title: Percutaneous renal tumour biopsy.
abstract: 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.
authors.affiliation: Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington, New Zealand.
authors.forename: Brett
authors.initials: B
authors.lastname: Delahunt
authors.forename: Hemamali
authors.initials: H
authors.lastname: Samaratunga
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.forename: John R
authors.initials: JR
authors.lastname: Srigley
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Evans
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
mesh_terms: D018249:Adenoma, Oxyphilic / Q000175:diagnosis / Q000473:pathology; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D015203:Reproducibility of Results
keywords: biopsy; diagnosis; kidney; neoplasm; renal cell carcinoma