)

    Marta Maria das Chagas Medeiros

    2004-08-01

    Full Text Available OBJETIVOS: analisar características clínico-laboratoriais dos pacientes com nefrite lúpica que se submeteram à biópsia renal em um hospital universitário; correlacionar manifestações clínicolaboratoriais com os principais tipos de nefrite lúpica; determinar fatores associados ao desenvolvimento de insuficiência renal crônica (IRC. MÉTODOS: dados demográficos, clínicos, laboratoriais e histológicos de todos pacientes com diagnóstico de nefrite lúpica que realizaram biópsia renal no período de janeiro de 1997 a julho de 2002 foram avaliados retrospectivamente. RESULTADOS: Setenta e sete pacientes com nefrite lúpica realizaram 95 bióspias. Considerando apenas 76 amostras com resultados conclusivos, a glomerulonefrite (GMN proliferativa difusa foi o tipo histológico mais prevalente (68,4%, seguido pela proliferativa focal (14,5% e mesangial (7,9%. Hipertensão arterial, creatinina > 1,2g/dL, hipoalbuminemia (albumina OBJECTIVE: To analyze the laboratory and clinical characteristics of patients diagnosed with lupus nephritis and submitted to renal biopsy at a university hospital; to correlate laboratory and clinical manifestations with the main types of lupus nephritis; to determinate factors associated with the development of chronic renal failure (CRF. METHODS: Retrospective evaluation of the demographic, clinical, laboratory and histological data of patients diagnosed with lupus nephritis and submitted to renal biopsy from January/1997 to July/2002. RESULTS:Seventy-seven patients with lupus nephritis were submitted to 95 renal biopsies. Considering only the samples with conclusive results (n=76, diffuse proliferative glomerulonephritis (DPGN was the most prevalent histological type (68.4%, followed by the focal (14.5% and mesangial (7.9% types. Arterial hypertension, creatinine > 1.2 g/dL, hypoalbuminemia (albumin < 2.6 g/dL and nephrotic syndrome were present on the first biopsy in 43.8%, 48.7%, 55.2% and 15.6% of the

  7. Clinical epidemiology of renal diseases in Xuzhou area based on 1217 renal biopsy data%1217例肾活检患者临床与病理资料分析

    Institute of Scientific and Technical Information of China (English)

    潘俊美; 尹忠诚; 李胜开

    2013-01-01

    目的 了解行肾穿刺活检患者的流行病学特点及病理类型与临床表现间的关系.方法 回顾性分析1217例行肾活检者的性别、年龄、病理类型及临床表现等相关资料.结果 1217例患者行肾活检时的平均年龄为(30.86±13.41)岁,男性612例(50.3%),女性605例(49.7%).男性占本组原发性肾小球疾病(PGN)的52.2%,继发性肾小球疾病(SGN)的39.0%.肾脏病患者的高发年龄段为20 ~39岁(50.9%).本组患者最常见的临床表现为肾病综合征(NS)610例(50.1%),其余分别为尿检异常型(Uab)453例(37.2%),反复发作性肉眼血尿型(rGH)89例(7.3%),慢性肾衰竭(CRF)31例(2.5%),急性肾损伤(AKI) 12例(1.0%),高血压型(HT)11例(0.9%),急性肾炎综合征(ANS)8例(0.7%),孤立性肉眼血尿型(iGH)3例(0.2%).原发性肾小球疾病以系膜增生性肾炎(MsPGN),继发性肾小球疾以狼疮性肾炎(LN)为主要病理类型.本组患者中各临床分型均以系膜增生性肾炎为主要病理类型,除系膜增生性肾炎外,肾病综合征以MN,Uab以IgAN为主要病理类型.结论 原发性肾小球疾病是徐州地区最常见的肾脏疾病,男性、青壮年是高发人群,系膜增生性肾炎是最常见病理类型,肾病综合征是最常见的临床表现.%Objective To summarize the clinical epidemiology and correlation between pathology and clinical features of all the renal biopsy cases in the Affiliated Hospital of Xuzhou Medical University. Method To retrospectively investigate the clinico-pathological date in 1217 cases having underwent renal biopsy in the Affiliated Hospital of Xuzhou Medical University. Demographic data were obtained from all patients. Results The mean age of the whole group patients was 30. 86 ±13.41(6 ~75) years,50. 3% patients were male and 49. 7% were female. Of the 1048 patients with Primary glomerular disease( PGD) 52.2% were male; with the secondary glomerulonephritis(SGN) ,male amounted to 39%. A high

  8. Kidney biopsy findings in primary Sjögren syndrome.

    Science.gov (United States)

    Kidder, Dana; Rutherford, Elaine; Kipgen, David; Fleming, Stewart; Geddes, Colin; Stewart, Graham A

    2015-08-01

    Renal involvement is rare in primary Sjögren syndrome (PSS). In this study, we examined renal biopsy findings in patients with PSS and correlated them with their clinical and renal findings. Twenty-five patients with PSS who underwent renal biopsies from two renal units in Scotland between 1978 and 2013 were identified from renal biopsy database. We examined the renal morphologic, clinical and renal findings at the time of renal biopsy, renal and patient outcomes. The diagnosis of PSS preceded renal biopsy in 18/25 patients. In this group, the median duration of the disease was 5.5 years. Significant proteinuria, combined microscopic haematuria and proteinuria and reduced renal excretory function were found in 76, 56 and 84% of patients, respectively. The 3-year actuarial patient survival was significantly lower in patients with glomerulonephritis as compared with tubulointerstitial nephritis (66 versus 100%, P = 0.02). There was no difference in 3-year actuarial renal survival between these two groups (92 versus 92%, P = 1.0). Renal biopsy is rare in PSS and often reveals diverse pathological findings. Glomerulonephritis, as compared with tubulointerstitial nephritis, is associated with higher early mortality. Further studies are needed to evaluate the utility of renal biopsy and its impact on disease management. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  9. Investigation on anxiety status of the patients before renal biopsy and its nursing intervention.%肾穿刺患者术前焦虑状况护理干预

    Institute of Scientific and Technical Information of China (English)

    贾海红; 席海峰; 张文英; 杨兰兰

    2011-01-01

    目的:探讨护理干预对肾穿刺活体组织检查术患者的焦虑状态的影响.方法:将欲行肾穿刺的患者在术前按年龄和性别随机分为实验组和对照组,应用焦虑自评量表(SAS),评定其在护理干预前后的焦虑状态,并将结果进行统计学分析.结果:肾穿刺患者术前存在着较严重的焦虑状态,进行有针对性的心理干预、认知干预和行为干预后患者的焦虑状态明显减轻,差异有统计学意义(P<0.01).结论:肾穿刺活体组织检查患者术前存在不同程度的焦虑状态,实施有针对性的护理干预后可明显降低患者的焦虑情绪.%Objective: To explore the influence on the anxiety of the patients before renal biopsy after they received the nursing intervention.Method: According to age and gender.Patients were divided into experimental group and control group randomly before renal biopsy, using the application of self - evaluation of anxiety scale ( SAS), asessing the patients' anxiety status after the nursing intervention, and analyzing the results by statistical methods.Result:there exists severe anxiety in patients before renal biopsy.Try to employ psychological intervention ,cognitional intervention and biopsy, so that the anxiety status on patients decreased obviously.In addition, the difference was stutistically significant ( P < 0.01 ).Conclusion: Patients before renal biopsy exist different degree of anxiety, it is obvious to decrease the anxiety status of patients after the employment of pertinent nursing intervention.

  10. 超声介入经皮肾活检的临床应用和严重并发症分析%Clinical application and complications of ultrasound-guided renal biopsy

    Institute of Scientific and Technical Information of China (English)

    王中阳

    2008-01-01

    Objective To discuss the importance and seeurity of renal biopsy with automatic biopsy gun. Methods 132 patients were performed renal biopsy in our hospital from january, 2004 to september, 2007. The eomplieation ineidenee and related factors were analysed in the eases. Results The suecessful rate for getting sample was 96. 2%. All the patients undergoing renal biopsy got identified pathological diagnosis. The incidence of mild complications was 8. 33%, the incidence of severe complications was 1.52%. The incidence had no relation with sex, age, puncturing times, or neddle types. The incidence of severe complications had some relation with preoperative and postoperative medication and management. Conclusion With good preoperative preparation, strict indications for it,and resonable preoperative and postoperative medication, renal biopsy was a safe, useful, and important diagnostic method.%目的 本文旨在讨论肾自动活检的重要性和安全性.方法 总结2004年1月至2007年9月我院住院行肾活检的患者计132例,统计术后并发症发生率以及与相关因素的关系.结果 取材成功率为96.2%,所有经过肾活检的患者术后均得出明确的病理诊断,轻度并发症发生率为8.33%,严重并发症发生率为1.52%,与性别、年龄、穿刺的次数、针型无相关性;严莺并发症与术前、后用药及管理存在一定的关系.结论 只要术前做好准备工作,严格按照手术适应证选择患者,术前、术后合理用药,超声介入肾自动活检术是一种安全、有效、重要的诊断手段.

  11. Assessment and Clinical Application on uitrasound-guided percutaneous renal biopsy%超声引导下肾脏穿刺活检术的临床应用及探讨

    Institute of Scientific and Technical Information of China (English)

    余启军

    2014-01-01

    Objectives:To observe the success rate and complication rate of taking the renal biopsy specimens in the ultrasound guided puncture, and to evaluate the value of this technology in clinical diagnosis and treatment. Meth-ods:Having collected 128 cases of kidney disease patients who lived in the nephrology of hospital .We adopted the method in which we took the renal biopsy specimens by using automatic biopsy needle in the puncture with oriented linear array guided probe quickly. Their specimens were sent to be checked with optical microscope, electron microscope and immunofluorescence examination. Results:All the 128 patients were successfully completed the ul-trasound-guided renal biopsy, except 2 cases with perirenal hematoma and 1 case with hematuria, the others didn't have significant postoperative complications, all the patients got recovered after appropriate treatment without postoperative infection and obtained correct pathological diagnosis. Conclusion:It is safe and effective to use ultra-sound guided percutaneous renal biopsy to cure the patients with such advantages as accurate positioning, convenient operation, high success rate and less complications.%目的:观察在超声引导下穿刺取肾脏活组织的取材成功率、并发症的发生率,评价此项技术对临床诊断及治疗的价值。方法:选取肾内科128例肾脏疾病患者,采用在带穿刺针导向的线阵探头引导下自动活检针快速肾脏活体组织取材,标本分别送检病理光镜、电镜及免疫荧光检查。结果:128例患者均顺利完成了超声引导下肾脏活检术,除2例肾周血肿、1例肉眼血尿外,其余均无明显术后并发症,128例均取得正确的病理诊断,术后无感染,经治疗后痊愈出院。结论:超声引导下经皮肾脏穿刺活检术定位准确、操作简便、成功率高、并发症少,是一种安全有效的方法。

  12. Body mass index and prostate cancer severity: do obese men harbor more aggressive disease on prostate biopsy?

    Science.gov (United States)

    Chamie, Karim; Oberfoell, Stephanie; Kwan, Lorna; Labo, Jessica; Wei, John T; Litwin, Mark S

    2013-05-01

    To examine the association of obesity with the prebiopsy prostate-specific antigen (PSA), Gleason score, clinical stage, and D'Amico tumor risk in 2 independent cohorts of men with prostate cancer. We retrospectively reviewed the medical records of men with biopsy-proven prostate cancer from California's Improving Access, Counseling and Treatment for Californians with Prostate Cancer program and from a random sample of men treated at the University of Michigan. We performed multivariate analyses to examine the relationship of body mass index (BMI) with the prebiopsy PSA level, Gleason score, clinical stage, and D'Amico tumor risk, while controlling for demographics. The mean age was 61.5 years, and the median prebiopsy PSA level was 6.7 ng/mL. Greater than 70% of men were at least overweight. On univariate analysis, the BMI was not associated with prebiopsy PSA levels, Gleason score, or D'Amico tumor risk. On multivariate analysis, we found no association between BMI and log-transformed PSA, Gleason score, clinical T stage, or D'Amico risk. Advancing age was associated with a greater risk of a higher prebiopsy PSA level, Gleason score, and D'Amico tumor risk. Obese men with prostate cancer were no more likely to have a higher prebiopsy PSA level, Gleason score, clinical T stage, or D'Amico risk than those of normal weight. Although we do not know whether the BMI affected the prebiopsy PSA values in those without a diagnosis of prostate cancer, our findings suggest that the BMI does not affect the interpretation of the prebiopsy PSA levels in those with cancer. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Nursing Care of 56 Patients Undergoing B-type Ultrasound-guided Percutaneous Renal Biopsy%56例肾穿刺患者的护理与观察

    Institute of Scientific and Technical Information of China (English)

    任启芳; 胡红艳; 徐亚梅; 郭贝清; 张艳丽; 张玮

    2011-01-01

    Objective To investigate the safety and nursing of patients with renal biopsy. Methods The success rate and complications of renal biopsy were observed in 56 patients in hospital from 2009.10 -2010.6, nursing care of renal biopsy were summarized. Results Puncture was successful in all 56 cases ,puncture success rate was 100% ;postoperative complication of microscopic hematuria occurred in 7 patients ( 12.50% ), gross hematuria in 1 case ( 3.57% ), puncture site pain in 6 patients ( 10.70% ). Postoperative infection, continued gross hematuria, subcapsular hematoma, and renal rupture was not found. Conclusion The renal biopsy was a safe and effective inspection. With good preoperative psychological care and postoperative care,the success rate of puncture can be improved;which was important to reduce complications.%目的 探讨患者肾穿刺的安全性及护理体会.方法 对56例肾脏病患者进行肾活检术,通过观察56例患者肾穿刺的成功率及并发症,总结患者肾穿刺的护理体会.肾活检术是项创伤性检查,术后易并发出血、感染、血尿、腰痛、尿潴留等并发症.结果 56例穿刺全部成功,穿刺成功率为100%;术后并发镜下血尿7例(12.50%),肉眼血尿1例(3.57%),穿刺部位疼痛6例(10.70%).未发现术后感染、持续大量肉眼血尿、肾包膜下血肿、肾破裂等并发症.结论 患者进行肾穿刺是一项安全有效的检查,做好术前的心理护理,术后痛过加强患者并发症的观察与护理,积极采取相关的护理措施,从而有效地减少并发症的发生.

  14. 经皮肾穿刺活检在肾脏疾病诊断中的应用价值%The Value of Percutaneous Renal Biopsy in the Diagnosis of Kidney Disease

    Institute of Scientific and Technical Information of China (English)

    张燕飞

    2014-01-01

    Objective:To study the application value of percutaneous renal biopsy in the diagnosis of kidney disease.Method:18-16G automatic biopsy gun,under the guidance of the B ultrasound from October 2011 to May 2013 in our hospital nephrology examined 100 cases of patients with renal biopsy.Result:96 cases were successful,accounted for 96.0%,4 cases did not succeed,accounted for 4.0%.98 cases had no serious complications puncture biopsy,biopsy diagnosis rate was 88.5%.Conclusion:B ultrasound-guided percutaneous renal biopsy is not only able to improve the clinical diagnosis of reliable data,and to understand the morphological changes in the kidney tissue,clinical judgment illness,prognosis and determine treatment options are provided an important basis.%目的:研究经皮肾穿刺活检在肾脏疾病诊断中的应用价值。方法:应用18-16G自动式活检枪,在B超引导下对2011年10月-2013年5月在笔者所在医院肾病科检查的100例患者进行肾穿刺活检。结果:96例穿刺成功,占96.0%;4例未成功,占4.0%。其中98例穿刺肾活检均无严重并发症发生,穿刺病理诊断符合率为88.5%。结论:B超引导下经皮肾穿刺活检不仅能为临床诊断提供可靠的资料,并能了解肾脏的组织形态学改变,对临床判断病情、估计预后及确定治疗方案均提供了重要的依据。

  15. Growing Renal Mass: Lessons Learned on the Road From an Atypical Presentation to Successful Therapy

    Directory of Open Access Journals (Sweden)

    Eliza Lamin

    2015-09-01

    Full Text Available A 25 4/7 week boy was born with a prenatal diagnosis of polyhydramnios and enlarged left kidney. Over the next 2 months serial ultrasounds demonstrated abnormal growth of the kidney, with 28.9% split function. At gestational age 39 4/7, he underwent a left radical nephrectomy. Pathology revealed congenital mesoblastic nephroma with mixed classic and cellular features. This case was puzzling due to prenatally diagnosed renal enlargement in a premature infant and inconclusive post-natal ultrasonographic imaging. Although the patient had paraneoplastic signs of polyhydramnios and hypertension, the mass did not have a classic appearance of CMN; possibly due to severe prematurity.

  16. MALDI Orbitrap Mass Spectrometry Profiling of Dysregulated Sulfoglycosphingolipids in Renal Cell Carcinoma Tissues

    Science.gov (United States)

    Jirásko, Robert; Holčapek, Michal; Khalikova, Maria; Vrána, David; Študent, Vladimír; Prouzová, Zuzana; Melichar, Bohuslav

    2017-08-01

    Matrix-assisted laser desorption/ionization coupled with Orbitrap mass spectrometry (MALDI-Orbitrap-MS) is used for the clinical study of patients with renal cell carcinoma (RCC), as the most common type of kidney cancer. Significant changes in sulfoglycosphingolipid abundances between tumor and autologous normal kidney tissues are observed. First, sulfoglycosphingolipid species in studied RCC samples are identified using high mass accuracy full scan and tandem mass spectra. Subsequently, optimization, method validation, and statistical evaluation of MALDI-MS data for 158 tissues of 80 patients are discussed. More than 120 sulfoglycosphingolipids containing one to five hexosyl units are identified in human RCC samples based on the systematic study of their fragmentation behavior. Many of them are recorded here for the first time. Multivariate data analysis (MDA) methods, i.e., unsupervised principal component analysis (PCA) and supervised orthogonal partial least square discriminant analysis (OPLS-DA), are used for the visualization of differences between normal and tumor samples to reveal the most up- and downregulated lipids in tumor tissues. Obtained results are closely correlated with MALDI mass spectrometry imaging (MSI) and histologic staining. Important steps of the present MALDI-Orbitrap-MS approach are also discussed, such as the selection of best matrix, correct normalization, validation for semiquantitative study, and problems with possible isobaric interferences on closed masses in full scan mass spectra.

  17. Report of an unusual renal mass:Primary renal lympho-ma---Difficult procedure for laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Seyedeh Atefeh Emadi; Marzieh Akbarpour; Shahram Azhdari

    2008-01-01

    Lymphomas form a heterogenous group of clonal(neoplastic)diseases.Primary renal lymphoma(PRL)is rare. Diagnosis of primary renal lymphoma is important for the patients to receive appropriate therapy.Laparoscopic nephrectomy should be the standard procedure in most cases of both malignant and benign,renal tumors with the possible exception of tumor >10cm.Probably this case report of laparoscopic surgery of primary renal lym-phoma is the first report of this kind and may be useful for the other laparoscopic surgeons.A 53 years-old man with unilateral primary renal lymphoma who had a history of renal colic and ESWL(Extracorporeal Shock Wave Lithotripsy)of the left kidney stone 3 years ago,he underwent laparoscopic radical left nephrectomy and chem-otherapy.The patient was monitored for follow up for 4 months and had a significant improvement.Although treatment of lymphoma is now guided by phenotype of tumor,we found that appropriate treatment is possible af-ter radical nephrectomy and assessment of pathology.Renal lesions may compeletly regress by appropriate treatment.There was not any report of laparoscopic surgery of PRL in our literature.We are reporting the first case of successful laparoscopic surgery of PRL successfully.

  18. Biopsy of the transplanted kidney--role of protocol biopsies.

    Science.gov (United States)

    Masin-Spasovska, J; Spasovski, G

    2012-01-01

    Traditionally, renal allograft biopsies were performed mainly in the setting of acute graft dysfunction. Recently, there has been a change of paradigms. Several reports suggested that acute rejection of the graft and chronic allograft nephropathy are often subclinical without any deterioration in the graft function. This raises the issue of biopsies in functionally stable allografts (e.g. protocol biopsies) and the clinically useful information they provide. Namely, recent reports provide evidence in favour of treating biopsy-proven subclinical rejections. Moreover, by early identification of chronic histological lesions, protocol biopsies give an opportunity for individualized immunosuppressive regimen and use of targeted therapeutic strategies, in order to prevent chronic allograft dysfunction and improve long-term graft outcome. In this review, diagnostic, therapeutic and research benefit information on protocol biopsies performed in stable kidney recipients are described.

