Early-stage clear cell tubulopapillary renal cell carcinoma: imaging features and distinction from clear cell and papillary subtypes.

Mnatzakanian, Gevork N; Shinagare, Atul B; Sahni, V Anik; Hirsch, Michelle S; Silverman, Stuart G

Mnatzakanian, Gevork N; Shinagare, Atul B; Sahni, V Anik; Hirsch, Michelle S; Silverman, Stuart G.

Afiliación

Mnatzakanian GN; Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. mnatzakanian@smh.ca.
Shinagare AB; Department of Medical Imaging, St. Michael's Hospital, 3-141CC, 30 Bond St., Toronto, ON, M5B 1W8, Canada. mnatzakanian@smh.ca.
Sahni VA; Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
Hirsch MS; Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA.
Silverman SG; Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.

Abdom Radiol (NY) ; 41(11): 2187-2195, 2016 11.

Article en En | MEDLINE | ID: mdl-27383741

RESUMEN

PURPOSE: Clear cell tubulopapillary renal cell carcinoma (CCTPRCC) is a recently described, low-grade subtype of renal cancer. We determined if imaging features could be used to distinguish early-stage CCTPRCC from stage-matched clear cell RCC (ccRCC) and papillary RCC (pRCC). METHODS: This IRB-approved retrospective study included 54 stage T1a patients with pathologically confirmed CCTPRCC (n = 18), ccRCC (n = 18), and pRCC (n = 18). CT (n = 48) and MRI (n = 27) exams were reviewed and imaging features compared. Continuous variables were evaluated using ANOVA and Tukey's multiple comparison tests. Categorical variables were compared using Chi-square test or Fisher's exact test. RESULTS: Compared to pRCC, CCTPRCC had a lower mean attenuation value on unenhanced CT (p < 0.017), was more often hyperintense on T2-weighted images (p < 0.0001), showed an ill-defined margin (p = 0.003), and demonstrated nonenhancing areas (p = 0.0003). The presence of all three of these statistically significant features [hypoattenuation (unenhanced attenuation ≤25 HU), ill-defined margin, nonenhancing areas] yielded an area under the receiver operator curve (ROC) of 0.92 (95% CI 0.83-0.99) for differentiating CCTPRCC from pRCC. There were no significant differences in the imaging features of CCTPRCC and ccRCC. CONCLUSIONS: Early-stage clear cell tubulopapillary renal cell carcinoma can be distinguished from papillary RCC based on low attenuation on unenhanced CT, high intensity on T2-weighted images, an ill-defined margin, and presence of nonenhancing areas, but cannot be distinguished from clear cell RCC.

Asunto(s)

Carcinoma Papilar/diagnóstico por imagen; Carcinoma Papilar/patología; Carcinoma de Células Renales/diagnóstico por imagen; Carcinoma de Células Renales/patología; Neoplasias Renales/diagnóstico por imagen; Neoplasias Renales/patología; Anciano; Anciano de 80 o más Años; Medios de Contraste; Diagnóstico Diferencial; Femenino; Humanos; Imagen por Resonancia Magnética; Masculino; Persona de Mediana Edad; Clasificación del Tumor; Estadificación de Neoplasias; Estudios Retrospectivos; Sensibilidad y Especificidad; Tomografía Computarizada por Rayos X

Palabras clave

CT and MRI features; Clear cell tubulopapillary renal cell carcinoma; Renal cell carcinoma subtype; Renal mass

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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Papilar / Carcinoma de Células Renales / Neoplasias Renales Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Abdom Radiol (NY) Año: 2016 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

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