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Kidney

  • Luan D. Truong
  • Jae Y. Ro
  • Richard A. Goldfarb
  • Steven S. Shen
Chapter
Part of the Frozen Section Library book series (FROZEN, volume 2)

Abstract

Intraoperative pathology consultation (IPC) for kidney lesions is relatively infrequent.1 However, it has a definite role in the surgical management of these lesions.2 Gross and frozen section (FS) consultations were requested in 10.8% and 12.2%, respectively, for 6,907 radical nephrectomy specimens; whereas the percentages were 11.2% and 53.8%, respectively, for 600 partial nephrectomy specimens.2 The possible reasons for intraoperative pathology consultation are listed in Table 1.1. The indications for IPC are not well defined and probably reflect personal preference, institutional tradition, and the types of hospitals.2

Keywords

Renal Cell Carcinoma Partial Nephrectomy Urothelial Carcinoma Laparoscopic Partial Nephrectomy Freeze Section 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Oneson RH, Minke JA, Silverberg SG. Intraoperative pathologic consultation. An audit of 1,000 recent consecutive cases. Am J Sur Pathol. 1989;13:237–243.CrossRefGoogle Scholar
  2. 2.
    Miller DC, Shah RB, Bruhn A, Madison R, Saigal CS. Trends in the use of gross and frozen section pathological consultations during partial or radical nephrectomy for renal cell carcinoma. J Urol. 2008;179:461–467.CrossRefPubMedGoogle Scholar
  3. 3.
    Krishnan B, Lechago J, Ayala G, Truong L. Intraoperative consultation for renal lesions. Implications and diagnostic pitfalls in 324 cases. Am J Clin Pathol. 2003;120:528–535.CrossRefPubMedGoogle Scholar
  4. 4.
    Blute ML, Leibovich BC, Cheville JC, Lohse CM, Zincke H. A protocol for performing extended lymph node dissection using primary tumor pathological features for patients treated with radical nephrectomy for clear cell renal cell carcinoma. J Urol. 2004;172:465–469.CrossRefPubMedGoogle Scholar
  5. 5.
    Campbell SC, Fichtner J, Novick AC, et al. Intraoperative evaluation of renal cell carcinoma: a prospective study of the role of ultrasonography and histopathological frozen sections. J Urol. 1996;155:1191–1195.CrossRefPubMedGoogle Scholar
  6. 6.
    Eble JN, Sauter S, Epstein JI, Sesterhenn IA. Pathology & Genetics of Tumors of the Urinary System and Male Genital Organs. Lyon: IARC Press; 2004.Google Scholar
  7. 7.
    Parsons MA, Harris SC, Longstaff AJ, Grainger RG. Xanthogranulomatous pyelonephritis: a pathological, clinical and aetiological analysis of 87 cases. Diagn Histopathol. 1983;6:203–219.PubMedGoogle Scholar
  8. 8.
    Dobyan DC, Truong LD, Eknoyan G. Renal malacoplakia reappraised. Am J Kidney Dis. 1993;22:243–252.PubMedGoogle Scholar
  9. 9.
    Silva EG, Kraemer B. Intraoperative Pathologic Diagnosis: Frozen Sections and Other Technique. Wilkins & Williams; 1987.Google Scholar
  10. 10.
    Iskandar SS, Prahlow JA, White WL. Lipid-laden foamy macrophages in renal cell carcinoma. Potential frozen section diagnostic pitfall. Pathol Res Pract. 1993;189:549–552.PubMedGoogle Scholar
  11. 11.
    Amin MB, Crotty TB, Tickoo SK, Farrow GM. Renal oncocytoma: a reappraisal of morphologic features with clinicopathologic findings in 80 cases. Am J Sur Pathol. 1997;21:1–12.CrossRefGoogle Scholar
  12. 12.
    Cochand-Priollet B, Molinie V, Bougaran J, et al. Renal chromophobe cell carcinoma and oncocytoma. A comparative morphologic, histochemical, and immunohistochemical study of 124 cases. Arch Pathol Lab Med. 1997;121:1081–1086.PubMedGoogle Scholar
  13. 13.
    Latham B, Dickersin GR, Oliva E. Subtypes of chromophobe cell renal carcinoma: an ultrastructural and histochemical study of 13 cases. Am J Sur Pathol. 1999;23:530–535.CrossRefGoogle Scholar
  14. 14.