  19. Refractory anemia leading to renal hemosiderosis and renal failure

    OpenAIRE

    Sujatha Siddappa; K M Mythri; Kowsalya, R.; Ashish Parekh

    2011-01-01

    Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  20. Refractory anemia leading to renal hemosiderosis and renal failure

    Directory of Open Access Journals (Sweden)

    Sujatha Siddappa

    2011-01-01

    Full Text Available Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  1. 护理干预对肾活检术中患者呼吸配合的影响%Nursing intervention affect breathing in patients with renal biopsy

    Institute of Scientific and Technical Information of China (English)

    李冬; 郑红梅

    2014-01-01

    Objective To explore the nursing intervention in patients with percutaneous renal biopsy in breathing coordination. Methods 50 patients with percutaneous renal biopsy were randomly divided into control group and intervention group with 25 patients in each group. The control group only received general nursing instruction,while the intervention group was given comprehensively guidance for preoperative breathless breathing,compare two groups of patients with the situation. Results The intervention group is better than that of control group. Conclusion Preoperative nursing intervention can improve patients with percutaneous renal biopsy of breathing.%目的:探讨护理干预对经皮肾穿刺活检术中患者呼吸配合的影响。方法将50例行经皮肾穿刺活检患者随机分为对照组和干预组各25例,对照组仅行一般护理指导,干预组在此基础上实施术前呼吸配合的全面指导,比较2组患者术中呼吸配合情况。结果干预组术中呼吸配合良好率明显优于对照组。结论术前护理干预能有效改善经皮肾穿刺活检术中患者的呼吸配合情况。

  2. 肾穿刺活检术患者术前焦虑状况及影响因素调查分析%Analysis of the anxiety status of patients before renal biopsy and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    杨春芳; 施惠; 张维霞

    2014-01-01

    Objective:To know the status of anxiety in patients before renal biopsy and discuss the correlation between the influencing factors of preoperative anxiety and social support in order to provide the basis for relieving patient’s bad mood and reducing postoperative complications. Methods:The Hamilton anxiety scale( HAMA)and social support rating scale was used to investigate 124 hospitalized pa-tients who would undergo renal biopsy. Results:The total scores of anxiety of patients undergoing renal biopsy were 6. 49 ± 2. 84 points,the anxiety level was significantly different between the patients with different educational level(P<0. 05);the difference in the comparison of anxiety level was statistically significant between the patients with different marital status(P<0. 05);the anxiety score of the patients and social support score was negatively correlated(r= -0. 23,P=0. 00). Conclusion:The incidence of anxiety was higher in patients before renal biopsy and early psychological nursing intervention should be implemented.%目的:了解肾穿刺活检术患者术前焦虑状况,探讨术前焦虑影响因素及与社会支持的相关性,为改善患者不良情绪,减少术后并发症提供依据。方法:采用汉密尔顿焦虑量表( HAMA)、社会支持评定量表对拟接受肾穿刺活检术的124例住院患者进行问卷调查。结果:肾穿刺活检术患者焦虑总分为(6.49±2.84)分;不同文化程度患者焦虑水平比较差异有统计学意义( P<0.05),不同婚姻状况患者焦虑水平比较差异有统计学意义( P<0.05);患者的焦虑水平得分与社会支持得分呈显著负相关( r=

  3. 肾穿术6小时后下床排尿对患者术后并发症的影响%Effect of urination off-bed after 6 hours of renal biopsy on complications

    Institute of Scientific and Technical Information of China (English)

    温怡; 刁永书; 温月; 罗芳; 付琴

    2012-01-01

    目的 探讨经皮肾脏穿刺组织活检术(肾穿术)6小时后患者下床排尿对术后并发症影响.方法 将86例行肾穿术的患者分为实验组和对照组各43例,两组在术后6小时采取不同的排尿方法:下床排尿(实验组)和卧床排尿(对照组),观察两种排尿方法对术后并发症及尿潴留的影响.结果 术后并发症在两组之间无统计学差异(P>0.05);而尿潴留情况,实验组低于对照组(P<0.05).结论 肾穿术6小时后患者下床排尿不会增加术后并发症,且明显降低术后尿潴留.%Objective To investigate the influences of urination off-bed after 6 hours of renal biopsy on complications and urine retention. Methods A total of 86 patients receiving renal biopsy were divided into a study group (n=43) and a control group (n=43). Patients in the study group urinated off-bed after 6 hours of renal biopsy, while patients in the control group lied flat on their back and urinated in bed. Complications and urine retention between the two groups were compared. Results There was no statistical difference between the study group and the control group on the incidence of complications (P>0. 05); while the incidence of urine retention in the study group was lower than in the control group (P<0. 05). Conclusion Urination off-bed after 6 hours of renal biopsy, which significantly decreases the incidence of urine retention, does not influence the incidence of complications.

  4. The application and effect of scene imitation method in health education in pre-renal biopsy%术前情景模拟对肾活检患者依从性及并发症的影响

    Institute of Scientific and Technical Information of China (English)

    樊蓉; 龚德燕; 宋霞; 刘芳

    2011-01-01

    目的 探讨情景模拟在肾活检患者术前健康教育中应用的效果.方法 将182名需行肾活检的患者分为实验组和对照组,术前分别进行常规健康教育及情景模拟式健康教育,观察术中两组患者的心理变化、配合程度及术后并发症.结果 对照组患者术中紧张程度明显高于实验组(P<0.05),而术中配合程度低于实验组(P<0.05),术后并发排尿困难、腰背酸痛及肾周血肿的发生率实验组低于对照组(P<0.05).结论 术前采用情景模拟式健康教育能够患者的紧张情绪,提高患者的依从性,减少术后并发症的发生,是一种行之有效的健康教育方法.%Objective To evaluate the effect of scene imitation method in pre- renal biopsy education. Methods 182 patients were divided into two groups before renal biopsy. The patients were educated with the scene imitation method in the treatment group and with the usual method in control group. The patients' perioperative emotional reactions and compliance and the post- biopsy complications were observed. Results The psychometric score of the treatment group was higher than that of the control group (P<0.05). The compliance of the control group was lower than that of the treatment group ( P < 0. 05 ). The incidence of postbiopsy lumbago and abdominal pain was lower in the test group (P < 0.05). Conclusion The application of scene imitation method in pre - renal biopsy education can reduce nervousness and compliance of patients and decrease post - biopsy complications. Thus it proves to be effective and worth promoting.

  5. Relationships between body mass index and short-circuit current in human duodenal and colonic mucosal biopsies. Osbak PS, Bindslev N, Hansen MB. Acta Physiol (Oxf). 2011 Jan;201(1):47-53

    DEFF Research Database (Denmark)

    Osbak, Philip Samuel; Bindslev, Niels; Berner-Hansen, Mark

    2011-01-01

    Aim: Retrospectively, to investigate the relationship between body mass index (BMI) and basal electrogenic transport as measured by short-circuit current (SCC) in human duodenal and colonic mucosal biopsies. Methods: The study included biopsies from mucosa of normal appearance in the sigmoid colo...

  6. Kidney Biopsy: An Experience from Tertiary Hospital.

    Science.gov (United States)

    Ghimire, Madhav; Pahari, Bishnu; Paudel, Navaraj; Das, Gayatri; Das, Gopal Chandra; Sharma, Sanjib Kumar

    2014-01-01

    Kidney Biopsy is an important diagnostic tool in Nephrology. It is useful in Nephrology in terms of diagnosis, prognosis and management. There is little information on renal biopsy data from central Nepal. We describe our center`s experience in kidney biopsy in term of histological patterns, complications and outcomes. We prospectively analyzed the biopsies data of patients over a period of one and half year. All kinds of kidney disease patients were included for kidney biopsy, irrespective of their clinical syndromes and underlying diagnosis. A total of 75 biopsies were analyzed. Majority of them were females; 42 (56%). Most of the biopsies; 63 (84%) were from younger subjects ≤ 45 years and majority of them fell in the age group 11-20 years. Most common clinical renal syndrome to undergo biopsy was Sub Nephrotic range Proteinuria in 40 (53.3%). Among comorbid conditions, 40 (53.3%) had Hypertension. The most common histological pattern seen was Mesangial proliferative Glomerulonephritis seen in 18 (24%). Among complications associated with the procedure, macroscopic hematuria was seen in 5 (6.7%) cases and clinically significant perinephric hematoma causing pain was seen in 4 (5.3%). There was no mortality associated with biopsy procedure. Sub Nephrotic range Proteinuria was the commonest clinical renal Syndrome observed. In terms of renal histology, Mesangial Proliferative Glomerulonephritis (MesPGN) was the commonest histological pattern observed. Kidney biopsy is a safe procedure without any significant adverse events.

  7. High rate of benign histology in radiologically suspect renal lesions

    DEFF Research Database (Denmark)

    Lindkvist Pedersen, Christina; Winck-Flyvholm, Lili; Dahl, Claus;

    2014-01-01

    or radical nephrectomy between November 2010 and July 2013. All patients underwent a multiphase helical computed tomography (CT), which revealed suspected renal malignancy. The exclusion criteria were cystic tumours, biopsy before surgery, and disseminated and locally advanced disease. Lesions were defined......INTRODUCTION: The objective of this study was to determine the incidence of benign renal lesions for clinically localised renal masses and the need for new diagnostic procedures to assess these lesions. MATERIAL AND METHODS: This retrospective study included patients who underwent partial.......4% of patients with intermediate tumours, p renal masses ≤ 4 cm even though CT revealed a suspect renal lesion. The need for new diagnostic approaches for clinically localised renal lesions is evident. FUNDING: not relevant. TRIAL REGISTRATION...

  8. Development of growth and body mass index after pediatric renal transplantation.

    Science.gov (United States)

    Vester, Udo; Schaefer, Antonia; Kranz, Birgitta; Wingen, Anne-Margret; Nadalin, Silvio; Paul, Andreas; Malagò, Massimo; Broelsch, Christoph E; Hoyer, Peter F

    2005-08-01

    Suboptimal final height and marked weight gain after renal transplantation (RTx) are common and may result in obesity. Steroid free immunosuppression has been advocated to improve growth and limit weight gain. We evaluated retrospectively the evolution of growth and body mass index (BMI) after renal transplantation to study risk factors for weight gain under steroid based treatment. Sixty-four pediatric patients (age 9.9 +/- 5.0 yr) were included in the study. To allow comparison between different age groups, standard deviation scores (SDS) for height and BMI for height age were calculated at time of transplantation and 3, 6, 9, 12, 24, 36, 48 and 60 months later. Induction immunosuppression consisted of basiliximab, cyclosporine and prednisone. Growth retardation at time of RTx was obvious with a SDS for height of -2.20 +/- 1.34. Height during the first year improved to an SDS of -2.0 +/- 1.27 (p return to baseline values under steroid-based immunosuppression. Obesity (>2 SDS above normal) does not occur more often than in the normal population. The most predictive parameter of inappropriate weight gain during 3 yr is the BMI of the mother. We would speculate that steroids may play a major role in weight gain in the early phase after RTx. However, genetic or environmental factors predict the long-term weight development.

  9. CT contrast enhancement following renal cryoablation – artefact or treatment failure?

    DEFF Research Database (Denmark)

    Nielsen, Tommy Kjærgaard; Østraat, Øyvind; Andersen, Gratien;

    Introduction and objective: Renal cryoablation is a valid treatment option for localized pT1a renal cancer. Treatment success is typically defined as absence of contrast enhancement (CE) and a decrease in size of the cryoablated renal mass (i.e. cryolesion) on follow-up imaging. We investigated...... the CT characteristics and treatment outcome of renal cryolesions demonstrating CE during postoperative follow-up. Material and methods: A retrospective review of Aarhus Cryoablation Register identified 113 patients with a pT1a biopsy verified malignant renal lesion who underwent primary laparoscopic...

  10. A position paper on standardizing the nonneoplastic kidney biopsy report

    NARCIS (Netherlands)

    A. Chang (Anthony); I.W. Gibson (Ian); A.H. Cohen (Arthur); J.J. Weening (Jan); J.C. Jennette (Charles); A.B. Fogo (Agnes)

    2012-01-01

    textabstractThe biopsy report for nonneoplastic kidney diseases represents a complex integration of clinical data with light, immunofluorescence, and electron microscopic findings. Practice guidelines for the handling and processing of the renal biopsy have previously been created. However, specific

  11. Analysis of pathological data of renal biopsy: a report of 239 cases%肾活检239例病理资料分析

    Institute of Scientific and Technical Information of China (English)

    冯立英; 王志东

    2012-01-01

    Objective To investigate the correlation between epidemiological characteristics and clinical manifestations, and between pathology type and clinical manifestations of kidney diseases among 239 cases in our hospital. Methods Between September 2004 and October 2011, a retrospective study was done in in-patients after renal biopsy, including sex, age, clinical syndrome and pathology type. Results In this group (male: female vs 1:1.39), the mean age was 39.1. Notably, the kidney diseases were most likely to occur between 30 and 39 years old. Of clinical manifestations, nephrotic syndrome (53.1%) was most commonly seen, followed by urinary abnormalities (36.0%). The pathology types of nephrotic syndrome were membranous nephropathy (29.9%) and minimal change disease (21.3%), while those of urinary abnormalities were IgA nephropathy (40.7%) and Henoch-Schonlein purpura glomerulonephritis (15.1%). Of the 239 patients, the occurrence rate of primary glomerular disease was 76.2%. Notably, IgA nephropathy was 33.0%, followed by membranous nephropathy (26.4%). On other hand, the occurrence rate of secondary glomerulosclerosis was 19.2%. Notably, lupus nephritis (34.8%) was the most commonly found, followed by Henoch-Schonlein purpura glomerulonephritis (28.3%). Conclusion Primary glomerular disease was the most common kidney disease, and nephrotic syndrome was the most common clinical manifestation. Adolescents were high-risk populations.%目的 了解我院239例肾脏疾病的流行病学特点及病理类型与临床表现之间的联系.方法 回顾性分析我院2004年9月至2011年10月经皮肾穿刺活检术住院患者的性别、年龄、临床表现、病理类型.结果 本组患者的平均年龄39.1岁,30~39岁为肾脏病的高发年龄段,男女比例为1∶1.39.临床表现以肾病综合征最多见,占53.1%,其次为尿检异常占36.0%.肾病综合征的病理类型依次为:膜性肾病(MN)29.9%,微小病变21.3%;尿检异常的病

  12. Clinical application of core needle biopsy for pancreatic head mass%胰头部肿块术中组织芯活检临床价值

    Institute of Scientific and Technical Information of China (English)

    夏菁; 陈坚; 徐天放

    2011-01-01

    目的 评价胰头部肿块术中组织芯活检的定性诊断价值.方法 对11 年间行胰头部肿块术中组织芯活检245 例患者的结果,结合手术后病理切片,进行比较和分析.结果 全组患者术中组织芯活检诊断结果示:胰头腺癌188 例(76.7%),慢性胰腺炎39 例(15.9%)、胰腺不典型增生8 例(3.3%)、胰腺神经内分泌肿瘤10 例(4.1%).有3 例(1.2%)假阴性的患者,无假阳性病例.穿刺活检敏感性(与术后病理诊断符合率)高达98.8%,特异性为100%.2 例(0.8%)发生并发症,其中1 例活检过程中因损伤血管导致胆总管出血,病理提示为腺癌,遂行胰十二指肠切除术;另1 例慢性胰腺炎行胆肠内引流术,穿刺后引发急性胰腺炎,经非手术治疗后痊愈.结论 胰头部肿块术中组织芯活检是判断胰头部肿块性质较为安全、有效而准确的方法,与术后病理切片诊断符合率极高,可以为手术决策提供可靠依据.%Objective To evaluate the clinical value of core needle biopsy in the qualitative diagnosis of pancreatic head mass. Methods A total of 245 Core needle biopsies were performed in patients with pancre-atic head mass during 11-year period. The histopathological diagnosis on core needle biopsy was then com-pared with that of excision biopsy. Results In all cases in whom core needle biopsy was the diagnostic pro-cedure, there were 188 cases of pancreatic head cancer (76.7%), 39 cases of chronic pancreatitis (15.9%), 8 cases of pancreatic dysplasia (3.3%), and 10 cases of pancreatic neuroendocrine tumor (4.1%); 3 cases (1.2%) were false negative, but the false positive rate was zero. The sensitivity of core needle biopsy was 98.8%, with a specificity of 100%. 2 cases (0.8%) had complications. One case complicated with bile duct bleeding due to the injury of blood vessel and this complication was treated with pancreaticoduodenectomy. Another case of chronic pancreatitis with biliary drainage complicated with acute

  13. 临床路径在肾穿刺活检患者护理中的应用%Application of clinical path in nursing care of patients with renal biopsy

    Institute of Scientific and Technical Information of China (English)

    刘静梅; 李金林; 肖平; 何彦

    2013-01-01

    Objective:To explore the application effect of clinical path in nursing care of patients with renal biopsy. Methods: 156 patients who received renal biopsy were randomly divided into the experimental group and the control group( 78 cases in each group ). The holistic nursing service model was applied according to clinical path in the experimental group and conventional nursing service model was used in the control group. The coordination of the patients during performance of biopsy,days and cost of hospitalization and the degree of patients satisfaction with nursing service were compared between the two groups. Results:The days and cost of hospitalization were shorter and lower in the experimental group than the control group( P<0.05 );the intraoperative coordination of the patients and the degree of patients satisfaction with nursing service was better and higher in the experimental group than the control group( P <0.05 ). Conclusion:Application of clinical path to nursing care of patients with renal biopsy can improve their intraoperative coordination, shorten and reduce the days and cost of hospitalization and can also improve patients satisfaction.%目的:探讨临床路径在行肾穿刺活检患者护理中的应用效果.方法:将156例行肾穿刺活检患者随机分为实验组和对照组各78例,实验组采用临床路径式整体护理服务模式,对照组采用传统整体护理服务模式.比较两组患者的术中配合程度、住院天数、住院费用及对护理工作的满意度.结果:实验组患者的住院天数、住院费用均低于对照组(P<0.05),术中配合程度、对护理工作的满意度均高于对照组(P<0.05).结论:应用临床路径模式对肾穿刺活检患者进行护理,可提高患者的术中配合度,减少住院天数、住院费用,还可改善患者体验,提高患者满意度.

  14. Value of ultrasound-guided renal biopsy in patients with chronic kidney disease%超声引导下经皮肾穿刺活检术在慢性肾脏疾病中诊断价值

    Institute of Scientific and Technical Information of China (English)

    周敬勉; 姚丽婷; 杨鸣

    2015-01-01

    Objective To study the value of ultrasound-guided renal biopsy in the diagnosis of chronic kidney disease ( CKD). Methods Ultrasound-guided renal biopsy was performed to 94 CKD patients. On the postoperative 1, 2 and 3rd day, ultrasound examination was performed to detect whether there was a subcapsular hematoma. Then the success rate of ultrasound-guided renal biopsy was analyzed. Results Ultrasound-guided percutaneous renal biopsy was done successfully in all the 94 patients, with a mean length of 13-18 mm. After that, 45 patients complained of back pain, 12 of whom had subcapsular hematoma. And 8 patients had gross hematuria, while 30 ones had microscopic hematuria. Conclusion Ultrasound-guided renal biopsy is a safe and effective adjuvant screening method. It improves the success rate of puncturing, and reduces the occurrence of postoperative complications. It plays an important role in clinical practice.%目的:探讨超声引导下经皮肾脏穿刺活检术在诊断慢性肾脏病变中的应用价值。方法对我院94例慢性肾病患者采用超声引导下经皮肾穿刺活检术,取得组织送病理检查;术后观察患者是否有腰痛、腰酸、血尿、肾包膜下血肿等症状,并于第1、2、3天对穿刺患者行彩色多普勒超声检查,观察是否有肾包膜下血肿;查看病理结果,分析超声引导下经皮穿刺肾活检术的成功率。结果94例行超声引导下经皮肾穿刺活检术的患者均取材成功,取材长度从13~18 mm,根据取材长度穿刺1~3次。穿刺后对患者进行观察,94例患者中有45例患者自述有腰痛、腰酸症状,其中有12例患者有肾包膜下血肿;8例患者出现肉眼血尿,62例患者出现镜下血尿,余患者无明显不适症状。结论超声引导下肾脏穿刺活检术是一种安全有效的辅助检查方法,能提高穿刺的成功率,降低术后并发症,具有较重要的临床应用价值。

  15. Comparison of different methods for PAS staining of renal biopsy tissue sections%Schiff改良热配方与常见3种配方用于肾脏病理染色的效果比较

    Institute of Scientific and Technical Information of China (English)

    周展眉; 杨芳; 曹维

    2012-01-01

    Objective To compare the performance of a modified PAS staining, traditional PAS staining, Lyon's PAS staining, and Tsunahico Watanabe staining for staining sections of renal biopsy tissue. Methods The sections of the renal biopsy tissue were stained with the 4 methods and their staining performance was compared. Results The modified PAS staining method produced a better contrast and a higher resolution and showed a greater stability after repeated use than the other 3 methods for staining the renal tissue sections (P<0.05). Conclusion The modified PAS staining method shows a better applicability than the other 3 PAS methods for staining sections of renal biopsy tissue.%目的 比较改良Schiff染液热配方与3种常见Schiff液配方对肾穿刺活检组织切片糖原染色(periodic Acid Schiff,PAS)染色的影响,以确定自制改良配方的应用效果.方法 笔者经历了5843例肾穿刺组织染色的摸索,改良了Schiff染液的热配方.将该配方与传统热配法、Lyon's欧洲标准冷配法、渡边恒彦冷配法的应用效果进行比较.分别将上述4种配方应用于50例肾穿刺病理常规的PAS染色法和微波快速PAS染色法中,使用IPP图像分析系统进行光密度分析.结果 Schiff染液改良热配方对肾脏组织阳性部位的着色鲜艳程度、清晰程度和重复使用率均优于其他3种配法(P,<0.05).结论 改良的Schiff染液热配方,比传统热配法、Lyon's欧洲标准冷配法、渡边恒彦冷配法更适合肾穿刺活检组织切片的PAS染色.

  16. Bioelectrical impedance analysis and skinfold thickness sum in assessing body fat mass of renal dialysis patients.

    Science.gov (United States)

    Rodrigues, Natália Cristina Lima; Sala, Priscila Campos; Horie, Lilian Mika; Dias, Maria Carolina Gonçalves; Torrinhas, Raquel Susana Matos de Miranda; Romão, João Egídio; Cecconello, Ivan; Waitzberg, Dan Linetzky

    2012-07-01

    In chronic renal failure patients under hemodialysis (HD) treatment, the availability of simple, safe, and effective tools to assess body composition enables evaluation of body composition accurately, in spite of changes in body fluids that occur in dialysis therapy, thus contributing to planning and monitoring of nutritional treatment. We evaluated the performance of bioelectrical impedance analysis (BIA) and the skinfold thickness sum (SKF) to assess fat mass (FM) in chronic renal failure patients before (BHD) and after (AHD) HD, using air displacement plethysmography (ADP) as the standard method. This single-center cross-sectional trial involved comparing the FM of 60 HD patients estimated BHD and AHD by BIA (multifrequential; 29 women, 31 men) and by SKF with those estimated by the reference method, ADP. Body fat-free mass (FFM) was also obtained by subtracting the total body fat from the individual total weight. Mean estimated FM (kg [%]) observed by ADP BHD was 17.95 ± 0.99 kg (30.11% ± 1.30%), with a 95% confidence interval (CI) of 16.00 to 19.90 (27.56 to 32.66); mean estimated FM observed AHD was 17.92 ± 1.11 kg (30.04% ± 1.40%), with a 95% CI of 15.74 to 20.10 (27.28 to 32.79). Neither study period showed a difference in FM and FFM (for both kg and %) estimates by the SKF method when compared with ADP; however, the BIA underestimated the FM and overestimated the FFM (for both kg and %) when compared with ADP. The SKF, but not the BIA, method showed results similar to ADP and can be considered adequate for FM evaluation in HD patients. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  17. Depression Is Associated With Muscle Mass And Strength In Patients With End Stage Renal Disease

    Directory of Open Access Journals (Sweden)

    Young Rim Song

    2012-06-01

    Full Text Available Depression is the most common psychiatric complication in patients with end-stage renal disease (ESRD. Sarcopenia, defined as loss of muscle mass and strength, is expected to be associated with depression, because both are closely linked to physical inactivity and functional impairment. We investigated the association of sarcopenia with depression in patients with ESRD. A total of 115 patients undergoing hemodialysis (HD were included in this study. Muscle mass was assessed by lean tissue index (LTI using portable whole body bioimpedance spectroscopy, and muscle strength was measured with handgrip strength (HGS. Depression was defined as Beck Depression Inventory-II (BDI-II score ≥16. About 60% of prevalent HD patients had depression. Compared to subjects without depression, depressed patients had a higher prevalence of sarcopenia (45.5 vs. 8.2%, p<0.001 and significantly increased serum IL-6 and hs-CRP level. However, (prealbumin and body mass index (BMI failed to correlate with BDI-II. HGS and LTI had a consistent negative effect on BDI-II even after adjusting other parameters including inflammation. In multivariate analysis, lower , increased IL-6 and β2-microglobulin,and sarcopenia were significant predictors for depression; sarcopenia was most powerful [odds ratio 9.01, 95% CI 3.60-12.22, p=0.001]. In conclusion, the prevalence of sarcopenia and depression was considerably high and and the presence of sarcopenia was an important predictor for depression.

  18. From outward appearance to inner essence:the unique role of pathological diagnosis of renal allograft biopsy in renal transplantation%由表象到实质--论移植肾活检病理学诊断在肾移植中的独特作用

    Institute of Scientific and Technical Information of China (English)

    郭晖

    2015-01-01

    随着活检设备及技术的改良和经验的积累,移植肾经皮穿刺活检已经成为国际公认的诊断移植术后多种并发症的最佳途径,其在移植肾并发症的鉴别诊断、指导临床针对性的治疗和基础研究方面具有独特作用。随着移植肾缺血/再灌注损伤、排斥反应、免疫抑制剂毒性损伤和机会性病毒感染等主要并发症的发病机制和病理学特征的逐渐明了,以及移植肾 Banff 病理学诊断体系的建立,更有利于移植肾活检的规范开展。希望我国各肾移植中心能更好地应用这一手段,进一步促进移植肾和受者的长期存活。%With improvement and experience accumulation in biopsy device and technology ,percutaneous needle core biopsy of the renal allograft has become an internationally recognized diagnostic approach for posttransplant complications .It plays a unique and critical role in differential diagnosis,guiding clinical treatment and posttransplant management ,as well as basic research in renal trans -plantation.The renal graft biopsy could be standadizedly developed with pathogenesis and pathological featuresthe of main complications of renal allograft,such as ischemia /reperfusion injury,rejection,immunosuppressant toxicity and opportunistic viral infection ,are gradu-ally understood,and Banff Schema on renal allograft pathology is established .It is hoped that renal transplantation centers in China can better apply the method,and further promote the long-term survival of renal allografts and recipients .

  19. Computed tomography-guided percutaneous core needle biopsy for diagnosis of mediastinal mass lesions: Experience with 110 cases in two university hospitals in Isfahan, Iran

    Science.gov (United States)

    Rabbani, Masoud; Sarrami, Amir Hossein

    2016-01-01

    Background: Computed tomography-guided percutaneous core needle biopsy (PCNB) is a diagnostic technique for initial assessment of mediastinal mass lesions. This study was conducted to evaluate its diagnostic yield and its complication rate. Materials and Methods: We reviewed the records of CT-guided PCNB in 110 patients with mediastinal mass lesions performed in Kashani and Alzahra Hospitals, Isfahan, from 2006 to 2012. Gender, age at biopsy, size, and anatomic location of the lesion, number of passes, site of approach, complications, and final diagnosis were extracted. Results: Our series encompasses 52 (47.2%) females and 58 (52/7%) males with mean age of 41 ± 8 years. The most common site of involvement was the anterior mediastinum (91.8% of cases). An average of 3/5 passes per patient has been taken for tissue sampling. Parasternal site was the most frequent approach taken for PCNB (in 78.1% of cases). Diagnostic tissue was obtained in 99 (90%) biopsies while, in 11 (10%) cases, specimen materials were inadequate. Lymphoma (49.5%) and bronchogenic carcinoma (33.3%) were the most frequent lesions in our series. The overall complication rate was 17.2% from which 10.9% was pneumothorax, 5.4% was hemoptysis, and 0.9% was vasovagal reflex. Conclusion: CT-guided PCNB is a safe and reliable procedure that can provide a precise diagnosis for patients with both benign and malignant mediastinal masses, and it is considered the preferred first diagnostic procedure use for this purpose.

  20. Diagnostic accuracy of contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging of small renal masses in real practice: sensitivity and specificity according to subjective radiologic interpretation.

    Science.gov (United States)

    Kim, Jae Heon; Sun, Hwa Yeon; Hwang, Jiyoung; Hong, Seong Sook; Cho, Yong Jin; Doo, Seung Whan; Yang, Won Jae; Song, Yun Seob

    2016-10-12

    The aim of this study was to investigate the diagnostic accuracy of contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI) of small renal masses in real practice. Contrast-enhanced CT and MRI were performed between February 2008 and February 2013 on 68 patients who had suspected small (≤4 cm) renal cell carcinoma (RCC) based on ultrasonographic measurements. CT and MRI radiographs were reviewed, and the findings of small renal masses were re-categorized into five dichotomized scales by the same two radiologists who had interpreted the original images. Receiver operating characteristics curve analysis was performed, and sensitivity and specificity were determined. Among the 68 patients, 60 (88.2 %) had RCC and eight had benign disease. The diagnostic accuracy rates of contrast-enhanced CT and MRI were 79.41 and 88.23 %, respectively. Diagnostic accuracy was greater when using contrast-enhanced MRI because too many masses (67.6 %) were characterized as "4 (probably solid cancer) or 5 (definitely solid cancer)." The sensitivity of contrast-enhanced CT and MRI for predicting RCC were 79.7 and 88.1 %, respectively. The specificities of contrast-enhanced CT and MRI for predicting RCC were 44.4 and 33.3 %, respectively. Fourteen diagnoses (20.5 %) were missed or inconsistent compared with the final pathological diagnoses. One appropriate nephroureterectomy and five unnecessary percutaneous biopsies were performed for RCC. Seven unnecessary partial nephrectomies were performed for benign disease. Although contrast-enhanced CT and MRI showed high sensitivity for detecting small renal masses, specificity remained low.

  1. PATHOLOGICAL CHARACTERISTICS AND SURVIVAL FOLLOWING PARTIAL NEPHRECTOMY IN PATIENTS WITH SMALL RENAL MASSES SUITABLE FOR MINIMALLY INVASIVE THERAPIES

    OpenAIRE

    Morgia, G.; Castelli, M; Favilla, V.; Bertini, R.; Simeone, C.; Minervini, A.; Carini, M.; A. Simonato; Longo, N.; Novara, G.; F. Valotto; Fontana, D; Siracusano, S; Montorsi, F; Mirone, V.

    2010-01-01

    Introduction: The number of incidentally detected small renal masses is increasing due to the extensive use of imaging techniques. Similarly, elective nephronsparing surgery (NSS) is more and more often used Material and methods: We collected the data of 572 patients undergoing NSS from 1995 to 2007 for

  2. Open Partial Nephrectomy for High-Risk Renal Masses Is Associated with Renal Pseudoaneurysms: Assessment of a Severe Procedure-Related Complication

    Directory of Open Access Journals (Sweden)

    M. C. Kriegmair

    2015-01-01

    Full Text Available Objectives. A symptomatic renal pseudoaneurysm (RPA is a severe complication after open partial nephrectomy (OPN. The aim of our study was to assess incidence and risk factors for RPA formation. Furthermore, we present our management strategy. Patients and Methods. Clinical records of consecutive patients undergoing OPN were assessed for surgical outcome and postoperative complications. Renal masses were risk stratified for tumor complexity according to the PADUA score. Uni- and multivariate analysis for symptomatic RPAs were performed using the t-tests and logistic regression. Results. We identified 233 patients treated with OPN. Symptomatic RPAs were observed in 13 (5.6% patients, on average 14 (4–42 days after surgery. Uni- and multivariate analysis identified tumor complexity to be an independent predictor for symptomatic RPAs (p=0.004. There was a significant correlation between RPAs and transfusion and the duration of stay (p<0.001 and p=0.021. Symptomatic RPAs were diagnosed with CT scans and successfully treated with arterial embolization. Discussion. Symptomatic RPAs are not uncommon after OPN for high-risk renal masses. A high nephrometry score is a predictor for this severe complication and may enable a risk-stratified followup. RPAs can successfully be located by CT angiography, which enables targeted angiographic treatment.

  3. Kidney Biopsy

    Science.gov (United States)

    ... Care Provider People should talk with their health care provider about medical conditions they have and all prescribed and over- ... biopsy, a person should talk with their health care provider about medical conditions and allergies they have and all medications ...

  4. Secondary Ion Mass Spectrometry Analysis of Renal Cell Carcinoma with Electrospray Droplet Ion Beams

    Science.gov (United States)

    Ninomiya, Satoshi; Yoshimura, Kentaro; Chen, Lee Chuin; Takeda, Sen; Hiraoka, Kenzo

    2017-01-01

    Tissue samples from renal cell carcinoma patients were analyzed by electrospray droplet ion beam-induced secondary ion mass spectrometry (EDI/SIMS). Positively- and negatively-charged secondary ions were measured for the cancerous and noncancerous regions of the tissue samples. Although specific cancerous species could not be found in both the positive and negative secondary ion spectra, the spectra of the cancerous and noncancerous tissues presented different trends. For instance, in the m/z range of 500–800 of the positive secondary ion spectra for the cancerous tissues, the intensities for several m/z values were lower than those of the m/z+2 peaks (indicating one double bond loss for the species), whereas, for the noncancerous tissues, the inverse trend was obtained. The tandem mass spectrometry (MS/MS) was also performed on the tissue samples using probe electrospray ionization (PESI), and some molecular ions produced by PESI were found to be fragmented into the ions observed in EDI/SIMS analysis. When the positive secondary ion spectra produced by EDI/SIMS were analyzed by principal component analysis, the results for cancerous and noncancerous tissues were separated. The EDI/SIMS method can be applied to distinguish between a cancerous and a noncancerous area with high probability. PMID:28149705

  5. Clinical and pathological analysis of elderly patients after renal biopsy in Guangxi%广西老年肾活检患者临床与病理分析

    Institute of Scientific and Technical Information of China (English)

    谢丽君; 王明军; 潘玲; 廖蕴华

    2016-01-01

    Objective To analyze the common clinical and pathological types of elderly patients after renal biopsy in Guangxi.Methods By means of enrolling 373 elderly patients (aged ≥ 60 years)who had undergone renal biopsy in the First Affiliated Hospital of Guangxi Medical University from August 2012 to August 2015,and collecting the data of gender,age,nationality,clinical diagnosis,kidney pathological diagnosis,etc,the renal disease spectrum of elderly patients were retrospectively analyzed with the SPSS 13.0 software.And statistical descriptions were made for the categorical variables with frequency and percentage.Results The most common clinical syndrome in elderly patients after renal biopsy was nephrotic syndrome (NS,50.1%),followed by acute kidney injury (AKI,28.7%)and chronic nephritis syndrome (15.5%).In the elderly patients after renal biopsy,primary glomerular diseases accounted for 67.8%,and secondary glomerular diseases accounted for 26.8%.In primary glomerular diseases,idiopathic membranous nephropathy (IMN,71.9%)was the leading renal histopathological type,followed by minimal change disease (MCD,9.9%) and focal segmental glomerulosclerosis (FSGS,7.9%).In the secondary glomerular diseases,the most common type was ANCA-associated vasculitis (AAV,31.0%),followed by lupus nephritis (20.0%)and diabetic nephropathy (12%).In the NS of elderly patients,the most common cause was IMN (75.4%),followed by MCD (5.3%)and FSGS (5.3%).In the AKI of elderly patients after renal biopsy,the most common pathological type was IMN (26.2%),followed by AAV (24.3%). Conclusion NS was the most common clinical syndrome of elderly patients after renal biopsy in Guangxi. IMN was the most common pathological type in the elderly NS and primary glomerular diseases;AAV was the most common cause of secondary glomerular diseases;and IMN and AAV were the main causes of AKI.%目的:分析广西老年肾活检患者常见的临床和病理类型。方法本研究纳入了2012年8月至2015年8

  6. 舒适护理对肾活检术后排尿的影响分析%Effects of Comfortable Nursing Care on Urination in Renal Biopsy Patients

    Institute of Scientific and Technical Information of China (English)

    金淑君; 曹翠明

    2014-01-01

    To explore the effects of comfortable nursing care on urination in renal biopsy patients.Methods:Picking up 204 cases who underwent renal biopsy in our hospital from 2013 March to September.The patients were divided into control and comfortable nursing care group,and were observed the urination of the patients.Results:The incidence rate of non smooth urination is 22.5%in experimental group.It is lower than 35% in the control group significantly.That has statistical significance.Conclution:Comfortable nursing care makes the renal biopsy patients feel well in biology and sychology,and reduced the difficulty of urination.It deserves to be spread.%目的:研究肾活检过程中的舒适护理对术后排尿的影响。方法:选取2013年3~9月期间在我科行肾活检术的患者204例,按照手术的先后顺序分为对照组和实验组,分别采用常规护理和舒适护理措施,以两组患者的排尿情况作为观察指标,进行对比分析。结果:实验组患者的非顺利排尿的发生率为22.5%,明显低于对照组的35.3%,组间比较差异具有统计学意义(P<0.05)。结论:肾活检过程中舒适护理的干预能增加患者在生理和心理上的舒适,降低排尿困难的发生,值得临床进一步推广应用。

  7. Analysis of Fine-Needle Biopsy Versus Fine-Needle Aspiration in Diagnosis of Pancreatic and Abdominal Masses: A Prospective, Multicenter, Randomized Controlled Trial.

    Science.gov (United States)

    Cheng, Bin; Zhang, Yueming; Chen, Qian; Sun, Bo; Deng, Zhuang; Shan, Hongbo; Dou, Lizhou; Wang, Jinglin; Li, Yawen; Yang, Xiujiang; Jiang, Tianan; Xu, Guoliang; Wang, Guiqi

    2017-07-19

    Endoscopic ultrasound (EUS)-guided fine needles with side fenestrations are used to collected aspirates for cytology analysis and biopsy samples for histologic analysis. We conducted a large, multicenter study to compare the accuracy of diagnosis via specimens collected with fine-needle biopsy (FNB) versus fine-needle aspiration (FNA) for patients with pancreatic and nonpancreatic masses. We performed a prospective single-blind study at 5 tertiary care centers in China. The study comprised 408 patients undergoing EUS for a solid mass (>1 cm) in the pancreas, abdomen, mediastinum, or pelvic cavity, from December 2014 through January 2016. Patients were randomly assigned to groups (1:1) for assessment by FNA (n = 190) or FNB (n = 187). After lesions were identified by EUS, samples were collected in a total of 4 passes by each needle. All procedures were performed by experienced endosonographers; cytologists and pathologists were blinded to the sample collection method. Patients were followed for at least 48 weeks, and final diagnoses were obtained after surgery, imaging analysis, or resolution of lesion. The primary aim was to compare diagnostic yields of EUS-FNA with EUS-FNB for all solid masses, then separately as pancreatic and nonpancreatic masses. The secondary endpoint was the quality of histologic specimen. Findings from FNB analysis were accurate for 91.44% of all cases, compared with 80.00% for all FNA cases, based on final patient diagnoses (P = .0015). In patients with pancreatic masses (n = 249), findings from histologic analysis of FNBs were accurate for 92.68% of the cases, compared with 81.75% for FNAs (P = .0099). In cytology analysis of pancreatic masses, samples collected by FNB accurately identified 88.62% of all pancreatic lesions, whereas samples collected by FNA accurately identified 79.37% (P = .00468). Analyses of samples of nonpancreatic masses collected by FNA versus FNB produced similar diagnostic yields. In a prospective study of

  8. Detection of acute renal allograft rejection by analysis of renal tissue proteomics in rat models of renal transplantation

    Directory of Open Access Journals (Sweden)

    Dai Yong

    2008-01-01

    Full Text Available At present, the diagnosis of renal allograft rejection requires a renal biopsy. Clinical management of renal transplant patients would be improved if rapid, noninvasive and reliable biomarkers of rejection were available. This study is designed to determine whether such protein biomarkers can be found in renal-graft tissue proteomic approach. Orthotopic kidney transplantations were performed using Fisher (F344 or Lewis rats as donors and Lewis rats as recipients. Hence, there were two groups of renal transplant models: one is allograft (from F344 to Lewis rats; another is syngrafts (from Lewis to Lewis rats serving as control. Renal tissues were collected 3, 7 and 14 days after transplantation. As many as 18 samples were analyzed by 2-D Electrophoresis and mass spectrometry (MALDI-TOF-TOF-MS. Eleven differentially expressed proteins were identified between groups. In conclusion, proteomic technology can detect renal tissue proteins associated with acute renal allograft rejection. Identification of these proteins as diagnostic markers for rejection in patients′ urine or sera may be useful and non-invasive, and these proteins might serve as novel therapeutic targets that also help to improve the understanding of mechanism of renal rejection.

  9. Significance of Expression of Monocyte Chemoattractant Protein-1 in Renal Biopsy Tissue from Immunoglobulin A Nephropathy%IgA肾病患者肾组织单核细胞趋化蛋白-1表达的意义

    Institute of Scientific and Technical Information of China (English)

    杨晓庆; 高进

    2011-01-01

    目的 探讨原发性IgA肾病(IgAN)患者肾组织单核细胞趋化蛋白-1(MCP-1)的表达变化.方法 选择经皮肾组织穿刺活检确诊为IgAN的患者40例.根据肾脏病理Lee氏分级(Ⅰ~Ⅴ级)将纳入研究的患者分为2组:A组20例,病理分级为Ⅰ~Ⅲ级;B组20例,病理分级为Ⅳ~Ⅴ级.对照组20例标本选取手术切除的肾肿瘤、肾囊肿患者远离病变组织的正常肾组织.同时将肾组织的肾小管和肾间质按照Katafuchi标准分为无间质病变组21例,轻度间质病变组8例,中度间质病变组19例和重度间质病变组12例.均采用免疫组织化学方法测定其肾组织中MCP-1的表达(以灰度值反映),观察其肾组织切片的染色强度及染色透光度,灰度值大则MCP-1表达少,反之则表达多.结果 根据肾脏病理Lee分级分组,各组灰度值比较:B组灰度值(68.08±2.37)与A组灰度值(74.50±3.27)比较、B组与对照组灰度值(81.98±3.21)比较、A 组与对照组比较,差异均有统计学意义(Pa<0.01);根据Katafuchi标准分组,无间质病变组、轻度间质病变组、中度间质病变组及重度间质病变组灰度值分别为82.03±3.13、76.44±2.01、71.49±1.69、66.54±1.23,各组比较差异均有统计学意义(Pa<0.01).结论 MCP-1可反映原发性IgAN患者肾组织的病理损害程度,且表达水平与肾组织损害程度有关.%objective To explore the expression of monocyte chemoattractant protein - 1( MCP - 1) in renal biopsy tissue from IgA nephropathy (IgAN) patients. Methods Forty patients were diagnosed as IgAN by renal biopsy, and they were divided into 2 groups according to Lee classification ( Ⅰ - Ⅴ grade) :group A included 20 cases( Lee Ⅰ - Ⅲ grade) and group B included the other 20 cases( Lee Ⅳ - Ⅴgrade). The control group included 20 patients diagnosed as having normal kidney tissue by renal biopsy, whose kidney tissue came from patients whose renal tumors and renal cysts were removed. In the

  10. 护理干预对经皮肾穿刺活检术患者术后排尿情况的影响%Influence of nursing intervention on voiding effect in patients after percutaneous renal biopsy

    Institute of Scientific and Technical Information of China (English)

    魏燕; 韶红; 曾彩云

    2010-01-01

    Objective To observe the effect of nursing intervention on voiding effect in patients after percutaneous renal biopsy. Methods 80 cases of patients after percutaneous renal biopsy were randomly divided into the control group and the observation group with 40 patients in each group. The control group only received general health education, while the observation group was given specialist care measures pre, during and post operation. The complication after operation was compared between the two groups. Results Postoperative complication of the observation group was lower than that of the control group. Conclusions The whole process nursing intervention can alleviate voiding effect, reduce postoperative complications, and is worthy of clinical application.%目的 探讨护理干预对经皮肾穿刺活检术患者术后排便情况的影响.方法 将80例经皮肾穿刺活检术的患者随机分为观察组和对照组各40例,对照组仅行一般健康教育,观察组在此基础上实施术前、术中、术后全程护理干预.比较2组术后并发症发生情况.结果 观察组术后并发症发生率明显低于对照组.结论 全程护理干预能有效改善患者术后的排尿情况,减少排尿异常并发症,值得在临床中推广应用.

  11. Renal Transplant Patients Biopsied for Cause and Tested for C4d, DSA, and IgG Subclasses and C1q: Which Humoral Markers Improve Diagnosis and Outcomes?

