title: Multiphoton microscopy for rapid histopathological evaluation of kidney tumours.
abstract: To explore the potential of multiphoton microscopy (MPM) for rapid evaluation and triaging of ex vivo kidney tissue.
  
  
  
  Fresh neoplastic and non-neoplastic tissues from nephrectomy specimens (n = 40) were imaged with MPM and later submitted for routine histopathology.
  
  
  
  On MPM, normal kidney architecture was evident and clearly distinguishable from tumour. Forty malignant tumours (20 clear-cell renal cell carcinomas [RCCs], 10 papillary RCCs, five chromophobe RCCs and five papillary urothelial carcinomas [UCs], as diagnosed by haematoxylin and eosin staining) were imaged and subtyped as non-papillary and papillary, based on their architecture. Non-papillary tumours were further classified based on their unique cytoplasmic signatures. Clear-cell RCCs had a predominant population of cells with fat droplets in cytoplasm. Chromophobe RCCs had cells with non-fatty/homogeneous cytoplasm and distinct intra-cytoplasmic granules. Papillary RCCs had single-cell-lined papillae with often abundant histiocytes in their core, whereas PUC had multi-layered urothelium-lined papillae. The diagnostic accuracy of tumour subtyping by two independent uropathologists was 95%.
  
  
  
  We showed that MPM can reliably differentiate neoplastic from non-neoplastic kidney tissue and subtype kidney tumours in fresh, unprocessed tissue, MPM might therefore be useful as a rapid real-time diagnostic tool for the evaluation of kidney biopsies, and surgical margins in partial nephrectomies, to improve overall patient management.
authors.affiliation: Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.|Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Manu
authors.initials: M
authors.lastname: Jain
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.|Department of Urology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Robinson
authors.affiliation: Department of Biochemistry, Weill Cornell Medical College, New York, NY, USA.|Department of Natural Sciences, LaGuardia Community College, Long Island City, NY, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Shevchuk
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Scherr
authors.affiliation: Department of Biochemistry, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Sushmita
authors.initials: S
authors.lastname: Mukherjee
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D036641:Microscopy, Fluorescence, Multiphoton; D013997:Time Factors
keywords: evaluation; ex vivo; histopathology; kidney tumours; multiphoton microscopy; triage