European Radiology

, Volume 15, Issue 8, pp 1734–1744

Radiologic–pathologic correlations of intratumoral tissue components in the most common solid and cystic renal tumors. Pictorial review

  • Emilio Quaia
  • Rossana Bussani
  • Maria Cova
  • Roberto Pozzi Mucelli


This paper describes the correlation between US-CT images and pathologic findings in the most common solid and cystic renal tumors, to better differentiate malignant and benign renal masses. Several intratumoral tissue components present correlation with US-CT images. Macroscopic components, corresponding to necrotic, hemorrhagic and cystic changes, are identified by visual analysis of the gross specimen, while microscopic components are identified by histopathologic analysis. Microscopic components are classified as cellular [(1) high cellularity with poor extracellular stroma, ±high nucleus–cytoplasm ratio±high uniformity in tumoral cells dimensions; (2) low cellularity with large extracellular stroma±low nucleus–cytoplasm ratio±low uniformity in tumoral cells dimensions], stromal [(1) fibrotic; (2) fibrovascular; (3) fibromyxoid], vascular related to neoangiogenesis, necrotic [(1) coagulative; (2) colliquative; (3) hemorrhagic], calcific, and adipose.


Renal tumors US CT Radiologic–pathologic correlations 


  1. 1.
    Pickhardt PJ, Lonergan GJ, Davis CJ, Kashitani N, Wagner BJ (2000) From the archives of AFIP. Infiltrative renal lesions: radiologic–pathologic correlation. Radiographics 20:215–243Google Scholar
  2. 2.
    Levin E, King BF (2000) Adult malignant renal parenchymal neoplasms. In: Pollack HM, McClennan BL, Dyer R (eds) Clinical urography. Saunders, Philadelphia, pp 1440–1470Google Scholar
  3. 3.
    Dalla Palma L, Pozzi Mucelli F, Di Donna A, Pozzi Mucelli R (1990) Cystic renal tumors: US and CT findings. Urol Radiol 12:67–73Google Scholar
  4. 4.
    Storkel S, Eble JN, Adlakha K et al. (1997) Classification of renal cell carcinoma: workgroup no. 1—Union Internationale Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer 80:987–989CrossRefPubMedGoogle Scholar
  5. 5.
    Oyen R (1998) Renal Parenchymal tumours. Halley Project 1998–2000, 2nd refresher course series. Springer, Milan, ItalyGoogle Scholar
  6. 6.
    Oyen R, Verswijvel G, Van Poppel H, Roskams T (2001) Primary malignant renal parenchymal epithelial neoplasms. Eur Radiol 11(Suppl 2):S205–S217Google Scholar
  7. 7.
    Pavlovich CP, Schmidt LS, Phillips JL (2003) The genetics basis of renal cell carcinoma. Urol Clin N Am 30:437–454Google Scholar
  8. 8.
    Helenon O, Merran S, Paraf F et al. (1997) Unusual fat-containing tumors of the kidney: a diagnostic dilemma. Radiographics 17:129–144PubMedGoogle Scholar
  9. 9.
    Choyke PL, Glenn GM, Walther MM, Zbar B, Linehan WM (2003) Hereditary renal cancers. Radiology 226:33–46Google Scholar
  10. 10.
    Soyer P, Dufresne AC, Klein I, Barbagelatta M, Herve JM, Scherrer A (1997) Renal cell carcinoma of clear cell type: correlation of CT features with tumor size, architectural patterns and pathologic staging. Eur Radiol 7:224–229CrossRefGoogle Scholar
  11. 11.
    Amin MB, Corless CL, Renshaw AA, Tickoo SK, Kubus J, Schultz DS (1997) Papillary (chromophil) renal cell carcinoma: histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases. Am J Surg Pathol 21:621–635CrossRefGoogle Scholar
  12. 12.
    Choyke PL, Walther MM, Glenn GM et al. (1997) Imaging features of hereditary papillary renal cancers. J Comput Assist Tomogr 21:737–741CrossRefGoogle Scholar
  13. 13.
    Crotty TB, Farrow GM, Lieber MM (1995) Chromophobic cell renal carcinoma: clinicopathologic features of 50 cases. J Urol 154:964–967CrossRefGoogle Scholar
  14. 14.
    Jinzaki M, Tanimoto A, Mukai M et al. (2000) Double-phase helical CT of small renal parenchymal neoplasms: correlation with pathologic findings and tumor angiogenesis. J Comput Assist Tomogr 24:835–842CrossRefPubMedGoogle Scholar
  15. 15.
    Fukuya T, Honda H, Goto K, Ono M et al. (1996) Computed tomographic findings of Bellini duct carcinoma of the kidney. J Comput Assist Tomogr 20:399–403CrossRefGoogle Scholar
  16. 16.
