[Value of percutaneous biopsy for solid renal tumours less than 4 cm in diameter based on a series of 53 cases].
OBJECTIVE
To evaluate the reliability and clinical value of percutaneous biopsy in the diagnosis of small solid renal tumours (less or equal to 4 cm).


METHODS
Fifty-three patients underwent biopsy for solid renal tumour less than 4 cm in diameter (mean age: 61 years). The mean diameter was 2.57 cm. The mean number of biopsy cores was 1.93. A histological correlation between biopsy and resection specimen was performed on the 32 operated patients.


RESULTS
Biopsy allowed a precise histological diagnosis in 77% of cases: 9/53 benign tumours (17%), 32/53 cancers (60%); 12 biopsies were uninterpretable (normal renal tissue in six cases; necrotic or disrupted tissue in six cases). Management was modified in 13/53 cases (25%): eight benign tumours, three cases of normal renal tissue and two inconclusive cases were followed with no radiological signs of progression. Surgical resection was performed in 32 patients: two tumours were benign; 27 tumours were malignant; three specimens comprised normal renal tissue. For all positive biopsies with a diagnosis of malignant tumour, the Fuhrman grade was correctly evaluated by biopsy in 60% of cases. One false-negative biopsy was observed. For the 41 evaluable biopsies, the sensitivity and specificity were 96 and 100%, respectively.


CONCLUSIONS
In this series, biopsy was a reliable examination in this indication with good sensitivity. The absence of cancer on biopsy did not formally exclude neoplasm. If no tumour (benign or malignant) is observed on the examination, a repeat biopsy or surgical resection should be considered.
Thuillier
C
C
Service d'Urologie et de la Transplantation Rénale, Hôpital A-Michallon, CHU de Grenoble, La Tronche, France. cthuillier1@chu-grenoble.fr <cthuillier1@chu-grenoble.fr>
Long
J-A
JA
Lapouge
O
O
Pasquier
D
D
Terrier
N
N
Bocqueraz
F
F
Cyprien
J
J
Descotes
J-L
JL
Rambeaud
J-J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005188:False Negative Reactions; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography