title: Small renal cell carcinomas: resolving a diagnostic dilemma.
abstract: 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.
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
authors.forename: M A
authors.initials: MA
authors.lastname: Amendola
authors.forename: R L
authors.initials: RL
authors.lastname: Bree
authors.forename: H M
authors.initials: HM
authors.lastname: Pollack
authors.forename: I R
authors.initials: IR
authors.lastname: Francis
authors.forename: G M
authors.initials: GM
authors.lastname: Glazer
authors.forename: S Z
authors.initials: SZ
authors.lastname: Jafri
authors.forename: J E
authors.initials: JE
authors.lastname: Tomaszewski
mesh_terms: 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