    Wagner BJ, Wong You Cheong JJ, Davis CJ (1997) From the archives of the AFIP. Adult renal hamartomas. Radiographics 17:155–169Google Scholar
  17. 17.
    Sherman JL, Hartman DS, Friedman AC et al. (1981) Angiomyolipomas: CT-pathologic correlations of 17 cases. Am J Roentgenol 137:1221–1226Google Scholar
  18. 18.
    Israel G, Bosniak MA (2003) Renal imaging for diagnosis and staging of renal cell carcinoma. Urol Clin N Am 30:499–514Google Scholar
  19. 19.
    Hartman DS (2001) Benign renal and adrenal tumors. Eur Radiol 11(Suppl 2):S195–S204Google Scholar
  20. 20.
    Riccabona M (2003) Imaging of renal tumours in infancy and childhood. Eur Radiol 13(Suppl 4):L116–L129Google Scholar
  21. 21.
    Amin MB, Crotty TB, Tickoo SK, Farrow GM (1997) Renal oncocytoma: a reappraisal of morphologic features with clinicopathologic findings in 80 cases. Am J Surg Pathol 21:1–12CrossRefGoogle Scholar
  22. 22.
    Mahnken AH, Günther RW, Tacke J (2004) Radiofrequency ablation of renal tumors. Eur Radiol 14(8):1449–1455CrossRefGoogle Scholar
  23. 23.
    Chomas JE, Pollard RE, Sadlowski AR, Griffey SM, Wisner ER, Ferrara KW (2003) Contrast-enhanced US of microcirculation of superficially implanted tumors in rats. Radiology 229:439–446Google Scholar
  24. 24.
    Quaia E, Siracusano S, Bertolotto M et al. (2003) Characterization of renal tumours with pulse inversion harmonic imaging by intermittent high mechanical index technique: initial results. Eur Radiol 13(6):1402–1412PubMedGoogle Scholar
  25. 25.
    Lussanet QG, Backes WH, Griffionen AW et al. (2003) Gadopentetate dimeglumine versus ultrasmall superparamagnetic iron oxide for dynamic contrast-enhanced MR imaging of tumor angiogenesis in human colon carcinoma in mice. Radiology 229:429–438Google Scholar
  26. 26.
    Turetschek K, Huber S, Floyd E et al. (2001) MR imaging characterization of microvessels in experimental breast tumors by using a particulate contrast agent with histopathologic correlation. Radiology 218:562–569PubMedGoogle Scholar
  27. 27.
    van Dijke CT, Brasch RC, Roberts TP et al. (1996) Mammary carcinoma model: correlation of macromolecular contrast-enhanced MR imaging characterizations of tumoral microvasculature and histologic capillary density. Radiology 198:813–818PubMedGoogle Scholar
  28. 28.
    Olsen OE, Jeanes AC, Sebire NJ et al. (2004) Changes in computed tomography features following preoperative chemotherapy for nephroblastoma: relation to histopathological classification. Eur Radiol 14(6):990–994CrossRefGoogle Scholar
  29. 29.
    Helenon O, Chretien Y, Paraf F et al. (1993) Renal cell carcinoma containing fat: demonstration with CT. Radiology 188:429–430Google Scholar
  30. 30.
    D’Angelo PC, Gash JR, Horn AW et al. (2002) Fat in renal cell carcinoma that lack associated calcifications. Am J Roentgenol 178:931–932Google Scholar
  31. 31.
    Kido T, Yamashita Y, Sumi S et al. (1997) Chemical shift GRE MRI of renal angiomyolipoma. J Comput Assist Tomogr 21(2):268–270CrossRefGoogle Scholar
  32. 32.
    Yoshimitsu K, Honda H, Kuroiuna T et al. (1999) MR detection of cytoplasmic fat in renal cell carcinoma utilizing chemical shift GE imaging. J Magn Reson Imaging 9(4):579–585Google Scholar
  33. 33.
    Hartman DS (ed)(1989) Renal cystic disease. AFIP atlas of radiologic–pathologic correlations. Saunders Company, Philadelphia, USAGoogle Scholar
  34. 34.
    Bosniak MA (1986) The current radiological approach to renal cyst. Radiology 158:1–10PubMedGoogle Scholar
  35. 35.
    Israel G, Bosniak MA (2003) Calcification in cystic renal masses: is it important in diagnosis? Radiology 226:47–52PubMedGoogle Scholar
  36. 36.
    Roberts SC, Winick AB, Santi MR (1997) Papillary renal cell carcinoma: diagnostic dilemma of a cystic renal mass. Radiographics 17:993–998Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Emilio Quaia
    • 1
  • Rossana Bussani
    • 2
  • Maria Cova
    • 1
  • Roberto Pozzi Mucelli
    • 3
  1. 1.Department of Radiology, Cattinara HospitalUniversity of TriesteTriesteItaly
  2. 2.Department of PathologyUniversity of TriesteTriesteItaly
  3. 3.Department of Radiology, Hospital G.B. RossiUniversity of VeronaVeronaItaly

Personalised recommendations