    Science.gov (United States)

    Cicciarelli, James C.; Chang, Youngil; Koss, Michael; Hacke, Katrin; Kasahara, Noriyuki; Burns, Kevin M.; Min, David I.; Naraghi, Robert; Shah, Tariq

    2017-01-01

    The association between donor specific antibodies (DSA) and renal transplant rejection has been generally established, but there are cases when a DSA is present without rejection. We examined 73 renal transplant recipients biopsied for transplant dysfunction with DSA test results available: 23 patients diffusely positive for C4d (C4d+), 25 patients focally positive for C4d, and 25 patients negative for C4d (C4d−). We performed C1q and IgG subclass testing in our DSA+ and C4d+ patient group. Graft outcomes were determined for the C4d+ group. All 23 C4d+ patients had IgG DSA with an average of 12,500 MFI (cumulative DSA MFI). The C4d− patients had average DSA less than 500 MFI. Among the patients with C4d+ biopsies, 100% had IgG DSA, 70% had C1q+ DSA, and 83% had complement fixing IgG subclass antibodies. Interestingly, IgG4 was seen in 10 of the 23 recipients' sera, but always along with complement fixing IgG1, and we have previously seen excellent function in patients when IgG4 DSA exists alone. Cumulative DSA above 10,000 MFI were associated with C4d deposition and complement fixation. There was no significant correlation between graft loss and C1q positivity, and IgG subclass analysis seemed to be a better correlate for complement fixing antibodies in the C4d+ patient group.

  12. Lymph node biopsy

    Science.gov (United States)

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... A lymph node biopsy is done in an operating room in a hospital. Or, it is done at an outpatient surgical center. The ...

  13. Ultrasound-guided chest biopsies.

    Science.gov (United States)

    Middleton, William D; Teefey, Sharlene A; Dahiya, Nirvikar

    2006-12-01

    Pulmonary nodules that are surrounded by aerated lung cannot be visualized with sonography. Therefore, percutaneous biopsy must be guided with computed tomography or fluoroscopy. Although this restriction only applies to central lung nodules, it has permeated referral patterns for other thoracic lesions and has retarded the growth of ultrasound-guided interventions. Nevertheless, sonography is an extremely flexible modality that can expeditiously guide many biopsy procedures in the thorax. Peripheral pulmonary nodules can be successfully biopsied with success rates exceeding 90% and complications rates of less than 5%. Orienting the probe parallel to the intercostal space facilitates biopsies of peripheral pulmonary nodules. Anterior mediastinal masses that extend to the parasternal region are often easily approachable provided the internal mammary vessels, costal cartilage, and deep great vessels are identified and avoided. Superior mediastinal masses can be sampled from a suprasternal or supraclavicular approach. Phased array probes or tightly curved arrays may provide improved access for biopsies in this location. Posterior mediastinal masses are more difficult to biopsy with ultrasound guidance because of the overlying paraspinal muscles. However, when posterior mediastinal masses extend into the posterior medial pleural region, they can be biopsied with ultrasound guidance. Because many lung cancers metastasize to the supraclavicular nodes, it is important to evaluate the supraclavicular region when determining the best approach to obtain a tissue diagnosis. When abnormal supraclavicular nodes are present, they often are the easiest and safest lesions to biopsy.

  14. Treatment strategies for patients with negative biopsy for pancreatic head mass%胰头肿块组织活检阴性的处理对策

    Institute of Scientific and Technical Information of China (English)

    张太平; 李建; 赵玉沛

    2012-01-01

    The special anatomy around the head of pancreas leads to difficulties in arriving at a definitive diagnosis for a pancreatic head mass,the management of which has recently become a hot topic and a challenge for clinicians.Despite recent advances in tumor markers,ultrasound,CT,PET/CT and MRI,some of these pancreatic head masses cannot be diagnosed with certainty.A fine needle aspiration biopsy can be used before operation; however,false negative results not infrequently happen.Based on the reports from domestic and foreign medical literatures published recently,this paper reviewed and discussed the proper treatment strategies when biopsy results from a pancreatic head mass turn out negative.%由于胰头解剖部位的特殊性,该部位肿块的鉴别诊断是目前临床外科学界的难点和热点问题之一.近年来,虽然血清肿瘤标记物检查、超声、CT、PET/CT、MRI、内镜逆行胆胰管造影等各种影像学方法能为鉴别诊断提供帮助,但仍有部分病例不能通过非手术方法获得确诊.手术前穿刺加病理虽然有助于确诊,但仍有部分患者存在假阴性可能.该文综合近年国内外文献,就胰头肿块组织如果活检阴性,如何恰当地进一步处理,以使患者最大获益进行讨论.

  15. Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized parallel-group study.

    Science.gov (United States)

    Lee, Yun Nah; Moon, Jong Ho; Kim, Hee Kyung; Choi, Hyun Jong; Choi, Moon Han; Kim, Dong Choon; Lee, Tae Hoon; Cha, Sang-Woo; Cho, Young Deok; Park, Sang-Heum

    2014-12-01

    An endoscopic ultrasound (EUS)-guided fine needle biopsy (EUS-FNB) device using a core biopsy needle was developed to improve diagnostic accuracy by simultaneously obtaining cytological aspirates and histological core samples. We prospectively compared the diagnostic accuracy of EUS-FNB with standard EUS-guided fine needle aspiration (EUS-FNA) in patients with solid pancreatic masses. Between January 2012 and May 2013, consecutive patients with solid pancreatic masses were prospectively enrolled and randomized to undergo EUS-FNB using a core biopsy needle or EUS-FNA using a standard aspiration needle at a single tertiary center. The specimen was analyzed by onsite cytology, Papanicolaou-stain cytology, and histology. The main outcome measure was diagnostic accuracy for malignancy. The secondary outcome measures were: the median number of passes required to establish a diagnosis, the proportion of patients in whom the diagnosis was established with each pass, and complication rates. The overall accuracy of combining onsite cytology with Papanicolaou-stain cytology and histology was not significantly different for the FNB (n = 58) and FNA (n = 58) groups (98.3 % [95 %CI 94.9 % - 100 %] vs. 94.8 % [95 %CI 91.9 % - 100 %]; P = 0.671). Compared with FNA, FNB required a significantly lower median number of needle passes to establish a diagnosis (1.0 vs. 2.0; P < 0.001). On subgroup analysis of 111 patients with malignant lesions, the proportion of patients in whom malignancy was diagnosed on the first pass was significantly greater in the FNB group (72.7 % vs. 37.5 %; P < 0.001). The overall accuracy of FNB and FNA in patients with solid pancreatic masses was comparable; however, fewer passes were required to establish the diagnosis of malignancy using FNB.This study was registered on the UMIN Clinical Trial Registry (UMIN000014057). © Georg Thieme Verlag KG Stuttgart · New York.

  16. Isolated renal metastasis from squamous cell lung cancer

    Directory of Open Access Journals (Sweden)

    Cai Jun

    2013-01-01

    Full Text Available Abstract Renal metastasis from non-small cell lung cancer is rather uncommon. The mechanism underlying the occurrence of metastasis in this site is still not well understood. We report a case of a 53-year-old Chinese woman who had moderately differentiated squamous cell carcinoma of the lung. After a ten months post-surgery interval of disease free survival, computed tomography (CT scan found that left renal parenchymal was occupied by a mass, confirmed by kidney biopsy to be a metastasis from squamous cell lung carcinoma. Based on this case, we are warned to be cautious in diagnosis and treatment when renal lesion are detected.

  17. New kidney immobilization method for percutaneous renal biopsy technique in cats: Operational aspects and complications Novo método de imobilização do rim para biopsia renal percutânea em gatos: Aspectos operacionais e complicações

    Directory of Open Access Journals (Sweden)

    Daniele Alves Silva

    2012-01-01

    Full Text Available PURPOSE: Evaluate a new immobilization kidney method for collecting blind percutaneous renal biopsies (RB in healthy cats. METHODS: Ten cats were biopsied by a modified blinded percutaneous technique using semi-automated needles. Were evaluated the operational aspects of the technique, its complications, and the quality of the obtained samples. The evaluation included physical examination, hemogram, urinalysis, abdominal ultrasound, renal function, and histopathology of the biopsy specimens. RESULTS: The developed technique was fast and easy to perform; it required two operators, and the right kidney was elected for specimen collection. After the RB, a decrease in hematocrit levels was observed in addition to hematuria and perirenal transient hematoma; however, no clinical consequences were observed, and normal parameters were restored within 48 hrs. There were no major complications or deaths, alterations in the physical examination or renal function, or signs of infection. Of the samples, 95% revealed the presence of renal tissue, and in 100% of the cats the samples were of diagnostic quality. CONCLUSION: The technique was easily performed, provided adequate material for diagnosis with minimal transient complications.OBJETIVO: Avaliar um novo método de imobilização do rim para coleta de biopsia renal (BR percutânea às cegas em gatos hígidos. MÉTODOS: Dez gatos foram biopsiados por uma técnica de biopsia percutânea às cegas modificada, com uso de agulha semi-automática. Foram avaliados os aspectos operacionais da técnica, complicações e a qualidade das amostras obtidas. A avaliação incluiu exame físico, hemograma, urinálise, ultrassonografia abdominal, função renal e análise histopatológica do espécime de biopsia. RESULTADOS: A técnica foi de fácil realização; foram requeridos dois operadores, e o rim direito foi eleito para a coleta da BR. Após a BR, diminuição do hematócrito foi observada, em conjunto com hemat

  18. Different Methods for Prostate Biopsy and Biopsy Protocols

    Directory of Open Access Journals (Sweden)

    Mahyar Ghafoori

    2011-05-01

    Full Text Available Prostate carcinoma is one of the most common"nmalignancies among men. Increasing mortality rates due"nto prostate carcinoma have been observed worldwide."nThis disease usually progresses imperceptibly, for this"nreason; screening programs aimed at early detection"nhave been developed. The prostate specific antigen"n(PSA test is among the best screening tools available"nin medicine today because it is recognized as the best"nmarker for its early detection."nIn case of abnormal rise in PSA, the patient usually"nrefers for prostate biopsy under the guide of trans"nrectal ultrasonography (TRUS. Different methods are"nrecognized for prostate biopsy that may be divided"ninto two main categories namely, systematic biopsy"nand targeted biopsy."nIn systematic biopsy we divide the prostate gland"nrandomly to different sections and obtain biopsy"nspecimens from each section.The protocol of systematic biopsy is different among"ndifferent institutions. The number of biopsy specimens"ncould be started from less than 6 to more than 20"nbiopsies in some institutions. Increasing the number"nof biopsy specimens increases the detection rate for"nprostate cancer increasing the complications such"nas post biopsy prostatitis and septicemia, which are"nthe most important, as well. In scheduling a biopsy"nprotocol with high number of biopsies it is preferred"nto hospitalize the patient and prescribe intravenous"nantibiotics."nTargeted biopsy of the prostate means obtaining biopsy"nspecimens from a pathologic lesion that is suspicious"nfor prostate cancer. Different modalities could be"nused for detecting prostate cancer within the prostate"ngland. Transrectal ultrasonography, ultrasonography"nwith the use of ultrasound contrast agents, MRI of the"nprostate with the use of endorectal coil, dynamic MR"nstudy with contrast agent, diffusion weighted imaging"nof the prostate and MR spectroscopy all could help"nin the detection of a suspicious tumoral mass in the

  19. Element bioimaging of liver needle biopsy specimens from patients with Wilson's disease by laser ablation-inductively coupled plasma-mass spectrometry.

    Science.gov (United States)

    Hachmöller, Oliver; Aichler, Michaela; Schwamborn, Kristina; Lutz, Lisa; Werner, Martin; Sperling, Michael; Walch, Axel; Karst, Uwe

    2016-05-01

    A laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) method is developed and applied for the analysis of paraffin-embedded liver needle biopsy specimens of patients with Wilson's disease (WD), a rare autosomal recessive disorder of the copper metabolism causing various hepatic, neurological and psychiatric symptoms due to a copper accumulation in the liver and the central nervous system. The sample set includes two WD liver samples and one negative control sample. The imaging analysis was performed with a spatial resolution of 10 μm. Besides copper, iron was monitored because an elevated iron concentration in the liver is known for WD. In addition to this, both elements were quantified using an external calibration based on matrix-matched gelatine standards. The presented method offers low limits of detection of 1 and 5 μg/g for copper and iron, respectively. The high detection power and good spatial resolution allow the analysis of small needle biopsy specimen using this method. The two analyzed WD samples can be well differentiated from the control sample due to their inhomogeneous copper distribution and high copper concentrations of up to 1200 μg/g. Interestingly, the WD samples show an inverse correlation of regions with elevated copper concentrations and regions with high iron concentrations.

  20. Renal cell carcinomas mass of <4 cm are not always indolent

    DEFF Research Database (Denmark)

    Azawi, Nessn H; Lund, Lars; Fode, Mikkel

    2017-01-01

    CONTEXT: The rate of progression to metastatic disease in patients undergoing active surveillance for small renal tumors varies in the literature between 1% and 8%. AIMS: This study aims to examine the incidence of metastasis in small renal tumors of <4 cm in a Danish cohort. SETTINGS AND DESIGN:...

  1. No important influence of limited steroid exposure on bone mass during the first year after renal transplantation: a prospective, randomized, multicenter study.

    NARCIS (Netherlands)

    Meulen, C.G. ter; Riemsdijk, I.C. van; Hene, R.J.; Christiaans, M.H.; Borm, G.F.; Corstens, F.H.M.; Gelder, T. van; Hilbrands, L.B.; Weimar, W.; Hoitsma, A.J.

    2004-01-01

    BACKGROUND: Steroid-related bone loss is a recognized complication after renal transplantation. In a prospective, randomized, multicenter study we compared the influence of a steroid-free immunosuppressive regimen with a regimen with limited steroid exposure on the changes in bone mass after renal t

  2. Value of repeat biopsy in lupus nephritis flares

    Science.gov (United States)

    Greloni, G; Scolnik, M; Marin, J; Lancioni, E; Quiroz, C; Zacariaz, J; De la Iglesia Niveyro, P; Christiansen, S; Pierangelo, M A; Varela, C F; Rosa-Diez, G J; Catoggio, L J; Soriano, E R

    2014-01-01

    Objectives Renal flares are common in lupus nephritis (LN), and class switch is thought to be characteristic. There is no agreement on indications for performing a repeat renal biopsy. Our objective was to retrospectively review patients who had more than one renal biopsy performed on clinical indications, and analyse clinical, pathological and treatment changes after successive biopsies. Methods Forty-five patients with LN and one or more repeat renal biopsies were included, with a total of 116 biopsies. Results Of the 71 repeat biopsies, pathological transition occurred in 39 (54.9%). When having a previous biopsy with a proliferative lesion, class switch occurred in 55.6%, with 24.4% evolving into non-proliferative classes. When previous biopsy was class V, transition to other classes occurred in 58.3% and changes were all into proliferative classes. Conversion from one pure proliferative form to another (class III to class IV or vice versa) happened in 11.3% of the rebiopsies, with 62 rebiopsies (87.3%) leading to a change in the treatment regimen. Conclusions Histological transformations were common, and they occurred when the previous biopsy had non-proliferative lesions as well as when lesions were proliferative. Treatments were modified after repeat renal biopsy in the majority of patients. In this experience, kidney repeat biopsies were useful in guiding treatment of LN flares. PMID:25396056

  3. 22G versus 25G biopsy needles for EUS-guided tissue sampling of solid pancreatic masses: a randomized controlled study.

    Science.gov (United States)

    Woo, Young Sik; Lee, Kwang Hyuck; Noh, Dong Hyo; Park, Joo Kyung; Lee, Kyu Taek; Lee, Jong Kyun; Jang, Kee-Taek

    2017-09-12

    No comparative study of 22-gauge biopsy needles (PC22) and 25-gauge biopsy needles (PC25) has been conducted. We prospectively compared the diagnostic accuracy of PC22 and PC25 in patients with pancreatic and peripancreatic solid masses. We conducted a randomized noninferiority clinical study from January 2013 to May 2014 at Samsung Medical Center. A cytological and histological specimen of each pass was analyzed separately by an experienced pathologist. The primary outcome was to assess the diagnostic accuracy using the PC22 or PC25. Secondary outcomes included the optimal number of passes for adequate diagnosis, core specimen yield, sample adequacy, and complication rates. Diagnostic accuracy of combining cytology with histology in three cumulative passes was 97.1% (100/103) for the PC22 and 91.3% (94/103) for the PC25 group. Thus, noninferiority of PC25 to PC22 was not shown with a 10% noninferiority margin (difference, -5.8%; 95% CI, -12.1 to -0.5%). In a pairwise comparison with each needle type, two passes was non-inferior to three passes in the PC22 (96.1% vs. 97.1%; difference, -0.97%; 95% CI -6.63 to 4.69%) but noninferiority of two passes to three passes was not shown in the PC25 group (87.4% vs. 91.3%; difference, -3.88%; 95% CI, -13.5 to 5.7%). Non-inferiority of PC25 to PC22 diagnostic accuracy was not observed for solid pancreatic or peripancreatic masses without on-site cytology. PC22 may be a more ideal device because only two PC22 needle passes was sufficient to establish an adequate diagnosis, whereas PC25 required three or more needle passes.

  4. Comparison of different way of renal biopsy under ultrasound guide%超声引导不同方法经皮肾组织活检术比较

    Institute of Scientific and Technical Information of China (English)

    张祥文; 夏敬彪; 徐双双; 何川鄂; 杨芦蓉

    2011-01-01

    目的 探讨超声引导下肾组织活检术的最佳方法.方法回顾性分析超声引导下3种不同方法(十字定位法、实时超声定位法和穿刺架法)肾组织活检术的取材满意率、成功率及并发症发生率.结果十字定位法、实时超声定位法和穿刺架法的穿刺成功率分别为74.50%、95.90%和89.28%;取材满意率分别为68.48%、88.45%和84.64%;所取肾小球数目分别为25.37±13.26、30.42±11.19和28.61±12.68;肾包膜下血肿发生率分别为15.22%、10.60%和11.45%;肉眼血尿的发生率分别为8.70%、3.13%和3.35%.实时超声定位法的穿刺成功率和肾小球数明显优于十字定位法和穿刺架法(P<0.01或P<0.05)、取材满意率明显优于十字定位法(P<0.01);肉眼血尿低于十字定位法(P<0.05).结论实时超声定位法引导的经皮肾组织活检术值得临床推广.%Objective To explore the best way of renal biopsy under ultrasound guide. Methods Retrospectively analyze the a-chievement ratio, successful ratio, and incidence of complication in three different methods (cross shap localization, real -time ultrasono-graph, puncture probe) of renal biopsy under ultrasound guide. Results The successful ratio of method among cross shap localization, real - time ultrasonograph, puncture probe was 74.50% , 95. 90% , 89. 28% respectively; the achievement ratio was 68. 48% , 88.45% and 84. 64% respectively; the number of glomeruli was 25.37 ± 13. 26, 30.42 ± 11. 19 and 28.61 ± 12.68 respectively; the incidence of renal subcapsular hemorrhage was 15.22% , 10.60% and 11.45% respectively; the incidence of macrohematuria was 8. 70% , 3. 13% and 3. 35% respectively. Real - time ultrasonograph had an advantage on the successful ratio and number of glomeruli compared with cross shap localization and puncture probe ( P < 0.01 or P < 0.05), the achievement ratio was better than cross shap localization (P < 0.01), and the incidence of

  5. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys...

  6. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys...

  7. Initial Presentation of Renal Cell Carcinoma as a Metastatic Mass within the Masseter Muscle: A Case Report and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyung Eun; Lee, Han Bee; Cho, Woo Ho; Kim, Jae Hyung; Lee, Ji Hae; Kang, Min Jin [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kim, Hyun Jung [Dept. of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Renal cell carcinoma (RCC) is often concomitant with distant metastasis, and these metastases are the first sign of an otherwise occult primary. Whereas metastasis of RCC to the head and neck has been reported, metastasis to the masseter muscle, which is composed of skeletal muscle, is quite rare. We now report the case of a 66-year-old man who had a past history of pulmonary tuberculosis, with RCC metastasis of a well-defined intensely enhancing hypervascular mass in the masseter muscle as the initial presentation. We present the imaging findings of this case and a literature review about radiologic differential diagnosis of intramasseteric masses.

  8. Active haemorrhage of a renal allograft detected on portable ultrasound

    OpenAIRE

    Ricketts, James; Pang, Chun Lap; Dissanayake, Prageeth; Hutchinson, Rachel; Gutteridge, Catherine

    2013-01-01

    Function of a renal allograft relies on the integrity of its vascular anatomy. Renal biochemistry, ultrasound and percutaneous biopsy are used in combination to determine allograft function. Biopsy is not without risk, and in this case study we demonstrate a rare but a potentially life-threatening complication of renal allograft biopsy.

  9. Papillary Thyroid Carcinoma Metastases Presenting as Ipsilateral Adrenal Mass and Renal Cyst

    Directory of Open Access Journals (Sweden)

    Serge Ginzburg

    2015-11-01

    Full Text Available Metastatic spread of differentiated thyroid cancer to genitourinary organs is rare. Synchronous presentation of renal and adrenal thyroid metastasis is even less common, this case being only the 3rd reported. We describe a case of a 60-year-old male with oligometastatic thyroid cancer, where adrenal and renal metastases were the only extracervical sites of disease and triggered the patient's presentation.

  10. Comparative study of multiport laparoscopy and umbilical laparoendoscopic single-site surgery with reusable platform for treating renal masses.

    Science.gov (United States)

    Chantada, C; García-Tello, A; Esquinas, C; Moraga, A; Redondo, C; Angulo, J C

    Umbilical laparoendoscopic single-site (LESS) surgery is an increasingly used modality for treating renal masses. We present a prospective comparison between LESS renal surgery and conventional laparoscopy. A comparative paired study was conducted that evaluated the surgical results and complications of patients with renal neoplasia treated with LESS surgery (n=49) or multiport laparoscopy (n=53). The LESS approach was performed with reusable material placed in the navel and double-rotation curved instruments. An additional 3.5-mm port was employed in 69.4% of the cases. We assessed demographic data, the type of technique (nephrectomy, partial nephrectomy and nephroureterectomy), surgical time, blood loss, haemoglobin, need for transfusion, number and severity of complications (Clavien-Dindo), hospital stay, histological data and prognosis. There were no differences in follow-up, age, sex, body mass index, preoperative haemoglobin levels or type of surgery. Conversion occurred in 2 cases (1 in each group). The surgical time was equivalent (P=.6). Intraoperative transfusion (P=.03) and blood loss (Pmasses, with time consumption and safety comparable to conventional laparoscopy. The LESS approach is advantageous in terms of blood loss and hospital stay. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Micro-RNA analysis of renal biopsies in human lupus nephritis demonstrates up-regulated miR-422a driving reduction of kallikrein-related peptidase 4.

    Science.gov (United States)

    Krasoudaki, Eleni; Banos, Aggelos; Stagakis, Elias; Loupasakis, Konstantinos; Drakos, Elias; Sinatkas, Vaios; Zampoulaki, Amalia; Papagianni, Aikaterini; Iliopoulos, Dimitrios; Boumpas, Dimitrios T; Bertsias, George K

    2016-10-01

    Aberrancies in gene expression in immune effector cells and in end-organs are implicated in lupus pathogenesis. To gain insights into the mechanisms of tissue injury, we profiled the expression of micro-RNAs in inflammatory kidney lesions of human lupus nephritis (LN). Kidney specimens were from patients with active proliferative, membranous or mixed LN and unaffected control tissue. Micro-RNAs were quantified by TaqMan Low Density Arrays. Bioinformatics was employed to predict gene targets, gene networks and perturbed signaling pathways. Results were validated by transfection studies (luciferase assay, real-time PCR) and in murine LN. Protein expression was determined by immunoblotting and immunohistochemistry. Twenty-four micro-RNAs were dysregulated (9 up-regulated, 15 down-regulated) in human LN compared with control renal tissue. Their predicted gene targets participated in pathways associated with TGF-β, kinases, NF-κB, HNF4A, Wnt/β-catenin, STAT3 and IL-4. miR-422a showed the highest upregulation (17-fold) in active LN and correlated with fibrinoid necrosis lesions (β = 0.63, P = 0.002). In transfection studies, miR-422a was found to directly target kallikrein-related peptidase 4 (KLK4) mRNA. Concordantly, KLK4 mRNA was significantly reduced in the kidneys of human and murine LN and correlated inversely with miR-422a levels. Immunohistochemistry confirmed reduced KLK4 protein expression in renal mesangial and tubular epithelial cells in human and murine LN. KLK4, a serine esterase with putative renoprotective properties, is down-regulated by miR-422a in LN kidney suggesting that, in addition to immune activation, local factors may be implicated in the disease. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  12. Analysis on clinicopathological data of 334 cases undergoing percutaneous renal biopsy in Taizhou region%江苏省泰州地区334例经皮肾穿刺活检临床病理分析

    Institute of Scientific and Technical Information of China (English)

    章旭; 曹娟; 李海涛; 丁浩; 吴伟翔; 许琴; 赵彩霞

    2011-01-01

    Objective To investigate the clinical and pathological features of renal biopsy patients in Taizhou region and the relationship between them. Methods Retrospective analysis of age, etiology, clinical features and pathological types of 334 cases of patients with renal biopsy in the past four years in Taizhou region was done. The relationship between the clinical manifestations and pathological types was investigated. Results Among these patients, male accounted for 53. 3% and female 46.7% ; average age: males were(39.1 ± 18.1)years old and females(40.8 ± 13.3) years old. The main clinical manifestation of primary glomerulonephritis (PGN) was chronic glomerulonephritis(62.7%). The common pathological types of PGN were mesangial proliferative glomerulonephritis (MsPGN 36.4%), followed by IgA nephropathy (29.8%) and focal segmental glomerular sclerosis (FSGS 11%). The most common pathological type of secondary glomeru lonephritis was lupus nephritis (37.7%). Conclusion The majority of patients with renal biopsy in Taizhou region are young adults, and the most prevalent disease is primary nephropathy among which the common pathological types are MsPGN, followed by IgAN and FSGS. The top three of secondary ephropathy are lupus nephritis, purpura nephritis and hypertensive nephropathy.%目的 探讨泰州地区肾活检患者的临床及病理特点,以及2者之间的关系.方法 回顾性分析江苏省泰州地区近4年因肾脏疾病行经皮肾穿刺组织活检患者的年龄、病因、临床特点和病理类型,并探讨其临床特点和病理类型之间的关系.结果 本组患者中,男性占53.3%,女性占46.7%;平均年龄:男(39.1±18.1)岁、女(40.8±13.3)岁.原发性肾小球肾炎(PGD)主要临床表现为慢性肾小球肾炎占62.7%.PGD常见病理类型依次为系膜增生性肾小球肾炎(MsPGN)36.4%、IgA肾病29.8%、FSGS11.0%.继发性肾小球肾炎最常见的病理类型是狼疮性肾炎37.7%.结论 本地区肾活

  13. Clinical Application Value and Significance of Ultrasound Guided Renal Biopsy%超声引导下对肾活检技术的临床应用价值及意义

    Institute of Scientific and Technical Information of China (English)

    黄力; 陈玉平; 关洁仪

    2016-01-01

    目的:探讨超声引导下肾活检技术的临床应用价值及意义。方法:选取2013年7月-2015年7月本院收治的采用超声引导下经皮肾穿刺活检术的患者90例作为研究对象,回顾性分析穿刺取材成功率,病理结果及术后并发症情况。结果:所有患者取材成功率为100%;病理结果显示:系膜增生性肾小球肾炎46例,伴肾小球硬化22例;局灶性阶段硬化性肾小球肾炎19例;IgA肾病12例;狼疮性肾炎5例;过敏性紫癜性肾小球肾炎6例;膜性肾病1例;微小病变性肾小球病1例。术后出现并发症12例,其中6例自诉有腰酸和腰痛,2例患者出现肉眼血尿后自行消退,4例出现穿刺针处出血,并发症发生率为13.3%。结论:超声引导下肾脏穿刺活检术是一种安全有效的辅助检查方法,具有成功率高,术后并发症少的优点,值得临床应用。%Objective:To explore the clinical value and significance of ultrasound guided renal biopsy. Method:From July 2013 to July 2015,90 cases of ultrasound guided percutaneous renal biopsy were selected as the research objects,the success rate of drawing materials,pathological findings and postoperative complications were analyzed retrospectively.Result:The success rate of drawing materials for all patients was 100%.Pathological results showed,mesangial proliferative glomerulonephritis was 46 cases,glomerular sclerosis was 22 cases, focal stage hardening glomerulonephritis was 19 cases,IgA nephropathy was 12 cases,lupus nephritis was 5 cases,allergic purpura glomerulonephritis was 6 cases,membranous nephropathy was 1 case and minimal change glomerulopathy was 1 case.The postoperative complications were found in 12 cases,which 6 cases of private prosecution have backache and lumbago,2 cases of patients presented with gross hematuria after self regression, 4 cases of appearing puncture needle bleeding,the rate of adverse reaction was 13.3%.Conclusion

  14. Nasal mucosal biopsy

    Science.gov (United States)

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  15. Biopsy - biliary tract

    Science.gov (United States)

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  16. Cold knife cone biopsy

    Science.gov (United States)

    ... squamous cells - cone biopsy; Pap smear - cone biopsy; HPV - cone biopsy; Human papilloma virus - cone biopsy; Cervix - ... exam. The health care provider will place an instrument (speculum) into your vagina to better see the ...

  17. The value of blood oxygenation level-dependent (BOLD MR imaging in differentiation of renal solid mass and grading of renal cell carcinoma (RCC: analysis based on the largest cross-sectional area versus the entire whole tumour.

    Directory of Open Access Journals (Sweden)

    Guang-Yu Wu

    Full Text Available To study the value of assessing renal masses using different methods in parameter approaches and to determine whether BOLD MRI is helpful in differentiating RCC from benign renal masses, differentiating clear-cell RCC from renal masses other than clear-cell RCC and determining the tumour grade.Ninety-five patients with 139 renal masses (93 malignant and 46 benign who underwent abdominal BOLD MRI were enrolled. R2* values were derived from the largest cross-section (R2*largest and from the whole tumour (R2*whole. Intra-observer and inter-observer agreements were analysed based on two measurements by the same observer and the first measurement from each observer, respectively, and these agreements are reported with intra-class correlation coefficients and 95% confidence intervals. The diagnostic value of the R2* value in the evaluation was assessed with receiver-operating characteristic analysis.The intra-observer agreement was very good for R2*largest and R2*whole (all > 0.8. The inter-observer agreement of R2*whole (0.75, 95% confidence interval: 0.69~0.79 was good and was significantly improved compared with the R2*largest (0.61, 95% confidence interval: 0.52~0.68, as there was no overlap in the 95% confidence interval of the intra-class correlation coefficients. The diagnostic value in differentiating renal cell carcinoma from benign lesions with R2*whole (AUC=0.79/0.78[observer1/observer2] and R2*largest (AUC=0.75[observer1] was good and significantly higher (p=0.01 for R2*largest[observer2] vs R2*whole[observer2], p 0.7 and were not significantly different (p=0.89/0.93 for R2*largest vs R2*whole[observer1/observer2], 0.96 for R2*whole[observer1] vs R2*largest[observer2] and 0.96 for R2*whole [observer2] vs R2*largest[observer1].BOLD MRI could provide a feasible parameter for differentiating renal cell carcinoma from benign renal masses and for predicting clear-cell renal cell carcinoma grading. Compared with the largest cross

  18. ASSOCIATION BETWEEN DE NOVO DONOR SPECIFIC HLA ANTIBODY, C4D STAINING IN RENAL GRAFT BIOPSY AND GRAFT OUTCOME: A SINGLE CENTER EXPERIENCE.

    Science.gov (United States)

    Cicciarelli, James; Cho, Yong W; Koss, Michael; Helstab-Houston, Kathryn; Mendez, Robert; Kasahara, Noriyuki; Hutchinson, Ian V; Shah, Tariq

    2009-01-01

    In 69 renal transplant recipients (RTR), all had a functioning graft (SCr HLA antibodies and 41 (59%) had DSA. The proportion of C4d positivity was significantly higher in patients with DSA (HLA Class I only, II only, and I & II) in comparison to patients without post-transplant HLA antibodies. The incidence of graft failure (including current SCr > 4.0) in RTR with HLA Class II antibodies (Class II only or I & II) was significantly higher than in RTR without post-transplant HLA antibodies (P=0.03).Even after amelioration of rejection, the RTR with Class II DSA group continued to fail beyond 2 years after transplantation when compared with the other 2 groups (None/NDSA or HLA Class I only), however, the difference in graft survival between HLA Class II and None/NDSA groups did not reach statistical significance (log-rank P=0.32). Significant association between C4d staining, post-transplant HLA Class II antibodies and graft failure strongly suggests the importance of post-transplant HLA antibodies. HLA Class II DSAs may be an indicator of chronic allograft nephropathy (CAN) proceeding to graft loss. We propose that amelioration of CAN graft loss may be affected by monitoring and identification of DSA with appropriate immunosuppression of these antibodies.

  19. Pre-transplant CDKN2A expression in kidney biopsies predicts renal function and is a future component of donor scoring criteria.

    Directory of Open Access Journals (Sweden)

    Marc Gingell-Littlejohn

    Full Text Available CDKN2A is a proven and validated biomarker of ageing which acts as an off switch for cell proliferation. We have demonstrated previously that CDKN2A is the most robust and the strongest pre-transplant predictor of post-transplant serum creatinine when compared to "Gold Standard" clinical factors, such as cold ischaemic time and donor chronological age. This report shows that CDKN2A is better than telomere length, the most celebrated biomarker of ageing, as a predictor of post-transplant renal function. It also shows that CDKN2A is as strong a determinant of post-transplant organ function when compared to extended criteria (ECD kidneys. A multivariate analysis model was able to predict up to 27.1% of eGFR at one year post-transplant (p = 0.008. Significantly, CDKN2A was also able to strongly predict delayed graft function. A pre-transplant donor risk classification system based on CDKN2A and ECD criteria is shown to be feasible and commendable for implementation in the near future.

  20. Comparison of renal allograft (AG) biopsy diagnosis and temporal quantitation of Tc-99m sulfur colloid (SC) in clinically suspected AG rejection

    Energy Technology Data Exchange (ETDEWEB)

    George, E.A.; Brown, W.N.; Carney, K.; Naidu, R.G.; Palmer, D.C.

    1984-01-01

    The purpose of this study was to evaluate the diagnostic efficacy of temporal quantitation of SC compared to tissue diagnosis of AG needle biopsy (Bx). The principal clinical criteria for patient selection were sequential or persistent reduction (at least 40-50%) of AG function as determined by serial serum creatinine levels. Thirty-four AG recipients were examined with SC and subsequent AG Bx in 37 instances. %SC AG accumulation and bone marrow extraction were interpreted in view of the significant sequential of persistent reduction of Ag function. Each AG Bx was collected from multiple needle aspirates and processed for light microscopy and immunoflorescent staining. Bx and SC exam were evaluated for acute rejection (AR), chronic rejection (CR) or other, non-rejection pathology. Acute tissue changes superimposed on chronic were regarded as AR. Acute tissue changes and % SC AG accumulation in the rejection range were graded as mild, moderate and marked. In AR there was 28/28 agreement of Bx and SC diagnosis; of which 7/28 were superimposed on CR. In Cr Bx and SC agreed in 3/7 instances, in 3/7 SC Dx was AR and in 1/7 SC exam was normal. Sensitivity and specificity of the SC diagnosis in this series was 100% and 63% for AR, 43% and 100% for CR and 97% and 100% in all instances of rejection. Bx and SC grading of AR agreed in 64%. In conclusion, temporal quantitation of SC demonstrated overall good correlation with AG Bx diagnosis in this series. The poor sensitivity of 43% of SC in Cr and only 64% correlation in grading AR may be due to inherent Bx sampling and SC data analysis error.

  1. Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index

    NARCIS (Netherlands)

    Kwakernaak, Arjan J.; Zelle, Dorien M.; Bakker, Stephan J. L.; Navis, Gerjan

    2013-01-01

    Central distribution of body fat is associated with a higher risk of renal disease, but whether it is the distribution pattern or the overall excess weight that underlies this association is not well understood. Here, we studied the association between waist-to-hip ratio (WHR), which reflects centra

  2. Utility of anteroposterior diameter ratio of tumor and abdomen for laparoscopic approach for radical nephrectomy in large renal masses.

    Science.gov (United States)

    Yadav, Priyank; Srivastava, Devarshi; Arakere, Sachin; Gupta, Shashikant; Aga, Pallavi; Mandhani, Anil

    2017-08-07

    Laparoscopic radical nephrectomy (LRN) is now increasingly done for tumors larger than 10 cm. Despite selection of favorable cases, LRN may not be successful due to lack of adequate working space with large tumors. We describe a new feature on Contrast Enhanced Computed Tomography (CECT) abdomen to predict feasibility of LRN for large renal masses between 10 and 15 cm. From January 2005 to December 2015, renal tumors between 10 and 15 cm were selected retrospectively for LRN. Patients with retroperitoneal lymphadenopathy, Inferior vena cava (IVC) thrombus and involvement of adjacent organs were excluded. Anteroposterior (AP) diameter ratio of renal tumor and abdomen (APROTA) was calculated by dividing the maximum AP diameter of tumor along with normal renal parenchyma, by the AP diameter of abdomen on CECT. The patients were stratified into two groups: Group A (successful LRN) and Group B (conversion to open surgery) and outcomes were compared. The reasons for conversion were also noted. Of 29 patients, 16 (55.2%) had successful LRN (Group A), while 13 (44.8%) had conversion to open surgery (group B). The median tumor size in Group A was 11.3 ± 1.8 cm and in Group B was 13.6 ± 1.26 cm. Eleven of 13 patients had conversion due to large tumor size causing failure to progress. Two conversions were due to bleeding and injury to the colon each. There was a significant difference in the APROTA in group A and B [0.43 ± 0.09 in group A and 0.64 ± 0.14 in group B (p = 0.0001)]. Patients with APROTA of more than 0.65 are unlikely to have successful outcome with LRN.

  3. Comparison of Histologic Core Portions Acquired from a Core Biopsy Needle and a Conventional Needle in Solid Mass Lesions: A Prospective Randomized Trial.

    Science.gov (United States)

    Lee, Ban Seok; Cho, Chang-Min; Jung, Min Kyu; Jang, Jung Sik; Bae, Han Ik

    2017-07-15

    The superiority of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) over EUS-guided fine needle aspiration (EUS-FNA) remains controversial. Given the lack of studies analyzing histologic specimens acquired from EUS-FNB or EUS-FNA, we compared the proportion of the histologic core obtained from both techniques. A total of 58 consecutive patients with solid mass lesions were enrolled and randomly assigned to the EUS-FNA or EUS-FNB groups. The opposite needle was used after the failure of core tissue acquisition using the initial needle with up to three passes. Using computerized analyses of the scanned histologic slide, the overall area and the area of the histologic core portion in specimens obtained by the two techniques were compared. No significant differences were identified between the two groups with respect to demographic and clinical characteristics. Fewer needle passes were required to obtain core specimens in the FNB group (pcore (11.8%±19.5% vs 8.0%±11.1%, p=0.376) or in the diagnostic accuracy (80.6% vs 81.5%, p=0.935) between two groups. The proportion of histologic core and the diagnostic accuracy were comparable between the FNB and FNA groups. However, fewer needle passes were required to establish an accurate diagnosis in EUS-FNB.

  4. Metastatic renal cell carcinoma masquerading as a primary ovarian mass in a post-operative case of meningioma and renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Sangita Bohara

    2015-09-01

    Full Text Available The clinical presentation of metastatic renal cell carcinoma to ovary is extremely rare as well as confusing due to its close resemblance to primary ovarian tumors, especially clear cell carcinoma. We present a case of metastatic renal cell carcinoma diagnosed in a 48-year-old female, who had renal cell carcinoma of the right kidney and right sphenoid wing meningioma of transitional type.

  5. Reporting standards for the imaging-based diagnosis of renal masses on CT and MRI: a national survey of academic abdominal radiologists and urologists.

    Science.gov (United States)

    Davenport, Matthew S; Hu, Eric M; Smith, Andrew D; Chandarana, Hersh; Hafez, Khaled; Palapattu, Ganesh S; Stuart Wolf, J; Silverman, Stuart G

    2017-04-01

    To define important elements of a structured radiology report of a CT or MRI performed to evaluate an indeterminate renal mass. IRB approval was waived for this multi-site prospective quality improvement study. A 35-question survey investigating elements of a CT or MRI report describing a renal mass was created through an iterative process by the Society of Abdominal Radiology Disease-Focused Panel on renal cell carcinoma. Surveys were distributed to consenting abdominal radiologists and urologists at nine academic institutions. Consensus within and between specialties was defined as ≥70% agreement. Respondent rates were compared with Chi Square test. The response rate was 68% (117/171; 55% [39/71] urologists, 78% [78/100] radiologists). Inter-specialty consensus was that the following were essential: mass size with comparison to prior imaging, mass type (cystic vs. solid), presence of fat, presence of enhancement, and radiologic stage. Urologists were more likely to prefer the Nephrometry score (75% [27/36] vs. 22% [17/76], p < 0.0001), quantitative reporting of enhancement on CT (85% [32/38] vs. 46% [36/77], p < 0.0001), and mass position with respect to the renal polar lines (67% [24/36] vs. 36% [27/76], p = 0.002). There was inter-specialty consensus that the Bosniak classification for cystic masses was preferred. Most urologists (60% [21/35]) preferred management recommendations be omitted for solid masses or Bosniak III-IV cystic masses. Important elements to include in a CT or MRI report of an indeterminate renal mass are critical diagnostic features, the Bosniak classification if relevant, and the most likely specific diagnosis when feasible; including management recommendations is controversial.

  6. Prognosis in glomerulonephritis. A follow-up study of 395 consecutive, biopsy-verified cases. I. Classification, renal histology and outcome. Report from a Copenhagen study group of renal diseases.

    Science.gov (United States)

    Brahm, M; Balsløv, J T; Brun, C; Gerstoft, J; Jørgensen, F; Jørgensen, H E; Larsen, M; Larsen, S; Lorenzen, I; Løber, M

    1985-01-01

    Between 1967 and 1977, 395 consecutive cases of glomerulonephritis (GN) were collected by a Copenhagen study group. The diagnosis was established by histological and biochemical criteria. Light microscopy investigations of thin silver-stained sections were applied. In a follow-up in 1980 all cases were categorized by one of the following end points: death without uremia, uremia, recovery, or censored cases. The course is presented in figures showing the cumulated distribution of outcomes in relation to observation time. Each histological subgroup of GN had its own characteristic course with respect to initial rates of changes in the renal state, as well as to frequency of recovery, uremia and death. The prognosis was good in minimal changes GN and proliferative GN, bad in unclassified GN and worst in extracapillary GN. When part of a connective tissue disease, GN carried a poor prognosis. We conclude that histological classification of GN based on light microscopy offers a reliable means of predicting the long-term prognosis.

  7. Characteristics of repeated renal biopsy-proven primary focal segmental glomerulosclerosis in children%重复肾活检为原发性局灶节段性肾小球硬化症患儿临床病理分析

    Institute of Scientific and Technical Information of China (English)

    何瑞娟; 肖慧捷; 刘景城; 王素霞; 杨霁云

    2012-01-01

    目的 对8例经重复肾活检确诊为原发性局灶节段性肾小球硬化症(PFSGS)的患儿进行研究,探讨临床-病理相关性,两次肾活检病理类型的联系以及重复肾活检的指征.方法 回顾分析近10年在北京大学第一医院儿科肾活检的病例,对其中8例重复肾活检、并最终确诊为PFSGS的病例进行分析,总结其临床特点、重复肾活检的指征、前后两次肾活检病理类型的不同,以及治疗反应.其中局灶节段性肾小球硬化症(FSGS)分型依据2004年D'Agati提出的最新分型标准.结果 8例患儿首次发病年龄在1 ~12岁,临床诊断均为肾病综合征.首次肾穿年龄1.1 ~15.0岁,随访时间10个月~14年.重复肾活检的原因为治疗反应差,持续大量蛋白尿不缓解,伴或不伴肾功能下降.3例患儿两次肾活检均在北京大学第一医院完成,第1次病理类型分别为:系膜增生、FSGS细胞型(CELL)及FSGS顶端型(GTL).第2次肾穿后,分别加用或更换免疫抑制剂,3例出现肾功能下降或终末期肾病,起病年龄均在1岁左右;2例FSGS塌陷型(COLL)者,1例重复肾活检发现伴随亚急性小管间质肾炎.结论 PFSGS是一组临床病理综合征,临床表现以肾病综合征多见.在病程中出现治疗反应差,病情持续不缓解时,通常提示病理转型.系膜增生可以转化为FSGS,FSGS各亚型也可发生转换.塌陷型及发病年龄小者预后差.%Objective To analyze the characteristics of repeated renal biopsy-proven primary focal segmental glomerulosclerosis (PFSGS) in 8 children,and to reveal the relationship between clinical features and pathology,between the two times of renal biopsy pathology,and the indications for repeated renal biopsy.Method The records of cases who ever experienced renal biopsy in this hospital were reviewed,of whom 8 cases of repeated renal biopsy-proven PFSGS were enrolled.The clinical manifestations,the reason why they had renal biopsy again

  8. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  9. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  10. Muscle biopsy (image)

    Science.gov (United States)

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  11. Skin lesion biopsy

    Science.gov (United States)

    ... procedure will leave a small indented area. This type of biopsy is often done when a skin cancer is ... may have stitches to close the area. This type of biopsy is often done to diagnose rashes . EXCISIONAL BIOPSY ...

