Ces Urol 2020, 24(2):113-125 | DOI: 10.48095/cccu2020014

Renal tumor biopsy - indications, technique, results

Jiří Kolář¹, Tomáš Pitra¹, Kristýna Pivovarčíková², Ivan Trávníček¹, František Lepič³, Ondřej Hes², Milan Hora¹

¹ Urologická klinika LF UK a FN Plzeň

² Šiklův ústav patologie LF UK a FN Plzeň

³ Klinika zobrazovacích metod LF UK a FN Plzeň

Kolář J, Pitra T, Pivovarčíková K, Trávníček I, Lepič F, Hes O, Hora M. Renal tumor biopsy - indications, technique, results.

Aim: To evaluate kidney biopsies performed at our department and to compare the data with the literature.

Material and methods: A retrospective analysis of patients who underwent renal tumor biopsy during the years 2007-2019.

Results: During the time period I/2017-XII/2019, we performed renal tumor biopsy on 200 patients at our department - 128 men (64.0 %) and 72 women (36.0 %). The average age of the patients was 64.8 years (34-85 years). Most of the biopsies were performed under CT guidance (n = 192; 96.0 %), a minority of the biopsies performed under ultrasonography guidance (n = 8; 4.0 %). The most common indication for the kidney biopsy was histological verification in metastatic disease before the beginning of oncologic treatment (n = 162; 81.0 %), the histological verification of unclear lesions (n = 32; 16.0 %) and biopsy prior to radiofrequency ablation (n = 6; 3.0 %). The initial biopsies were diagnostic in 165 cases (82.5 %). The most common histological findings were clear cell renal cell carcinoma (n = 107; 53.5 %), papillary renal cell carcinoma (n = 19; 9.5 %), urothelial carcinoma (n = 15; 7.5 %) and chromophobe renal cell carcinoma (n = 3; 1.5 %). The remainder of histological findings were collected from 21 patients (10.5 %). Non-diagnostic were 35 histological samples (17.5 %); re-biopsy was performed in 17 cases from which 16 were positive. In the remaining 18 cases biopsy was not performed again (due to the deterioration of patient's health (n = 6), due to re-biopsy being refused by the patient (n = 2), due to the absence of suspicion for the malignant tumor (n = 4) and finally, 6 of the patients underwent surgery and had the histological examination performed from the removed tissue). The most serious complication was in the form of perirenal hematoma which required blood transfusion (Clavien 2).

Conclusion: At our department, we performed the biopsy of the kidney on 200 patients during 2007-2019, under CT guidance in the vast majority of cases. The most common indication was histological verification preceding oncological treatment and the most common finding was clear renal carcinoma.

Keywords: Biopsy, carcinoma, diagnosis, histology, kidney.………

Received: February 16, 2020; Revised: April 21, 2020; Accepted: May 13, 2020; Prepublished online: May 13, 2020; Published: June 23, 2020