    Yip SK, Tan PH, Cheng WS, Li MK, Foo KT. Surgical management of angiomyolipoma: nephron-sparing surgery for symptomatic tumour. Scand J Urol Nephrol. 2000;34:32–35.CrossRefPubMedGoogle Scholar
  15. 15.
    Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol. 2001;166:6–18.CrossRefPubMedGoogle Scholar
  16. 16.
    Gill IS, Kavoussi LR, Lane BR, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007;178:41–46.CrossRefPubMedGoogle Scholar
  17. 17.
    Kubinski DJ, Clark PE, Assimos DG, Hall MC. Utility of frozen section analysis of resection margins during partial nephrectomy. Urology. 2004;64:31–34.CrossRefPubMedGoogle Scholar
  18. 18.
    Breda A, Stepanian SV, Liao J, et al. Positive margins in laparoscopic partial nephrectomy in 855 cases: a multi-institutional survey from the United States and Europe. J Urol. 2007;178:47–50.CrossRefPubMedGoogle Scholar
  19. 19.
    Eble JN. Angiomyolipoma of kidney. Semin Diagn Pathol. 1998;15:21–40.PubMedGoogle Scholar
  20. 20.
    de Peralta-Venturina M, Moch H, Amin M, et al. Sarcomatoid differentiation in renal cell carcinoma: a study of 101 cases. Am J Sur Pathol. 2001;25:275–284.CrossRefGoogle Scholar
  21. 21.
    Grignon DJ, Eble JN. Papillary and metanephric adenomas of the kidney. Semin Diagn Pathol. 1998;15:41–53.PubMedGoogle Scholar
  22. 22.
    Ro JY, Ayala AG, el-Naggar A, Grignon DJ, Hogan SF, Howard DR. Angiomyolipoma of kidney with lymph node involvement. DNA flow cytometric analysis. Arch Pathol Lab Med. 1990;114:65–67.PubMedGoogle Scholar
  23. 23.
    Perez-Montiel D, Wakely PE, Hes O, Michal M, Suster S. High-grade urothelial carcinoma of the renal pelvis: clinicopathologic study of 108 cases with emphasis on unusual morphologic variants. Mod Pathol. 2006;19:494–503.CrossRefPubMedGoogle Scholar
  24. 24.
    Kennedy SM, Merino MJ, Linehan WM, Roberts JR, Robertson CN, Neumann RD. Collecting duct carcinoma of the kidney. Hum Pathol. 1990;21:449–456.CrossRefPubMedGoogle Scholar
  25. 25.
    Davis CJ, Jr., Mostofi FK, Sesterhenn IA. Renal medullary carcinoma. The seventh sickle cell nephropathy. Am J Sur Pathol. 1995;19:1–11.CrossRefGoogle Scholar
  26. 26.
    Moncino MD, Friedman HS, Kurtzberg J, Pizzo SV. Papillary adenocarcinoma of the renal pelvis in a child: case report and brief review of the literature. Med Pediatr Oncol. 1990;18:81–86.CrossRefPubMedGoogle Scholar
  27. 27.
    Warren KS, McFarlane JP. The Bosniak classification of renal cystic masses. BJU Int. 2005;95:939–942.CrossRefPubMedGoogle Scholar
  28. 28.
    Todd TD, Dhurandhar B, Mody D, Ramzy I, Truong LD. Fine-needle aspiration of cystic lesions of the kidney. Morphologic spectrum and diagnostic problems in 41 cases. Am J Clin Pathol. 1999;111:317–328.PubMedGoogle Scholar
  29. 29.
    Truong LD, Krishnan B, Cao JT, Barrios R, Suki WN. Renal neoplasm in acquired cystic kidney disease. Am J Kidney Dis. 1995;26:1–12.CrossRefPubMedGoogle Scholar
  30. 30.
    Watson ML. Complications of polycystic kidney disease. Kidney Int. 1997;51:353–365.CrossRefPubMedGoogle Scholar
  31. 31.
    Eble JN, Bonsib SM. Extensively cystic renal neoplasms: cystic nephroma, cystic partially differentiated nephroblastoma, multilocular cystic renal cell carcinoma, and cystic hamartoma of renal pelvis. Semin Diagn Pathol. 1998;15:2–20.PubMedGoogle Scholar
  32. 32.
    Andonian S, Janetschek G, Lee BR. Laparoscopic partial nephrectomy: an update on contemporary issues. Urol Clin North Am. 2008;35:385–396.CrossRefPubMedGoogle Scholar
  33. 33.
    Yossepowitch O, Thompson RH, Leibovich BC, et al. Positive surgical margins at partial nephrectomy: predictors and oncological outcomes. J Urol. 2008;179:2158–2163.CrossRefPubMedGoogle Scholar
  34. 34.
    Lam JS, Bergman J, Breda A, Schulam PG. Importance of surgical margins in the management of renal cell carcinoma. Nat Clin Pract Urol. 2008;5:308–317.PubMedGoogle Scholar
  35. 35.
    Eroglu M, Unsal A, Bakirtas H, Tekdogan U, Ataoglu O, Balbay MD. Routine frozen-section biopsy from the surgical bed should be performed during nephron-sparing surgery for renal cell carcinoma. Scand J Urol Nephrol. 2005;39:222–225.CrossRefPubMedGoogle Scholar
  36. 36.
    Lattouf JB, Beri A, D’Ambros OF, Grull M, Leeb K, Janetschek G. Laparoscopic partial nephrectomy for hilar tumors: technique and results. Eur Urol. 2008;54:409–416.CrossRefPubMedGoogle Scholar
  37. 37.
    McHale T, Malkowicz SB, Tomaszewski JE, Genega EM. Potential pitfalls in the frozen section evaluation of parenchymal margins in nephron-sparing surgery. Am J Clin Pathol. 2002;118:903–910.CrossRefPubMedGoogle Scholar
  38. 38.
    Li QL, Guan HW, Zhang QP, Zhang LZ, Wang FP, Liu YJ. Optimal margin in nephron-sparing surgery for renal cell carcinoma 4 cm or less. Eur Urol. 2003;44:448–451.CrossRefPubMedGoogle Scholar
  39. 39.
    Tsuchiya K, Jinbo H, Kurita M, et al. Pathologic examination of renal cell cancer by means of step-sectioning. Int J Urol. 2000;7:335–339.CrossRefPubMedGoogle Scholar
  40. 40.
    Baltaci S, Orhan D, Soyupek S, Beduk Y, Tulunay O, Gogus O. Influence of tumor stage, size, grade, vascular involvement, histological cell type and histological pattern on multifocality of renal cell carcinoma. J Urol. 2000;164:36–39.CrossRefPubMedGoogle Scholar
  41. 41.
    Renshaw AA, Corless CL. Papillary renal cell carcinoma. Histology and immunohistochemistry. Am J Sur Pathol. 1995;19:842–849.CrossRefGoogle Scholar
  42. 42.
    Tickoo SK, Reuter VE, Amin MB, et al. Renal oncocytosis: a morphologic study of fourteen cases. Am J Sur Pathol. 1999;23:1094–1101.CrossRefGoogle Scholar
  43. 43.
    Bernie JE, Albers L, Baird S, Parsons CL. Synchronous ipsilateral renal adenocarcinoma, transitional cell carcinoma of the renal pelvis and metastatic renal lymphoma. J Urol. 2000;164:773–774.CrossRefPubMedGoogle Scholar
  44. 44.
    Jimenez RE, Eble JN, Reuter VE, et al. Concurrent angiomyolipoma and renal cell neoplasia: a study of 36 cases. Mod Pathol. 2001;14:157–163.CrossRefPubMedGoogle Scholar
  45. 45.
    Solomon D, Schwartz A. Renal pathology in von Hippel-Lindau disease. Hum Pathol. 1988;19:1072–1079.CrossRefPubMedGoogle Scholar
  46. 46.
    Walther MM, Choyke PL, Glenn G, et al. Renal cancer in families with hereditary renal cancer: prospective analysis of a tumor size threshold for renal parenchymal sparing surgery. J Urol. 1999;161:1475–1479.CrossRefPubMedGoogle Scholar
  47. 47.
    Steinbach F, Novick AC, Zincke H, et al. Treatment of renal cell carcinoma in von Hippel-Lindau disease: a multicenter study. J Urol. 1995;153:1812–1816.CrossRefPubMedGoogle Scholar
  48. 48.
    Lubensky IA, Pack S, Ault D, et al. Multiple neuroendocrine tumors of the pancreas in von Hippel-Lindau disease patients: histopathological and molecular genetic analysis. Am J Pathol. 1998;153:223–231.PubMedGoogle Scholar
  49. 49.
    Truong LD, Caraway N, Ngo T, Laucirica R, Katz R, Ramzy I. Renal lymphoma. The diagnostic and therapeutic roles of fine-needle aspiration. Am J Clin Pathol. 2001;115:18–31.CrossRefPubMedGoogle Scholar
  50. 50.
    Anderson CM, Pusztai L, Palmer JL, Cabanillas F, Ellerhorst JA. Coincident renal cell carcinoma and nonHodgkin’s lymphoma: the M. D. Anderson experience and review of the literature. J Urol. 1998;159:714–717.CrossRefPubMedGoogle Scholar
  51. 51.
    Pantuck AJ, Zisman A, Dorey F, et al. Renal cell carcinoma with retroperitoneal lymph nodes: role of lymph node dissection. J Urol. 2003;169:2076–2083.CrossRefPubMedGoogle Scholar
  52. 52.
    Walker PD, Cavallo T, Bonsib SM. Practice guidelines for the renal biopsy. Mod Pathol. 2004;17:1555–1563.CrossRefPubMedGoogle Scholar
  53. 53.
    Hefter LG, Brennan GG. Transillumination of renal biopsy specimens for rapid identification of glomeruli. Kidney Int. 1981;20:411–415.CrossRefPubMedGoogle Scholar
  54. 54.
    Corwin HL, Schwartz MM, Lewis EJ. The importance of sample size in the interpretation of the renal biopsy. Am J Nephrol. 1988;8:85–89.CrossRefPubMedGoogle Scholar
  55. 55.
    Colvin RB, Cohen AH, Saiontz C, et al. Evaluation of pathologic criteria for acute renal allograft rejection: reproducibility, sensitivity, and clinical correlation. J Am Soc Nephrol. 1997;8:1930–1941.PubMedGoogle Scholar
  56. 56.
    Racusen LC, Solez K, Colvin RB, et al. The Banff 97 working classification of renal allograft pathology. Kidney Int. 1999;55:713–723.CrossRefPubMedGoogle Scholar
  57. 57.
    Sung RS, Christensen LL, Leichtman AB, et al. Determinants of discard of expanded criteria donor kidneys: impact of biopsy and machine perfusion. Am J Transplant. 2008;8:783–792.CrossRefPubMedGoogle Scholar
  58. 58.
    Randhawa P. Role of donor kidney biopsies in renal transplantation. Transplantation. 2001;71:1361–1365.CrossRefPubMedGoogle Scholar
  59. 59.
    Munivenkatappa RB, Schweitzer EJ, Papadimitriou JC, et al. The Maryland aggregate pathology index: a deceased donor kidney biopsy scoring system for predicting graft failure. Am J Transplant. 2008;8:2316–2324.CrossRefPubMedGoogle Scholar
  60. 60.
    Gaber LW, Moore LW, Alloway RR, Amiri MH, Vera SR, Gaber AO. Glomerulosclerosis as a determinant of posttransplant function of older donor renal allografts. Transplantation. 1995;60:334–339.CrossRefPubMedGoogle Scholar
  61. 61.
    Pastural M, Barrou B, Delcourt A, Bitker MO, Ourahma S, Richard F. Successful kidney transplantation using organs from a donor with disseminated intravascular coagulation and impaired renal function: case report and review of the literature. Nephrol Dial Transplant. 2001;16:412–415.CrossRefPubMedGoogle Scholar
  62. 62.
    Colvin RB, Nickeleit V. Renal transplant pathology. In: Jennette JC, Olson JL, Schwartz MM, Silva FG, eds. Heptinstall’s Pathology of the Kidney. 6th ed. Lippincott Williams & Wilkins; 2007:1347–1490.Google Scholar
  63. 63.
    Wunderlich H, Wilhelm S, Reichelt O, Zermann DH, Borner R, Schubert J. Renal cell carcinoma in renal graft recipients and donors: incidence and consequence. Urol Int. 2001;67:24–27.CrossRefPubMedGoogle Scholar
  64. 64.
    Ditonno P, Lucarelli G, Bettocchi C, et al. Incidentally discovered yellowish lesions in a renal graft from a deceased donor. Transplant Proc. 2008;40:2062–2064.CrossRefPubMedGoogle Scholar
  65. 65.
    Penn I. Primary kidney tumors before and after renal transplantation. Transplantation. 1995;59:480–485.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Luan D. Truong
    • 1
    • 2
    • 3
  • Jae Y. Ro
    • 1
    • 3
  • Richard A. Goldfarb
    • 1
    • 2
    • 3
  • Steven S. Shen
    • 1
    • 3
  1. 1.Weill Medical College of Cornell University New YorkNew YorkUSA
  2. 2.Baylor College of MedicineHoustonUSA
  3. 3.The Methodist HospitalHoustonUSA

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