  12. Population-based estimation of renal function in healthy young Indian adults based on body mass index and sex correlating renal volume, serum creatinine, and cystatin C

    Directory of Open Access Journals (Sweden)

    Rajagopalan P

    2016-09-01

    Full Text Available Prashanth Rajagopalan,1 Georgi Abraham,2 Yuvaram NV Reddy,2 Ravivarman Lakshmanasami,1 ML Prakash,1 Yogesh NV Reddy2 1Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, 2Department of Nephrology, Madras Medical Mission Hospital, Chennai, India Abstract: This population-based prospective study was undertaken in Mahatma Gandhi Medical College to estimate the renal function in young healthy Indian adults. A young healthy heterogeneous Indian cohort comprising 978 individuals, predominantly medical students, was assessed by a detailed questionnaire, and variables such as height, weight, body mass index (BMI, birth weight, and blood pressure were documented. Laboratory investigations included serum creatinine, serum cystatin C, blood sugar, urine protein, and imaging of the kidneys with ultrasound. The mean age of the cohort was 25±6 years, comprising 672 males and 306 females. The estimated glomerular filtration rates (eGFRs by the Cockcroft–Gault formula for BMI <18.5 kg/m2, 18.5–24.99 kg/m2, 25–29.99 kg/m2, and ≥30 kg/m2 were 71.29±10.45 mL/min, 86.38±13.46 mL/min, 98.88±15.29 mL/min, and 109.13±21.57 mL/min, respectively; the eGFRs using cystatin C for the four groups of BMI were 84.53±18.14 mL/min, 84.01±40.11 mL/min, 79.18±13.46 mL/min, and 77.30±10.90 mL/min, respectively. This study attempts to establish a normal range of serum creatinine and cystatin C values for the Indian population and shows that in young healthy Indian adults, eGFR and kidney volume vary by BMI and sex. Keywords: eGFR, birth weight, renal volume

  13. Duodenal Bleeding from Metastatic Renal Cell Carcinoma

    Science.gov (United States)

    Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

    2011-01-01

    Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested. PMID:21577373

  14. Duodenal Bleeding from Metastatic Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Tarun Rustagi

    2011-04-01

    Full Text Available Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.

  15. Duodenal bleeding from metastatic renal cell carcinoma.

    Science.gov (United States)

    Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

    2011-04-20

    Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.

  16. Research on Control of Renal Biopsy Operation Positioning Robot Under the Guidance of C Arm%C型臂引导下肾穿剌手术定位机器人控制研究

    Institute of Scientific and Technical Information of China (English)

    许东; 谢叻; 孟纪超; 夏海豹; 夏术介

    2013-01-01

    C-arm image—guided surgical positioning technology is widely used in domestic renal biopsy surgery. C-arni for the two-dimensional images cannot directly provide a three- dimensional image information, and work long hours will lead to health care workers suffer from high—dose radiation. In order to improve the above limitations, we design new surgical positioning robot to access three-dimensional image by two positioning image. Robot control is used fuzzy controller as compensator, which improve control accuracy effectively. The surgical positioning robot can quickly locate, and greatly improve the surgery a success rate, to protect health care workers from the X—ray radiation.%以C型臂图像为引导的定位手术目前在国内肾穿刺手术中广泛应用,但C型臂为二维图像,无法直接提供三维图像信息,且长时间工作会导致医护人员遭受大剂量辐射.为改进上述局限性,设计了新型手术定位机器人通过两次定位来完成对三维图像的获取.在机器人控制中,利用模糊控制器作为补偿器,有效地提高控制精度.这套手术定位机器人可以快速定位,并大大提高了手术的一次成功率,保护医护工作者免受X射线辐射.

  17. Renal Hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    İbrahim Halil Bozkurt

    2015-03-01

    Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

  18. Renal Cell Carcinoma Metastasized to Pagetic Bone.

    Science.gov (United States)

    Ramirez, Ashley; Liu, Bo; Rop, Baiywo; Edison, Michelle; Valente, Michael; Burt, Jeremy

    2016-01-01

    Paget's disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent. Patients with Paget's disease of the bone are at increased risk for primary bone neoplasms, particularly osteosarcoma. Many cases of metastatic disease to pagetic bone have been reported. However, renal cell carcinoma metastasized to pagetic bone is extremely rare. A 94-year-old male presented to the emergency department complaining of abdominal pain. A computed tomography scan of the abdomen demonstrated a large mass in the right kidney compatible with renal cell carcinoma. The patient was also noted to have Paget's disease of the pelvic bones and sacrum. Within the pagetic bone of the sacrum, there was an enhancing mass compatible with renal cell carcinoma. A subsequent biopsy of the renal lesion confirmed renal cell carcinoma. Paget's disease of the bone places the patient at an increased risk for bone neoplasms. The most commonly reported sites for malignant transformation are the femur, pelvis, and humerus. In cases of malignant transformation, osteosarcoma is the most common diagnosis. Breast, lung, and prostate carcinomas are the most common to metastasize to pagetic bone. Renal cell carcinoma associated with Paget's disease of the bone is very rare, with only one prior reported case. Malignancy in Paget's disease of the bone is uncommon with metastatic disease to pagetic bone being extremely rare. We report a patient diagnosed with concomitant renal cell carcinoma and metastatic disease within Paget's disease of the sacrum. Further research is needed to assess the true incidence of renal cell carcinoma associated with pagetic bone.

  19. Minimal Invasive Management of Small Renal Masses: State of Art and New Trends

    Directory of Open Access Journals (Sweden)

    Senol Tonyali

    2016-04-01

    Full Text Available With the widespread use of abdominal imaging modalities such as ultrasound (US, computerized tomography (CT and magnetic resonance imaging (MRI, there has been a pronounced increase in the incidence of renal tumors especially clinically localized, small < 2 cm ones. Moreover the final pathology of these lesions is benign up to 30%. The development of ablation techniques (radiofrequency ablation, cryoablation, high-intensity focused ultrasound and microwave ablation with continuous innovations such as refinement of probes and real-time imaging capabilities has pioneered the great interest in these techniques, especially for the treatment of T1 renal malignancies. RFA and CA have similar cancer specific survival, disease-free survival, recurrence free survival and overall survival rates compared to nephrectomy. MWA and HIFU remain still experimental due to low patient volume and insufficient clinical experience. Minimal invasive techniques can be a feasible treatment alternative for patients who have high surgical and anesthetic risk with multiple comorbidities, have multiple tumors due to a systemic disease like VHL or do not want to undergo extirpative surgery. Especially elderly patients can be good candidates for these procedures with their relatively short life expectance and impaired performance status.

  20. Clear cell renal cell tumors: Not all that is "clear" is cancer.

    Science.gov (United States)

    Williamson, Sean R; Cheng, Liang

    2016-07-01

    Continued improvement of our understanding of the clinical, histologic, and genetic features of renal cell tumors has progressively evolved renal tumor classification, revealing an expanding array of distinct tumor types with different implications for prognosis, patient counseling, and treatment. Although clear cell renal cell carcinoma is unequivocally the most common adult renal tumor, there is growing evidence that some "clear cell" renal neoplasms, such as exemplified by multilocular cystic clear cell renal neoplasm of low malignant potential (formerly multilocular cystic renal cell carcinoma), do not have the same potential for insidious progression and metastasis, warranting reclassification as low malignant potential tumors or benign neoplasms. Still other novel tumor types such as clear cell papillary renal cell carcinoma have been more recently recognized, which similarly have shown a conspicuous absence of aggressive behavior to date, suggesting that these too may be recategorized as noncancerous or may be premalignant neoplasms. This importance for prognosis is increasingly significant in the modern era, in which renal masses are increasingly found incidentally by imaging techniques at a small tumor size, raising consideration for less aggressive management options guided by renal mass biopsy diagnosis, including imaging surveillance, tumor ablation, or partial nephrectomy.

  1. Performance of dual-energy CT with tin filter technology for the discrimination of renal cysts and enhancing masses.

    Science.gov (United States)

    Leschka, Sebastian; Stolzmann, Paul; Baumüller, Stephan; Scheffel, Hans; Desbiolles, Lotus; Schmid, Bernhard; Marincek, Borut; Alkadhi, Hatem

    2010-04-01

    To assess the performance of dual-energy computed tomography (DECT) equipped with the new tin filter technology to classify phantom renal lesions as cysts or enhancing masses. Forty spherical lesion proxies ranging in diameter from 6 to 27 mm were filled with either distilled water (n = 10) representing cysts or titrated iodinated contrast solutions with a concentration of 0.45 (n = 10), 0.9 (n = 10), and 1.8 mg/mL (n = 10) representing enhancing masses. The lesion proxies were placed in a 12-cm diameter renal phantom containing minced beef and submerged in a 28-cm water bath. DECT was performed using the new dual-source CT system (Definition Flash, Siemens Healthcare, Forchheim, Germany) allowing for an improved energy separation by using a tin filter. DECT was performed at tube voltages of 140/80 kV without the tin filter (protocol A) and with tin filter (protocol B). The tube current time product was selected in each protocol to achieve a constant CTDI (computed tomography dose index) with both protocols of 19 mGy (full dose), 9.5 mGy (half dose), and 4.8 mGy (quarter dose). Two blinded readers classified each lesion as a cyst or enhancing mass by using iodine overlay (IO) images. One reader measured the CT numbers of each lesion at 120 kV, in the IO, linear blending (LB), and virtual noncontrast (VNC) images. The CT numbers of the lesions at 120 kV were 0.1 +/- 0.7 HU (0 mg iodine/mL), 9.1 +/- 0.7 HU (0.45 mg/mL), 18.1 +/- 1.4 HU (0.9 mg/mL), and 37.6 +/- 1.6 HU (1.8 mg/mL). Mean diameter of the lesion proxies filled with water or different iodine concentrations was similar (P = 0.38). Image noise was not significantly different in protocols A and B at the corresponding dose levels. At full dose, protocol A had a sensitivity of 93% and a specificity of 60% for discriminating renal lesions. Sensitivity and specificity declined to 84% and 38% at quarter dose. In protocol B, sensitivity was 100% and specificity was 90% at full dose and 93% and 70% at quarter dose

  2. Multidimensional Interactive Radiology Report and Analysis: standardization of workflow and reporting for renal mass tracking and quantification

    Science.gov (United States)

    Hwang, Darryl H.; Ma, Kevin; Yepes, Fernando; Nadamuni, Mridula; Nayyar, Megha; Liu, Brent; Duddalwar, Vinay; Lepore, Natasha

    2015-12-01

    A conventional radiology report primarily consists of a large amount of unstructured text, and lacks clear, concise, consistent and content-rich information. Hence, an area of unmet clinical need consists of developing better ways to communicate radiology findings and information specific to each patient. Here, we design a new workflow and reporting system that combines and integrates advances in engineering technology with those from the medical sciences, the Multidimensional Interactive Radiology Report and Analysis (MIRRA). Until recently, clinical standards have primarily relied on 2D images for the purpose of measurement, but with the advent of 3D processing, many of the manually measured metrics can be automated, leading to better reproducibility and less subjective measurement placement. Hence, we make use this newly available 3D processing in our workflow. Our pipeline is used here to standardize the labeling, tracking, and quantifying of metrics for renal masses.

  3. Postoperative Urinary Leakage Following Partial Nephrectomy for Renal Mass: Risk Factors and a Proposed Algorithm for the Diagnosis and Management.

    Science.gov (United States)

    Erlich, T; Abu-Ghanem, Y; Ramon, J; Mor, Y; Rosenzweig, B; Dotan, Z

    2017-06-01

    To evaluate the current incidence, risk factors, management, and long-term follow-up of urinary leakage following partial nephrectomy, in order to propose an algorithm for diagnosis and evaluation of postoperative urinary leakage. The study included 752 patients who underwent elective partial nephrectomies for renal masses between the years 1988 and 2013. Patients' demographics, clinico-pathologic variables, and operative details were collected retrospectively. The associations between urinary leakage and patients' variables were assessed by univariate and multivariate analyses. Of the 752 patients, 21 (2.8%) experienced urinary leakage; 4 of the 21 patients with urinary leakage had spontaneous resolution, 1 patient underwent nephrectomy, and 16 patients were treated by retrograde ureteral stents insertion. One of them necessitated insertion of an additional percutaneous nephrostomy and another one deserved concomitant percutaneous drainage of a perirenal urinoma. The average period of time that elapsed from the operation until the insertion of stent was 8.5 ± 4.5 days. Stents were removed 68 ± 20.5 days postoperatively. None of the patients had either persistent or repeated leakage. On univariate analysis, hilar renal masses (p < 0.04) and higher preoperative creatinine levels (p < 0.01) were found to be associated with higher rates of urinary leakage. None of these variables was significant on a multivariate analysis. Review of the urinary leakage rate over time revealed it has been constantly decreasing over time, from 4% in early cases to 1.3% among the most recent ones. None of the preoperative variables that were examined in this study was significantly associated with increased risk of urinary leakage. However, cumulative surgical experience was associated with lower rates of urinary leakage, suggesting that the decrease in its incidence is related to the improved surgical skills, rather than to differences in tumors' or patients

  4. Population-based estimation of renal function in healthy young Indian adults based on body mass index and sex correlating renal volume, serum creatinine, and cystatin C.

    Science.gov (United States)

    Rajagopalan, Prashanth; Abraham, Georgi; Reddy, Yuvaram Nv; Lakshmanasami, Ravivarman; Prakash, M L; Reddy, Yogesh Nv

    2016-01-01

    This population-based prospective study was undertaken in Mahatma Gandhi Medical College to estimate the renal function in young healthy Indian adults. A young healthy heterogeneous Indian cohort comprising 978 individuals, predominantly medical students, was assessed by a detailed questionnaire, and variables such as height, weight, body mass index (BMI), birth weight, and blood pressure were documented. Laboratory investigations included serum creatinine, serum cystatin C, blood sugar, urine protein, and imaging of the kidneys with ultrasound. The mean age of the cohort was 25±6 years, comprising 672 males and 306 females. The estimated glomerular filtration rates (eGFRs) by the Cockcroft-Gault formula for BMI <18.5 kg/m(2), 18.5-24.99 kg/m(2), 25-29.99 kg/m(2), and ≥30 kg/m(2) were 71.29±10.45 mL/min, 86.38±13.46 mL/min, 98.88±15.29 mL/min, and 109.13±21.57 mL/min, respectively; the eGFRs using cystatin C for the four groups of BMI were 84.53±18.14 mL/min, 84.01±40.11 mL/min, 79.18±13.46 mL/min, and 77.30±10.90 mL/min, respectively. This study attempts to establish a normal range of serum creatinine and cystatin C values for the Indian population and shows that in young healthy Indian adults, eGFR and kidney volume vary by BMI and sex.

  5. Diagnostic Potential of Multidetector Computed Tomography for Characterizing Small Renal Masses

    Directory of Open Access Journals (Sweden)

    Maria Elisabetta Mancini

    2015-01-01

    Full Text Available Objectives. To assess the potential of CT for characterizing small renal tumors. Methods. 76 patients with <4 cm renal tumors underwent CT examination. The following parameters were assessed: presence of calcifications, densitometry on unenhanced and enhanced scans, washout percentage, urinary tract infiltration, star-shaped scar, and paradoxical effect. Results. Calcifications were found in 7/56 (12.5% carcinomas. Clear cell carcinomas were as follows: mean density 183.5 HU (arterial phase, 136 HU (portal phase, and 94 HU (delayed phase, washout 34.3%; chromophobe carcinomas were as follows: mean density 135 HU (arterial phase, 161 HU (portal phase, and 148 HU (delayed phase, washout 28%; papillary carcinomas were as follows: mean density 50.3 HU (arterial phase, 60 HU (portal phase, and 58.1 HU (delayed phase, washout 2.7%. In 2/56 (3.6% cases urinary tract infiltration was found. Oncocytomas were as follows: mean density 126.5 HU (arterial phase, 147.5 HU (portal phase, and 115.5 HU (delayed phase, washout 28.6%. On unenhanced scans, angiomyolipomas were as follows: density values <30 HU in 12/12 (100% of cases and on enhanced scans: mean density 78 HU (arterial phase, 128 HU (portal phase, and 80 HU (delayed phase, washout 50%. Conclusions. Intralesional calcifications and urinary tract infiltration are suggestive for malignancy, with the evidence of adipose tissue for angiomyolipomas and a modest increase in density with a reduced washout for papillary carcinomas. The intralesional density on enhanced scans, peak enhancement, and washout do not seem significant for differentiating clear cell, chromophobe carcinomas, angiomyolipomas, and oncocytomas.

  6. Biopsy with the New Essen Biopsy Forceps

    Directory of Open Access Journals (Sweden)

    Peter G. Traine

    2013-01-01

    Full Text Available Purpose. To present initial experience with a novel biopsy method, the Essen biopsy forceps. Therefore, two patients with diagnostic suspicion of uveal melanoma underwent biopsy for histopathological confirmation. Case Presentation. Two patients presented with painless unilateral vision reduction. Ultrasound revealed the diagnostic suspicion of uveal melanoma. Therefore, biopsy with the Essen biopsy forceps using a sutureless 23-gauge three-port vitrectomy system was performed. The specimens were then submitted to a pathologist and processed. Histopathology of the obtained specimen confirmed the diagnostic suspicion of choroid melanoma in both patients. Conclusion. Essen biopsy forceps is a very practicable alternative method to the FNAB, allowing a combined histopathological and immunohistochemical examination for achieving high diagnostic accuracy at minimal risk.

  7. ON RENAL BIOPSY: A PROSPECTIVE STUDY

    African Journals Online (AJOL)

    This study is important because of the increasing prevalence of diabetes mellitus and diabetic ... Packed cell volume, platelet count, prothrombin and bleeding times were ... (to demonstrate basement membrane) and trichome stain (to show.

  8. Estimating renal function in children: a new GFR-model based on serum cystatin C and body cell mass.

    Science.gov (United States)

    Andersen, Trine Borup

    2012-07-01

    This PhD thesis is based on four individual studies including 131 children aged 2-14 years with nephro-urologic disorders. The majority (72%) of children had a normal renal function (GFR > 82 ml/min/1.73 square metres), and only 8% had a renal function GFR model based on a novel theory of body cell mass (BCM) and cystatin C (CysC); 2) to investigate the diagnostic performance in comparison to other models as well as serum CysC and creatinine; 3) to validate the new models precision and validity. The model´s diagnostic performance was investigated in study I as the ability to detect changes in renal function (total day-to-day variation), and in study IV as the ability to discriminate between normal and reduced function. The model´s precision and validity were indirectly evaluated in study II and III, and in study I accuracy was estimated by comparison to reference GFR. Several prediction models based on CysC or a combination of CysC and serum creatinine have been developed for predicting GFR in children. Despite these efforts to improve GFR estimates, no alternative to exogenous methods has been found and the Schwartz´s formula based on height, creatinine and an empirically derived constant is still recommended for GFR estimation in children. However, the inclusion of BCM as a possible variable in a CysC-based prediction model has not yet been explored. As CysC is produced at a constant rate from all nucleated cells we hypothesize that including BCM in a new prediction model will increase accuracy of the GFR estimate. Study I aimed at deriving the new GFR-prediction model based on the novel theory of CysC and BCM and comparing the performance to previously published models. The BCM-model took the form GFR (mL/min) = 10.2 × (BCM/CysC)E 0.40 × (height × body surface area/Crea)E 0.65. The model predicted 99% within ± 30% of reference GFR, and 67% within ±10%. This was higher than any other model. The present model also had the highest R E2 and the narrowest 95

  9. N-acetyl-seryl-aspartyl-lysyl-proline attenuates renal injury and dysfunction in hypertensive rats with reduced renal mass: council for high blood pressure research.

    Science.gov (United States)

    Liao, Tang-Dong; Yang, Xiao-Ping; D'Ambrosio, Martin; Zhang, Yanlu; Rhaleb, Nour-Eddine; Carretero, Oscar A

    2010-02-01

    N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) is a naturally occurring peptide of which the plasma concentration is increased 4- to 5-fold by angiotensin-converting enzyme inhibitors. We reported previously that, in models of both hypertension and postmyocardial infarction, Ac-SDKP reduces cardiac inflammation and fibrosis. However, it is unknown whether Ac-SDKP can prevent or reverse renal injury and dysfunction in hypertension. In the present study, we tested the hypothesis that, in rats with 5/6 nephrectomy (5/6Nx)-induced hypertension, Ac-SDKP reduces renal damage, albuminuria, and dysfunction by decreasing inflammatory cell infiltration and renal fibrosis and by increasing nephrin protein. Ac-SDKP (800 microg/kg per day, SC via osmotic minipump) or vehicle was either started 7 days before 5/6Nx (prevention) and continued for 3 weeks or started 3 weeks after 5/6Nx (reversal) and continued for another 3 weeks. Rats with 5/6Nx developed high blood pressure, left ventricular hypertrophy, albuminuria, decreased glomerular filtration rate, and increased macrophage infiltration (inflammation) and renal collagen content (fibrosis). Ac-SDKP did not affect blood pressure or left ventricular hypertrophy in either group; however, it significantly reduced albuminuria, renal inflammation, and fibrosis and improved glomerular filtration rate in both prevention and reversal groups. Moreover, slit diaphragm nephrin protein expression in the glomerular filtration barrier was significantly decreased in hypertensive rats. This effect was partially prevented or reversed by Ac-SDKP. We concluded that Ac-SDKP greatly attenuates albuminuria and renal fibrosis and improves renal function in rats with 5/6Nx. These effects may be related to decreased inflammation (macrophages) and increased nephrin protein.

  10. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys......) aged 2-14 years. GFR was 14-147 mL/min/1.73m2. BCM was estimated using bioimpedance spectroscopy. Log-transformed data on BCM/CysC, serum creatinine (SCr), body-surface-area (BSA), height×BSA/SCr, CysC, weight, sex, age, height, serum urea and albumin were considered possible explanatory variables...

  11. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys......) aged 2-14 years (mean 8.8 years). GFR was 14-147 mL/min/1.73m2 (mean 97 mL/min/1.73m2). BCM was estimated using bioimpedance spectroscopy (Xitron Hydra 4200). Log-transformed data on BCM/CysC, serum creatinine (SCr), body-surface-area (BSA), height x BSA/SCr, serum CysC, weight, sex, age, height, serum...

  12. Laparoscopic Nephrectomy with Adrenalectomy for Synchronous Adrenal Myelolipoma and Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Kallappan Senthil

    2015-01-01

    Full Text Available Introduction. Adrenal myelolipomas are uncommon nonfunctioning tumors of the adrenal. Synchronous renal cell carcinomas with adrenal myelolipomas are very rare. We present the case report of adrenal myelolipoma with synchronous RCC managed laparoscopically. Case Report. A 60-year-old old gentleman presented with incidental right upper polar mass with right adrenal mass. Metastatic work-up was negative. Laparoscopic radical nephrectomy with adrenalectomy was done under general anesthesia. The biopsy report was right kidney clear cell adenocarcinoma (T1b with right adrenal myelolipoma. Conclusion. This is the first case report of laparoscopic adrenalectomy with nephrectomy for ipsilateral synchronous renal cell carcinoma with adrenal myelolipoma.

  13. Botryoid-type of embryonal rhabdomyosarcoma of renal pelvis in a young woman

    Directory of Open Access Journals (Sweden)

    A Kaabneh

    2014-01-01

    Full Text Available A 22-year-old woman presented with three weeks history of intermittent left loin pain, on radiological evaluation by U\\S and MRI revealed left renal pelvic mass, ureterorenoscopy and biopsy taken, but couldn′t reveal definitive diagnosis other than presence of a malignant process. Left nephroureterctomy was performed. Grossly there is a polypoid mass attached to the upper pole of the kidney by stalk. Light microscopic examination and immunohistochemical staining confirm a diagnosis of Botryoid-type of embryonal rhabdomyosarcoma. Treatment and follow up to 1 year is mentioned. Reviewing the literature the presented case is the second of this tumor in adult renal pelvis.

  14. Renal inflammatory myofibroblastic tumor

    DEFF Research Database (Denmark)

    Heerwagen, S T; Jensen, C; Bagi, P

    2007-01-01

    Renal inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor of controversial etiology with a potential for local recurrence after incomplete surgical resection. The radiological findings in renal IMT are not well described. We report two cases in adults with a renal mass treated...

  15. Detection of apoptosis in kidney biopsies of patients with D+ hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Loo, D.M.W.M. te; Monnens, L.A.H.; Heuvel, L.P.W.J. van den; Gubler, M.C.; Kockx, M.M.

    2001-01-01

    In this study we have investigated the presence of apoptotic cells in renal biopsy material of seven patients with hemolytic uremic syndrome (HUS) by using an improved and stringent terminal deoxynucleotidyl nick-end labeling (TUNEL) technique. Renal biopsy material was taken in the second or third

  16. 肾穿刺活检术后出血合并急性精神障碍患者的原因分析及护理%Postoperative hemorrhage complicating acute renal biopsy analysis of the causes of mental disorders and nursing

    Institute of Scientific and Technical Information of China (English)

    赵丽芳

    2015-01-01

    Objective Explore postoperative hemorrhage complicating acute renal biopsy disorder causes and nursing measures to reduce the occurrence of postoperative complications and improve quality of care. Methods In May 2013 to October 2014 of 4 cases of renal biopsy admitted in our department an analysis of the causes of postoperative hemorrhage complicating acute mental disorders, and effective nursing intervention, the drug therapy. Results Carefully, treatment and nursing care of patients were cured in 4 patients. Conclusions Renal biopsy is not only focus on common postoperative complication of nursing, and should pay attention to patients' mental nursing, preventing the psychological problems affect the progress of the disease.%目的:探讨肾穿刺活检术后出血合并急性精神障碍发生的原因及护理措施,减少术后并发症的发生,提升护理质量。方法:对2013年5月至2014年10月我科收治的4例肾穿刺活检术后出血合并急性精神障碍患者进行原因分析,并进行有效的护理干预,药物治疗。结果:经过精心的治疗护理,4例患者均治愈。结论:肾穿刺活检术后不仅关注常见的并发症的护理,而且要注重患者心理精神的护理,防止因心理问题影响疾病的发展。

  17. Collaborative Review of Risk Benefit Trade-offs Between Partial and Radical Nephrectomy in the Management of Anatomically Complex Renal Masses.

    Science.gov (United States)

    Kim, Simon P; Campbell, Steven C; Gill, Inderbir; Lane, Brian R; Van Poppel, Hein; Smaldone, Marc C; Volpe, Alessandro; Kutikov, Alexander

    2017-07-01

    While partial nephrectomy (PN) is the recommended treatment for many small renal masses, anatomically complex tumors necessitate a clear understanding of the potential risks and benefits of PN and radical nephrectomy (RN). To critically review the comparative effectiveness evidence of PN versus RN; to describe key trade-offs involved in this treatment decision; and to highlight gaps in the current literature. A collaborative critical review of the medical literature was conducted. Patients who undergo PN for an anatomically complex or large mass may be exposed to perioperative and potential oncologic risks that could be avoided if RN were performed, while patients who undergo RN may forgo long-term benefits of renal preservation. Decision-making regarding the optimal treatment with PN or RN among patients with anatomically complex or large renal mass is highly nuanced and must balance the risks and benefits of each approach. Currently, high-quality evidence on comparative effectiveness is sparse. Retrospective comparisons are plagued by selection biases, while the one existing prospective randomized trial, albeit imperfect, suggests that nephron-sparing surgery may not benefit all patients. For anatomically complex tumors, PN preserves renal parenchyma but may expose patients to higher perioperative risks than RN. The risks and benefits of each surgical approach must be better objectified for identification of patients most suitable for complex PN. A prospective randomized trial is warranted and would help in directing patient counseling. Treatment decisions for complex renal masses require shared decision-making regarding the risk trade-offs between partial and radical nephrectomy. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  18. Analysis of renal cyst of high density containing proteinaceous fluid: report of 6 cases

    Institute of Scientific and Technical Information of China (English)

    Jin Wen; Han zhong Li; He Xiao

    2008-01-01

    Objective:To investigate clinical features and imageology of renal cysts of high density, containing proteinaceous fluid and increase the diagnosis and treatment level of this special type renal cyst. Methods:Six cases were proven to be renal cysts of high density(pathologically) from 2002 to 2007 were reviewed. Among 6 cases, 1 was in the upper pole of kidney, 4 were medial and 1 was located in the anus perineum. All were 2-5 cm in size. Ultrasonography(US) excretory unognaphy, multiphase CT and renal angiography DSA imaging was performed for preoperative diagnosis. The preoperative diagnosis found renal neoplasms in 4 and renal cysts in 2. All of them were operated by partial nephrectomy. Results:All of the 6 renal high density renal masses were reseoted surgically, which were proved pathologically to be renal cysts; high density present. All of them contained proteinaceous fluid with benign cyst walls on histologic examination. No recurrence was seen in any of these cases during a long follow-up. Conclusion:CT and B-US have a higher diagnostic value, which can show the internal shape and character better. B-US or CT guided puncturing biopsy can be better applied to atypical renal cysts. Once the correct diagnosis is acquired, laparoscopic surgical treatment should be carried out.

  19. Influencing Factors Analysis and Interventions of Psychological Status in Children with Percutaneous Renal Biopsy%肾穿刺活检儿童心理状态的影响因素分析及其干预

    Institute of Scientific and Technical Information of China (English)

    刘旭; 庞礼娟; 史佩佩; 宋学勤

    2011-01-01

    Objective To study the influencing tactors and interventions ot psychological status in children with percutaneous renal biopsy(PRB). Methods Two hundred and twenty -eight children were divided into control group and intervention group randomly. Before and after PRB, the screen for children Anxiety Related Emotional Disorder ( SCARED ), Depression Self - Rating Scale for Children ( DSRSC ),Symptom Check List - 90 ( SCL - 90) and basic intormations list were filled in by all 228 children with the help of their parents. Of tbe total 114 children in intervention group were increased psychological intervention before PRB. To evaluate the psychological status of patients, the differences in psychological changes between the control group and intervention group before and after renal biopsy were compared, then the factors that affect the psychology of patiens were analyzed. Results Before PRB ( before psychological intervention ), the scores of the SCARED in control group was ( 52.34 ± 15.83 ) scores and intervention group was ( 50.73 ± 14.97 ) scores, they were all higher than that of the domestic routine model [ (39.94 ± 12.55 ) scores]. The SCARED total score decreased after talking and psychological intervention before PRB; the intervention group's change of the SCARED scores between preoperative and after surgery was higher than that of the control group,but the DSRSC scores' differences between groups( including control group and intervention group) and domestic routine model before and after PRB were not significant. The anxiety symptoms were significantly related to the children's age ,the place the family belonging to, and parents' educational background. The scores of sonatical change, anxiety, hostility and phobias were higher than domestic routine model before and after PRB,but the scores of anxiety, hostility and phobias were decreased after PRB than before. Anxiety,hostility and phobias, the intervention group's score differences before and after PRB

  20. Basics of kidney biopsy: A nephrologist′s perspective

    Directory of Open Access Journals (Sweden)

    S K Agarwal

    2013-01-01

    Full Text Available The introduction of the kidney biopsy is one of the major events in the history of nephrology. Primary indications of kidney biopsy are glomerular hematuria/proteinuria with or without renal dysfunction and unexplained renal failure. Kidney biopsy is usually performed in prone position but in certain situations, supine and lateral positions may be required. Biopsy needles have changed with times from Vim-Silverman needle to Tru-cut needle to spring-loaded automatic gun. The procedure has also changed from blind bedside kidney biopsy to ultrasound marking to real-time ultrasound guidance to rarely computerized tomography guidance and laparoscopic and open biopsy. In very specific situations, transjugular kidney biopsy may be required. Most of the centers do kidney biopsy on short 1-day admission, whereas some take it as an outdoor procedure. For critical interpretation of kidney biopsy, adequate sample and clinical information are mandatory. Tissue needs to be stained with multiple stains for delineation of various components of kidney tissue. Many consider that electron microscopy (EM is a must for all kidney biopsies, but facilities for EM are limited even in big centers. Sophisticated tests such as immunohistochemistry and in-situ hybridization are useful adjuncts for definitive diagnosis in certain situations.

  1. Sentinel node biopsy (image)

    Science.gov (United States)

    Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a ... is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, ...

  2. Mediastinoscopy with biopsy

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003864.htm Mediastinoscopy with biopsy To use the sharing features on this page, please enable JavaScript. Mediastinoscopy with biopsy is a procedure in which a lighted instrument ( ...

  3. Sentinel Lymph Node Biopsy

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    ... Ask about Your Diagnosis Research Sentinel Lymph Node Biopsy On This Page What are lymph nodes? What ... lymph node? What is a sentinel lymph node biopsy? What happens during an SLNB? What are the ...

  4. Nerve biopsy (image)

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    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  5. Salivary gland biopsy

    Science.gov (United States)

    ... also be performed to diagnose diseases such as Sjogren syndrome . How to Prepare for the Test There is ... few days after the biopsy. The biopsy for Sjogren syndrome requires an injection of the anesthetic in the ...

  6. Percutaneous liver biopsy.

    Science.gov (United States)

    Rustagi, Tarun; Newton, Eric; Kar, Premashish

    2010-01-01

    Percutaneous liver biopsy has been performed for more than 120 years, and remains an important diagnostic procedure for the management of hepatobiliary disorders. Modern biochemical, immunologic, and radiographic techniques have facilitated the diagnosis and management of liver diseases but have not made liver biopsy obsolete. This comprehensive review article will discuss the history of development of percutaneous liver biopsy, its indications, contraindications, complications and the various aspects of the biopsy procedure in detail.

  7. Biopsy (For Parents)

    Science.gov (United States)

    ... Teaching Kids to Be Smart About Social Media Biopsy KidsHealth > For Parents > Biopsy Print A A A What's in this article? ... Questions en español Biopsias What It Is A biopsy is a test that's performed to examine tissue ...

  8. MR angiography versus color Doppler sonography in the evaluation of renal vessels and the inferior vena cava in abdominal masses of pediatric patients.

    Science.gov (United States)

    Pfluger, T; Czekalla, R; Hundt, C; Schubert, M; Graubner, U; Leinsinger, G; Scheck, R; Hahn, K

    1999-07-01

    Involvement of renal vessels and the inferior vena cava (IVC) plays a decisive role during operative planning for removal of abdominal masses in pediatric patients. Advantages and limitations of MR angiography and color Doppler sonography for determining these factors were evaluated. MR angiography and color Doppler sonography were performed preoperatively in 42 neonates, infants, and children with abdominal masses and were compared with spin-echo MR imaging and with surgical findings. Variables evaluated were anatomic variants, vessel displacement, patency of vessels, collateral circulation, and intravascular tumor extension. Quality of vessel visualization was assessed in vessels not affected by tumor. In 88% of unaffected renal vessels, the entire vessel course could be visualized on MR angiography compared with 58% on color Doppler sonography and 43% on spin-echo MR imaging. In four of nine cases, color Doppler sonography revealed an accessory renal artery, whereas MR angiography revealed these variants in seven of nine cases. MR angiography showed 79% and color Doppler sonography 66% of displaced vessels. Unlike MR angiography, color Doppler sonography did not reveal five stenotic renal veins because they could not be completely imaged. In two cases, however, MR angiography falsely indicated an occlusion of the IVC, whereas color Doppler sonography showed residual flow. Anatomic variants, vessel displacement, collateral circulation, and neoplastic vessel infiltration were revealed more accurately by MR angiography than by color Doppler sonography. In cases in which patency of the IVC is unclear on MR angiography, color Doppler sonography should also be performed.

  9. Effect of Lowering Asymmetric Dimethylarginine (ADMA on Vascular Pathology in Atherosclerotic ApoE-Deficient Mice with Reduced Renal Mass

    Directory of Open Access Journals (Sweden)

    Johannes Jacobi

    2014-03-01

    Full Text Available The purpose of the work was to study the impact of the endogenous nitric oxide synthase (NOS inhibitor asymmetric dimethylarginine (ADMA and its degrading enzyme, dimethylarginine dimethylaminohydrolase (DDAH1, on atherosclerosis in subtotally nephrectomized (SNX ApoE-deficient mice. Male DDAH1 transgenic mice (TG, n = 39 and C57Bl/6J wild-type littermates (WT, n = 27 with or without the deletion of the ApoE gene underwent SNX at the age of eight weeks. Animals were sacrificed at 12 months of age, and blood chemistry, as well as the extent of atherosclerosis within the entire aorta were analyzed. Sham treated (no renal mass reduction ApoE-competent DDAH1 transgenic and wild-type littermates (n = 11 served as a control group. Overexpression of DDAH1 was associated with significantly lower ADMA levels in all treatment groups. Surprisingly, SNX mice did not exhibit higher ADMA levels compared to sham treated control mice. Furthermore, the degree of atherosclerosis in ApoE-deficient mice with SNX was similar in mice with or without overexpression of DDAH1. Overexpression of the ADMA degrading enzyme, DDAH1, did not ameliorate atherosclerosis in ApoE-deficient SNX mice. Furthermore, SNX in mice had no impact on ADMA levels, suggesting a minor role of this molecule in chronic kidney disease (CKD in this mouse model.

  10. Small renal masses: The molecular markers associated with outcome of patients with kidney tumors 7 cm or less

    Science.gov (United States)

    Spirina, L. V.; Usynin, Y. A.; Kondakova, I. V.; Yurmazov, Z. A.; Slonimskaya, E. M.; Pikalova, L. V.

    2016-08-01

    The investigation of molecular mechanisms of tumor cell behavior in small renal masses is required to achieve the better cancer survival. The aim of the study is to find molecular markers associated with outcome of patients with kidney tumors 7 cm or less. A homogenous group of 20 patients T1N0M0-1 (mean age 57.6 ± 2.2 years) with kidney cancer was selected for the present analysis. The content of transcription and growth factors was determined by ELISA. The levels of AKT-mTOR signaling pathway components were measured by Western blotting analysis. The molecular markers associated with unfavorable outcome of patients with kidney tumors 7 cm or less were high levels of NF-kB p50, NF-kB p65, HIF-1, HIF-2, VEGF and CAIX. AKT activation with PTEN loss also correlated with the unfavorable outcome of kidney cancer patients with tumor size 7 cm or less. It is observed that the biological features of kidney cancer could predict the outcome of patients.

  11. Body mass index and risk of renal cell cancer: a dose-response meta-analysis of published cohort studies.

    Science.gov (United States)

    Wang, Furan; Xu, Yinghua

    2014-10-01

    Obesity is accepted as one of the major risk factors for renal cell cancer (RCC). However, conflicting results persist for the pooled risks based on the results from case-control and cohort studies combined, and the exact shape of the dose-response relationship has not been clearly defined yet. To help elucidate the role of obesity, PubMed and Embase databases were searched for published cohort studies on associations between body mass index (BMI) and risk of RCC. Random-effects models and dose-response meta-analyses were used to pool study results. Subgroup analyses were conducted by the available characteristics of studies and participants. Cohort studies (21) with 15,144 cases and 9,080,052 participants were identified. Compared to normal weight, the pooled relative risks and the corresponding 95% confidence intervals of RCC were 1.28(1.24-1.33) for preobesity and 1.77(1.68-1.87) for obesity, respectively. A nonlinear dose-response relationship was also found for RCC risk with BMI (p = 0.000), and the risk increased by 4% for each 1 kg/m(2) increment in BMI. There was no significant between-study heterogeneity among studies (I(2) = 35.6% for preobesity and I(2) = 44.2% for obesity, respectively). Subgroup analysis showed a basically consistent result with the overall analysis. These results suggest that increased BMI are associated with increased risk of RCC both for men and women. © 2014 UICC.

  12. The diagnostic value of contrast-enhanced CT in Acute bilateral renal cortical necrosis: a case report

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    Choi, Pil Youb; Lee, Su Han; Lee, Woo Dong [Masan Samsung General Hospital, Seoul (Korea, Republic of)

    1996-11-01

    Acute renal cortical necrosis in which there is destruction of the renal cortex and sparing of the renal medulla, is a relatively rare cause of acute renal failure. A definitive diagnosis of acute renal cortical necrosis is based on renal biopsy, but on CT(computed tomography) the rather specific contrast-enhanced appearance of acute renal cortical necrosis has been described. As renal biopsy is not available, contrast-enhanced CT is a useful, noninvasive investigate modality for the early diagnosis of acute renal cortical necrosis. We report the characteristic CT findings of acute renal cortical necrosis in a patient with acute renal failure following an operation for abdominal trauma.

  13. Malignant renal tumors in children

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    Justin Scott Lee

    2015-05-01

    Full Text Available Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma. 

  14. Preeclampsia or initial diagnosis of chronic renal disease during pregnancy.

    Science.gov (United States)

    Iavazzo, C; Kalmantis, K; Bozemberg, T; Ntziora, F; Ioakeimidis, A; Paschalinopoulos, D

    2008-01-01

    An unusual case of early nephrotic syndrome without hypertension which slightly resolved after delivery is documented. Renal biopsy was performed postpartum and the diagnosis was focal and segmental glomerulosclerosis with moderate chronic renal changes. It is questioned whether the case was due to preeclampsia or was the initial diagnosis of chronic renal disease which was made during pregnancy. The role of renal biopsy in such cases is briefly discussed (Tab. 2, Ref. 15). Full Text (Free, PDF) www.bmj.sk.

  15. Ultrasonographic manifestations of rare renal inflammatory mass%肾脏罕见炎性肿块患者超声表现

    Institute of Scientific and Technical Information of China (English)

    黄思; 肖萤

    2012-01-01

    Objective To analyze the ultrasonographic manifestations of inflammatory mass in the rare diseases of xanthogranulomatous pyelonephritis and renal inflammatory pseudotumor. Methods Four patients with asxanthogranulomatous pyelonephritis and 2 with renal inflammatory pseudotumor underwent ultrasonography in our hospital between 2004 and 2011. The clinical data and ultrasound features were retrospectively reviewed,including mass size, shape, boundary, echogenecity and internal blood supply. All the results were confirmed by pathology. Renal transparent cell carcinoma was also identified in one case by pathology. Results According to ultrasonography, the mass of xanthogranulomatous pyelonephritis and renal inflammatory pseudotumor were mostly irregular in shape, with clear or fuzzy boundaries, predominantly hypo-, equal- or hyper-echoic masses. Some mass had hyperecho clumps with acoustic shadow. Color Doppler imaging showed a hypervascularized mass. No liquid or necrosis were found in them. Two lesions were diagnosed as benign, 1 was malignant, and 2 cases were uncertain. One cases was misdiagnosed as renal tuberculosis or renal teratoma. Conclusions The rare renal inflammatory mass presents some common, but not specific ultrasound features. Ultrasound is helpful for the differential diagnosis of renal inflammatory mass.%目的 总结肾脏罕见的黄色肉芽肿性肾盂肾炎(XGP)及肾脏炎性假瘤(RIP)患者肾脏炎性肿块的超声表现.方法 回顾性分析2004-2011年我院收治的4例XGP及2例RIP患者的超声声像图特征,包括肿块大小、肿块形态、边界、回声强弱及局限性回声改变、内部血流等情况.6例肾脏罕见炎性肿块患者均经术后病理证实,且1例患者合并肾早期透明细胞癌.结果 6例肾脏罕见炎性肿块超声声像图多表现为形态不规则、边界清或不清、内部以低回声为主或中等回声为主或强回声为主,肿块伴有强回声团伴声影,部分肿块内血流

  16. Delayed mTOR inhibition with low dose of everolimus reduces TGFβ expression, attenuates proteinuria and renal damage in the renal mass reduction model.

