Small renal cell carcinomas: resolving a diagnostic dilemma.
Thirty-nine patients with pathologically proved renal cell carcinomas 3 cm or les in diameter were examined. Results of intravenous urography (n = 30) were true positive in 20 patients and false negative in ten (sensitivity, 67%). Renal ultrasound (US) (n = 29) had true-positive results in 23 patients and false-negative results in six (sensitivity, 79%); computed tomography (CT) (n = 36) had true-positive results in 34 and false-negative results in two (sensitivity, 94%). For selective renal angiography (n = 35%), the results were true positive in 26 and false negative in nine (sensitivity, 74%), with typical hypervascular renal cell carcinomas demonstrated in 17. Finally, the findings of percutaneous fine-needle aspiration biopsy were true positive in one of five patients when US guidance was used (sensitivity, 20%) and in five of eight when CT guidance was used (sensitivity, 62%). Small renal cell carcinomas are more frequently encountered in clinical practice than heretofore realized, and they are best imaged by CT.
Amendola
M A
MA
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Bree
R L
RL
Pollack
H M
HM
Francis
I R
IR
Glazer
G M
GM
Jafri
S Z
SZ
Tomaszewski
J E
JE
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography