title: Can we improve the biopsy quality of upper urinary tract urothelial tumors? Single-center preliminary results of a new biopsy forceps.
abstract: OBJECTIVE
  Our aim was to evaluate the biopsy quality of upper urinary tract urothelial transitional cell carcinoma with a new biopsy forceps (BIGopsy®, Cook Medical) compared to a classic biopsy forceps (Piranha®, Boston Scientific).
  
  
  METHODS
  From December 2009 to December 2011, 20 patients with upper urinary tract urothelial transitional cell carcinoma underwent conservative treatment endoscopically. All lesions were evaluated and biopsied with 3 Fr cup forceps using both types of forceps (BIGopsy and Piranha). A single pathologist blindly analyzed the specimens in order to determine the optimal biopsy for each patient. Specimen histopathology results were graded; however, they were staged if the lamina propria was not invaded (T1) or if the tumor was detected at the lamina propria (T1+).
  
  
  RESULTS
  Of the 20 upper urinary tract lesions, 12 (60%) were in the renal pelvis, 3 (15%) in the upper calyx, 1 (5%) in the middle calyx, 1 (5%) in the lower calyx, 1 (5%) in the upper third of the ureter and 2 (10%) in the middle third of the ureter. We did not detect T1 in all biopsies. One patient had no valid biopsies by both forceps. A diagnosis of urothelial carcinoma was made in 17 BIGopsy biopsies compared to 7 Piranha biopsies.
  
  
  CONCLUSIONS
  Despite the limited number of cases, our study demonstrated the advantage of the new forceps (BIGopsy) in obtaining a valid biopsy of upper urinary tract urothelial tumors. Therefore, we recommend it in evaluating this pathology for optimal treatment.
authors.affiliation: Department of Urology, Tenon University Hospital, Paris, France.
authors.forename: Saeed M
authors.initials: SM
authors.lastname: Al-Qahtani
authors.forename: Dorian
authors.initials: D
authors.lastname: Legraverend
authors.forename: Sixtina
authors.initials: S
authors.lastname: Gil-Diez de Medina
authors.forename: Mathilde
authors.initials: M
authors.lastname: Sibony
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
mesh_terms: D001706:Biopsy / Q000379:methods*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology*; D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007682:Kidney Pelvis / Q000473:pathology; D007834:Lasers; D009092:Mucous Membrane / Q000473:pathology; D011446:Prospective Studies; D013525:Surgical Instruments; D014513:Ureter / Q000473:pathology; D014516:Ureteral Neoplasms / Q000175:diagnosis / Q000473:pathology*; D018666:Ureteroscopy; D014551:Urinary Tract / Q000473:pathology; D014571:Urologic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D019459:Urothelium / Q000473:pathology*