    Directory of Open Access Journals (Sweden)

    Melania Kurdián

    Full Text Available BACKGROUND: The immunosuppressive mammalian target of rapamycin (mTOR inhibitors are widely used in solid organ transplantation, but their effect on kidney disease progression is controversial. mTOR has emerged as one of the main pathways regulating cell growth, proliferation, differentiation, migration, and survival. The aim of this study was to analyze the effects of delayed inhibition of mTOR pathway with low dose of everolimus on progression of renal disease and TGFβ expression in the 5/6 nephrectomy model in Wistar rats. METHODS: This study evaluated the effects of everolimus (0.3 mg/k/day introduced 15 days after surgical procedure on renal function, proteinuria, renal histology and mechanisms of fibrosis and proliferation. RESULTS: Everolimus treated group (EveG showed significantly less proteinuria and albuminuria, less glomerular and tubulointerstitial damage and fibrosis, fibroblast activation cell proliferation, when compared with control group (CG, even though the EveG remained with high blood pressure. Treatment with everolimus also diminished glomerular hypertrophy. Everolimus effectively inhibited the increase of mTOR developed in 5/6 nephrectomy animals, without changes in AKT mRNA or protein abundance, but with an increase in the pAKT/AKT ratio. Associated with this inhibition, everolimus blunted the increased expression of TGFβ observed in the remnant kidney model. CONCLUSION: Delayed mTOR inhibition with low dose of everolimus significantly prevented progressive renal damage and protected the remnant kidney. mTOR and TGFβ mRNA reduction can partially explain this anti fibrotic effect. mTOR can be a new target to attenuate the progression of chronic kidney disease even in those nephropathies of non-immunologic origin.

  17. Renal MALT lymphoma associated with Waldenström macroglobulinemia.

    Science.gov (United States)

    Chi, Po-Jui; Pei, Sung-Nan; Huang, Tung-Liang; Huang, Shun-Chen; Ng, Hwee Yeong; Lee, Chien-Te

    2014-04-01

    Mucosa associated lymphoid tissue lymphoma (MALT lymphoma) is mostly seen in the gastrointestinal tract; origin from the kidney is extremely rare. Waldenström macroglobulinemia (WM) is a clinicopathologic syndrome denoted by the presence of monoclonal gammopathy in the serum, typically caused by lymphoproliferative disorder. Literature review did not find any report of renal MALT lymphoma accompanied by WM. Herein, for the first time, we report a 72 year-old female patient with a history of chronic kidney disease, presenting with solitary renal mass; MALT lymphoma was confirmed by pathological examination. A serology study identified the presence of WM. No manifestation of hyperviscosity syndrome was noted. Bone marrow biopsy disclosed the concurrent systemic involvement. Her treatment response was uneventful and the renal mass responded with regressive change in size after chemotherapy. The renal function remained stable during follow-up. MALT lymphoma should be considered as an underlying pathology of isolated renal mass. Furthermore, patients with MALT lymphoma should be screened for Waldenström macroglobulinemia and hyperviscosity syndrome.

  18. Three-Dimensional Printing as an Interdisciplinary Communication Tool: Preparing for Removal of a Giant Renal Tumor and Atrium Neoplastic Mass.

    Science.gov (United States)

    Golab, Adam; Slojewski, Marcin; Brykczynski, Miroslaw; Lukowiak, Magdalena; Boehlke, Marek; Matias, Daniel; Smektala, Tomasz

    2016-08-22

    Three-dimensional (3D) printing involves preparing 3D objects from a digital model. These models can be used to plan and practice surgery. We used 3D printing to plan for a rare complicated surgery involving the removal of a renal tumor and neoplastic mass, which reached the heart atrium. A printed kidney model was an essential element of communication for physicians with different specializations.

  19. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses sound waves ... Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast are often ...

  20. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  1. Abdominal wall fat pad biopsy

    Science.gov (United States)

    Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... method of taking an abdominal wall fat pad biopsy . The health care provider cleans the skin on ...

  2. Needle Biopsy of the Lung

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Needle Biopsy of the Lung Needle biopsy of the lung ... Needle Biopsy of Lung Nodules? What is Needle Biopsy of the Lung? A lung nodule is relatively ...

  3. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy ... limitations of Ultrasound-Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the ...

  4. [Bilateral Granulomatous Renal Masses after Intravesical BCG Therapy for Non-muscle-invasive Bladder Cancer and Carcinoma in Situ of the Upper Urinary Tract: A Case Study].

    Science.gov (United States)

    Higashioka, Kazuhiko; Miyake, Noriko; Nishida, Ruriko; Chong, Yong; Shimoda, Shinji; Shimono, Nobuyuki

    2015-07-01

    Bacillus Calmette-Guèrin (BCG) is commonly used not only as an infant vaccination, but also as a treatment of and prophylaxis to prevent recurrence in the management of non-muscle-invasive bladder cancer. However, the use of "live" BCG is sometimes complicated by associated infection. We present a case study of a 77-year-old man who developed bilateral renal masses after intravesical BCG therapy was initiated in November 2013, following transurethral resection of non-muscle-invasive bladder cancer. After four courses of BCG (Japan strain, 80 mg per treatment) instillations, a computed tomography examination for febrile episodes showed multiple bilateral renal masses, accompanied by a histological finding of a granulomatous reaction. An acid fast bacterium was cultured from only urine among blood, urine, and microscopic samples. Using the cultured strain, BCG infection was confirmed by the specific gene deletion pattern based on allele-specific polymerase chain reaction analysis. Anti-tuberculosis treatment, including isoniazid (300 mg/day), rifampicin (600 mg/day), and ethambutol (1,000 mg/day), was started for the BCG-related renal granuloma in February 2014. After 3 months, antibiotic therapy was discontinued owing to severe appetite loss, though the masses remained solid. No rapid growth has been detected after anti-BCG therapy. Intravesical BCG therapy is recommended worldwide as one of standard treatments for non-muscle-invasive bladder cancer. We should closely observe patients undergoing this approach for emerging BCG complications.

  5. Kidney Biopsy in Jordan: Complications and Histopathological Findings

    Directory of Open Access Journals (Sweden)

    Ghnaimat Mohamad

    1999-01-01

    Full Text Available In this retrospective study, we reviewed the medical records, and histopathology findings of 191 patients who underwent renal biopsies at King Hussein Medical Center (KHMC during a four-year period (1993-97. All were performed using Tru-Cut needles under ultrasound guidance. There were 119 males (62.3% and 72 females (37.7%; the mean age was 29.1 years (range 5-76 years. Side effects of the renal biopsies included pain at the site of he biopsy in 17 (8.9%, gross hematuria in six (3.1% and hematuria requiring blood transfusion in one (0.5% patient. Nephrotic syndrome was the most common indication for biopsy followed by acute renal failure of unknown etiology. Among the nephritic patients, minimal change disease and post-infectious glomerulonephritis (GN were the commonest findings in children below the age of 15 years, membrano-proliferative GN ranked first in adults whole membranous GN and amyloidosis were more common in the elderly. WE conclude that renal biopsy was associated with a n acceptably low rate of complications in our practice, and that the patterns of renal histology vary slightly from those reported from other countries.

  6. Body mass index is inversely associated with mortality in patients with acute kidney injury undergoing continuous renal replacement therapy

    Directory of Open Access Journals (Sweden)

    Hyoungnae Kim

    2017-03-01

    Full Text Available Background: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT. Thus, we aimed to investigate whether obesity can provide a survival benefit in this highly catabolic condition. Methods: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. The study end point was defined as death that occurred within 30 days after the initiation of CRRT. Results: Patients were categorized into three groups according to tertiles of body mass index (BMI. During ≥30 days after the initiation of CRRT, 39 patients (57.4% in the highest tertile died, as compared with 58 patients (78.4% in the lowest tertile (P = 0.02. In a multivariable analysis adjusted for cofounding factors, the highest tertile of BMI was significantly associated with a decreased risk of death (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.37–0.87; P = 0.01. This significant association remained unaltered for 60-day (HR, 0.64; 95% CI, 0.43–0.94; P = 0.03 and 90-day mortality (HR, 0.66; 95% CI, 0.44–0.97; P = 0.03. Conclusion: This study showed that a higher BMI confer a survival benefit over a lower BMI in AKI patients undergoing CRRT.

  7. Analysis of bone biopsies.

    Science.gov (United States)

    Goodrich, J A; Difiore, R J; Tippens, J K

    1983-11-01

    The orthopedic surgeon is frequently confronted with the decision of when to perform a bone biopsy and whether to do a needle biopsy or an open biopsy. Frequently consultations are received from other services requesting bone biopsies with questionable indications. The indications and contraindications for performing bone biopsies are discussed as well as advantages and disadvantages of either closed or open technique. Four selective cases are discussed with illustrations. The challenge of undiagnosed osseous lesions is best met by rational evaluation of each individual case and coordinated with the team effort of the primary care physician, surgeon, pathologist, and radiologist. The decision for either an open or closed biopsy technique must be based on the experience and skills of the surgeon and pathologist.

  8. [Bacteria isolated from urine and renal tissue samples and their relation to renal histology].

    Science.gov (United States)

    Gökalp, A; Gültekin, E Y; Bakici, M Z; Ozdeşlik, B

    1988-01-01

    The bacteria from the urine and renal biopsy specimens of 40 patients undergoing renal surgery were isolated and their relations with renal histology investigated. The urine cultures were positive in 14 patients, the same organisms being isolated from the renal tissue in 7 cases. In 6 patients with negative urine cultures, bacteria were isolated from renal tissues. Of the 28 cases pathologically diagnosed as chronic pyelonephritis, bacteria were isolated from the renal tissue in 13 cases, the urine cultures being positive in only 11 cases. E. coli was the most commonly encountered bacteria in both the urine and renal tissues.

  9. Diagnostic utility of kidney biopsy in patients with sarcoidosis and acute kidney injury

    Directory of Open Access Journals (Sweden)

    Nadasdy T

    2011-09-01

    Full Text Available Ravish Shah1, Ganesh Shidham1, Anil Agarwal1, Alia Albawardi2, Tibor Nadasdy21Division of Nephrology, 2Division of Renal Pathology, The Ohio State University, Columbus, Ohio, USABackground: Sarcoidosis is an idiopathic multisystem disease characterized by noncaseating granulomatous inflammation. Renal biopsy is often performed to evaluate the patient with sarcoidosis and acute kidney injury (AKI. Diagnosis rests on the demonstration of noncaseating granulomas and exclusion of other causes of granulomatous inflammation. This paper reports a patient with pulmonary sarcoidosis and AKI whose renal function improved after prednisone therapy despite the absence of kidney biopsy findings characteristic of sarcoidosis.Case report: A 63-year-old Caucasian male with history of hypertension was treated for pulmonary sarcoidosis with a 6-month course of prednisone. His creatinine was 1.6 mg/dL during the course. Two months after finishing treatment, he presented with creatinine of 4 mg/dL. A kidney biopsy was performed, which showed nonspecific changes without evidence of granuloma or active interstitial inflammation. He was empirically started on prednisone for presumed renal sarcoidosis, even with a nondiagnostic kidney biopsy finding. Within a month of treatment, his serum creatinine improved to 2 mg/dL, though not to baseline. He continues to be stable on low-dose prednisone. With this case as a background, we aimed to determine the incidence of inconclusive kidney biopsies in patients with sarcoidosis presenting with AKI and to identify the various histological findings seen in this group of patients.Methods: In this retrospective study, all patients who had native renal biopsies read at The Ohio State University over the period of 6 years were identified. Those patients with a diagnosis of sarcoidosis, presenting with AKI, were included for further review.Results: Out of 21 kidney biopsies done in patients with sarcoidosis over a period of 6 years

  10. Role of multiphasic multi-detector computed tomography (MDCT in the diagnosis and staging of solid neoplastic renal masses

    Directory of Open Access Journals (Sweden)

    Manal H. Wahba

    2015-03-01

    Conclusion: Multiphase multislice computed tomography combined with CT angiography and CT urography have a major role in solid renal neoplastic masses’ diagnosis, characterization and differentiating benign and malignant tumors.

  11. Appropriateness of Liver Biopsy

    OpenAIRE

    Thierry Poynard; Vlad Ratziu; Pierre Bedossa

    2000-01-01

    This review aims to discuss the appropriateness of liver biopsy in two frequent liver diseases, hepatitis C and alcoholic liver disease. The medical literature, published between 1965 and 1999, was reviewed by using MEDLINE. Only 0.1% of the publications were devoted specifically to the appropriateness of liver biopsy. Not all studies observed a significant agreement among doctors on the decision to use liver biopsy. Therefore, there is a possibility that hepatologists have significant, heter...

  12. Open lung biopsy

    Science.gov (United States)

    ... CT scan Disseminated tuberculosis Granulomatosis with polyangiitis Lung cancer - small cell Lung disease Lung needle biopsy Malignant mesothelioma Pulmonary tuberculosis Rheumatoid lung disease Sarcoidosis Simple pulmonary eosinophilia ...

  13. Geometric systematic prostate biopsy.

    Science.gov (United States)

    Chang, Doyoung; Chong, Xue; Kim, Chunwoo; Jun, Changhan; Petrisor, Doru; Han, Misop; Stoianovici, Dan

    2017-04-01

    The common sextant prostate biopsy schema lacks a three-dimensional (3D) geometric definition. The study objective was to determine the influence of the geometric distribution of the cores on the detection probability of prostate cancer (PCa). The detection probability of significant (>0.5 cm(3)) and insignificant (geometric distribution of the cores was optimized to maximize the probability of detecting significant cancer for various prostate sizes (20-100cm(3)), number of biopsy cores (6-40 cores) and biopsy core lengths (14-40 mm) for transrectal and transperineal biopsies. The detection of significant cancer can be improved by geometric optimization. With the current sextant biopsy, up to 20% of tumors may be missed at biopsy in a 20 cm(3) prostate due to the schema. Higher number and longer biopsy cores are required to sample with an equal detection probability in larger prostates. Higher number of cores increases both significant and insignificant tumor detection probability, but predominantly increases the detection of insignificant tumors. The study demonstrates mathematically that the geometric biopsy schema plays an important clinical role, and that increasing the number of biopsy cores is not necessarily helpful.

  14. 超声引导下经皮肺周围型肿块穿刺活检术的应用价值%Ultrasound Guided Percutaneous Lung Peripheral Mass Biopsy Application Value

    Institute of Scientific and Technical Information of China (English)

    樊文

    2013-01-01

    Objective: to study the ultrasound guided percutaneous lung peripheral mass biopsy of the clinical application value. Methods: between September 2010 and June 2010 in our hospital clinical and radiographic undiagnosed lung peripheral lesions in 48 patients with ultrasound guided by spring type automatic biopsy needle percutaneous lung biopsy, analysis the success rate of biopsy, pathological biopsy tissues and complications. Results: the overal success rate of puncture was 97.92%. Histopathological examination showed 6 cases squamous carcinoma, adenocarcinoma of 21 cases, 8 cases of smal cellcarcinoma, 2 cases of pleural mesothelioma, chronic inflammatory lesions in 6 cases, 4 cases of tuberculosis. This group of patients who appear pneumothorax in 1 case, postoperative haemoptysis in 2 cases, pleural reaction (3 cases), the incidence was 2.08%, 4.17% and 6.25%, respectively. Conclusion: ultrasound guided percutaneous lung puncture biopsy needle spring type automatic operation is simple, the biopsy puncture success rate is high, high accuracy, low complications, pulmonary disease has played an important role in the diagnosis and treatment, worthy of clinical popularization and application.%目的:探讨超声引导下经皮肺周围型肿块穿刺活检术的临床应用价值。方法2010年9月~2013年6月在我院住院的临床及影像学不能确诊的肺部周围性病变48例接受超声引导下弹簧式自动活检针经皮肺穿刺活检术,分析穿刺活检成功率、活检组织病理以及并发症的发生。结果本组总穿刺成功率为97.92%。组织病理学检查显示鳞癌6例,腺癌21例,小细胞癌8例,胸膜间皮瘤2例,慢性炎性病变6例,结核4例。本组患者术中出现气胸1例,术后出现咯血2例,出现胸膜反应3例,发生率分别为2.08%、4.17%和6.25%。结论超声引导下弹簧式自动活检针经皮肺穿刺术操作简便,活检穿刺成功率高、准确性高、并发症低,

  15. Proteomic approaches to the study of renal mitochondria.

    Science.gov (United States)

    Tuma, Zdenek; Kuncova, Jitka; Mares, Jan; Grundmanova, Martina; Matejovic, Martin

    2016-06-01

    Dysfunction of kidney mitochondria plays a critical role in the pathogenesis of a number of renal diseases. Proteomics represents an untargeted attempt to reveal the remodeling of mitochondrial proteins during disease. Combination of separation methods and mass spectrometry allows identification and quantitative analysis of mitochondrial proteins including protein complexes. The aim of this review is to summarize the methods and applications of proteomics to renal mitochondria. Using keywords "mitochondria", "kidney", "proteomics", scientific databases (PubMed and Web of knowledge) were searched from 2000 to August 2015 for articles describing methods and applications of proteomics to analysis of mitochondrial proteins in kidney. Included were publications on mitochondrial proteins in kidneys of humans and animal model in health and disease. Proteomics of renal mitochondria has been/is mostly used in diabetes, hypertension, acidosis, nephrotoxicity and renal cancer. Integration of proteomics with other methods for examining protein activity is promising for insight into the role of renal mitochondria in pathological states. Several challenges were identified: selection of appropriate model organism, sensitivity of analytical methods and analysis of mitochondrial proteome in different renal zones/biopsies in the course of various kidney disorders.

  16. Ductal carcinoma in situ diagnosed using an ultrasound-guided 14-gauge core needle biopsy of breast masses: can underestimation be predicted preoperatively?

    Directory of Open Access Journals (Sweden)

    Sung Hee Park

    2014-04-01

    Conclusion: We found a 30.4% rate of DCIS underestimation in breast masses based on a US-14G-CNB. The presence of abnormal lymph nodes as detected on axillary ultrasound may be useful to preoperatively predict underestimation.

  17. Usefulness of the ice-cream cone pattern in computed tomography for prediction of angiomyolipoma in patients with a small renal mass.

    Science.gov (United States)

    Kim, Kwang Ho; Yun, Bu Hyeon; Jung, Seung Il; Hwang, In Sang; Hwang, Eu Chang; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung; Kim, Jin Woong

    2013-08-01

    A morphologic contour method for assessing an exophytic renal mass as benign versus malignant on the basis of the shape of the interface with the renal parenchyma was recently developed. We investigated the usefulness of this morphologic contour method for predicting angiomyolipoma (AML) in patients who underwent partial nephrectomy for small renal masses (SRMs). From January 2004 to March 2013, among 197 patients who underwent partial nephrectomy for suspicious renal cell carcinoma (RCC), the medical records of 153 patients with tumors (AML or RCC) ≤3 cm in diameter were retrospectively reviewed. Patient characteristics including age, gender, type of surgery, size and location of tumor, pathologic results, and specific findings of the imaging study ("ice-cream cone" shape) were compared between the AML and RCC groups. AML was diagnosed in 18 patients and RCC was diagnosed in 135 patients. Gender (p=0.001), tumor size (p=0.032), and presence of the ice-cream cone shape (p=0.001) showed statistically significant differences between the AML group and the RCC group. In the multivariate logistic regression analysis, female gender (odds ratio [OR], 5.20; 95% confidence interval [CI], 1.45 to 18.57; p=0.011), tumor size (OR, 0.34; 95% CI, 0.12 to 0.92; p=0.034), and presence of the ice-cream cone shape (OR, 18.12; 95% CI, 4.97 to 66.06; p=0.001) were predictors of AML. This study confirmed a high incidence of AML in females. Also, the ice-cream cone shape and small tumor size were significant predictors of AML in SRMs. These finding could be beneficial for counseling patients with SRMs.

  18. Orem 自理模式在超声引导下经皮肾穿刺活检术患者中的应用%Application of Orem self - care model in patients with percutaneous renal biopsy under ultrasonic guidance

    Institute of Scientific and Technical Information of China (English)

    徐李鹏; 胡晓萍; 曹娟娟

    2015-01-01

    Objective:To explore the application methods and effect of Orem self - care model in patients with percutaneous renal biopsy under ultrasonic guidance. Methods:160 patients undergoing percutaneous renal biopsy under ultrasonic guidance were randomly divided into the control group and the observation group(80 cases in each group). The patients in the control group were given routine nursing care and the patients in the observation group were provided Orem self - care model,the effect of nursing care were compared between the two groups. Results:There were statistically significant differences in the comparison of the incidence of postoperative complications,hospi-talization time,re - admission rate and satisfaction rate between the two groups(P < 0. 05). Conclusion:Application of the Orem self - care model applied to patients with percutaneous renal biopsy under ultrasonic guidance can reduce postoperative complications,shorten hospital stay,decrease the re - admission rate and improve satisfaction rate.%目的:探讨 Orem 自理模式在超声引导下经皮肾穿刺活检术患者中的应用方法及效果。方法:将160例在超声引导下经皮肾穿刺活检术患者随机分为对照组和观察组各80例,对照组给予常规护理,观察组采取 Orem 自理模式,比较两组护理效果。结果:两组患者术后并发症发生率、住院时间、再入院率及满意度比较差异有统计学意义(P <0.05)。结论:Orem 自理模式应用于超声引导经皮肾穿刺活检术患者,可减少术后并发症,缩短住院时间,降低再入院率,提高患者满意度。