Biopsies renal cell carcinoma

A. R. Tate, P. J. D. Foxall, E. Holmes, D. Molca, M. Spraul, J. K. Nicholson, J. C. Lindon 2000, (Distinction between normal and renal cell carcinoma kidney cortical biopsy samples using pattern recognition of H-l magic angle spinning (MAS) NMR spectra), NMR Biomed. 13, 64-71. 

Proteome Analysis of Renal Cell Carcinoma Cell Lines and Biopsies 229... 

Extensive expression of KlM-1 has been found in proximal tubule cells in biopsies from patients with acute tubular necrosis [302]. KlM-1 is also expressed in other conditions where proximal tubules are dedifferentiated, including renal cell carcinoma [303, 304], chronic cyclosporine nephrotoxicity [305], a protein-overload model of tubulointerstitial disease [306], polycystic kidney disease [307], and contrast nephropathy. In several chronic conditions, KlM-1 has been found primarily expressed at the luminal side of dedifferentiated proximal tubules, in areas with fibrosis and inflammation. Independent of the specific disease, renal KIM-1 correlated positively with the extent of renal damage and negatively with renal function. In these patients, urinary levels of KIM-1 were and correlated positively with tissue KIM-1 and negatively with renal function. Thus, KIM-1 is upregulated in renal disease and is associated with renal fibrosis and inflammation. Urinary KIM-1 is also associated with inflammation and renal function, and reflects tissue KIM-1. 

Tate, A.R. Foxall, P.J.D. Holmes, R. Moka, D. Spraul, M. Nicholson, J.K. Lindon, J.C. Distinction between Normal and Renal Cell Carcinoma Kidney Cortical Biopsy Samples Using Pattern Recognition of H-1 Magic Angle Spinning (MAS) NMR Spectra, Nmr Biomed. 13(2), 64-71 (2000). 

Coffin CM, Swanson PE, Wick MR, et al. An immunohistochemical comparison of chordoma with renal cell carcinoma, colorectal adenocarcinoma, and myxopapillary ependymoma A potential diagnostic dilemma in the diminutive biopsy. Mod Pathol. 1993 6 531-538. 

Barocas DA, Mathew S, DelPizzo JJ, et al. Renal cell carcinoma sub-typing by histopathology and fluorescence in situ hybridization on a needle-biopsy specimen. BJU Int. 2007 99 290. 

Most renal masses can be characterized with high accuracy by noninvasive imaging alone, and a sohd non-fat-containing or complex renal mass should be considered a renal cell carcinoma until proven otherwise. Metas-tases to the kidney are usually small and multifocal or perinephric. Lymphomatous involvement of the kidneys also usually occurs in the setting of disseminated disease and is characterized by typical CT patterns like multiple small masses, spread from retroperitoneal disease, diffuse infiltration, and perinephric encasement. In a study by Lechevallier et al. (2000), CT-guided renal biopsy of 63 patients had an overall accuracy of 89%. Biopsy material was not sufficient for analysis in 15 patients (21%). Unsuccessful biopsy was related to lesion size biopsy was unsuccessful in 11 of 30 tumors (37%) of 3 cm or less, versus 4 of 43 (9%) of tumors greater than 3 cm. 

In bone lesions that are assumed to be extremely hy-pervascularized such as suspected metastases of renal cell carcinoma, a digital subtraction angiography may have to be obtained prior to biopsy. Transarterial embo-hzation or direct puncture of the lesion with injection of absorbable gelatin sponge or polyvinyl alcohol particles helps to prevent serious hemorrhage when samples of the lesion are taken. 

Urinary tract A 58-year-old man with advanced renal cell carcinoma developed grade 3 proteinuria (8.5 g/24 hours) without microscopic hematuria or renal insufficiency 5 days after an infusion of temsiroli-mus [104 ]. Kidney biopsy showed ischemic glomeruli and focal segmental glomerulosclerosis. His proteinuria fell to 2.8 g/day 2 weeks after temsirolimus withdrawal. 

Skin A 73-year-old woman with metastatic renal cell carcinoma developed a pruritic rash after receiving two infusions of temsirolimus 25 mg/week the rash was located on both antecubital areas and the backs of the knees [105 ]. Biopsy showed spongiotic dermatitis with eosinophils. The authors hypothesized that temsirolimus, an mTOR kinase inhibitor, has a direct inhibitory effect on signalling pathways that regulate cell growth and tissue repair. 

FIGURE 13.3 MALDI MS analysis of a human renal cell carcinoma (optical image, top) with attached nontumor (optical image, bottom) tissue biopsy section. The protein profiles are displayed (right) as a heat map illustrating the benefit of analyzing heterogeneous tissue samples in a spatially resolved manner. (From P. Chaurand, J. L. Norris, D. S. Cornett, J. A. Mobley, and R. M. Caprioli. J. Proteome Res. 5(11), 2889-2900, 2006. With permission.)... 

Fig. 24.14. Juvenile renal cell carcinoma in a 9-year-old girl presenting with abdominal pain. Enhanced CT scan shows a non-specific heterogeneous tumor of the left kidney. Relative small tumor size and patient age are suggestive criteria for renal cell carcinoma and must lead to a diagnostic biopsy...

This mitochondrial peroxisome enzyme, alpha-meth-ylacyl-CoA racemase (AMACR) (encoded by the gene P504S) catalyzes the racemization of alpha-methyl branched carboxylic coenzyme A thioesters and is present in prostate tissue and a wide variety of carcinomas (colorectal, ovarian, breast, bladder, lung, renal cell), melanoma, and lymphoma.AMACR is useful in prostate needle biopsies when the differential diagnosis... 

Figure 8. (A) Influence of sample size on the heat output per cell in a suspension of human renal carcinoma cells. Note that it decreases with increasing cell number. This may be expressed by a continuous transition from aerobiosis in a monolayer-like suspension to increasingly anaerobic conditions in a crowded ampoule. (B) Influence of sample size on heat output per unit dry weight (dw) in rat liver tissue samples. It increases with decreasing sample size. This is apparently due to a continuous transition from mainly anaerobic conditions in large tissue slices to an increasing amount of aerobiosis in biopsy -Iike samples. The two curves complement each other giving a sigmoidal relationship, whose steep portion fits a linear regression when plotted on log scales (Reproduced from Reference [43] with permission).

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