Benign Kidney Tumors Research Articles

Prospective Evaluation of 99mTc-sestamibi SPECT/CT for the Diagnosis of Renal Oncocytomas and Hybrid Oncocytic/Chromophobe Tumors

Nuclear imaging offers a potential noninvasive means of determining the histology of renal tumors. The aim of this study was to evaluate the accuracy of technetium-99m (99mTc)–sestamibi single-photon emission computed tomography/x-ray computed tomography (SPECT/CT) for the differentiation of oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) from other renal tumor histologies. In total, 50 patients with a solid clinical T1 renal mass were imaged with 99mTc-sestamibi SPECT/CT prior to surgical resection. Preoperative SPECT/CT scans were reviewed by two blinded readers, and their results were compared with centrally reviewed surgical pathology data. Following surgery, 6 (12%) tumors were classified as renal oncocytomas and 2 (4%) as HOCTs. With the exception of 1 (2%) angiomyolipoma, all other tumors were renal cell carcinomas (82%). 99mTc-sestamibi SPECT/CT correctly identified 5 of 6 (83.3%) oncocytomas and 2 of 2 (100%) HOCTs, resulting in an overall sensitivity of 87.5% (95% confidence interval [CI], 47.4−99.7%). Only two tumors were falsely positive on SPECT/CT, resulting in a specificity of 95.2% (95% CI, 83.8−99.4%). In summary, 99mTc-sestamibi SPECT/CT is a promising imaging test for the noninvasive diagnosis of renal oncocytomas and HOCTs. Patient summaryWe found that the imaging test 99mTc-sestamibi SPECT/CT can be used to accurately diagnose two types of benign kidney tumors. This test may be eventually used to help better evaluate patients diagnosed with a renal tumor.

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Mesenchymal tumors of the kidney, although infrequently encountered, constitute a wide spectrum of lesions. The relative rarity of these tumors means that in some instances criteria to differentiate between benign and malignancy are currently incompletely defined. More recently a variety of novel stromal tumors have been characterized, with hemangioblastoma and myopericytoma being notable examples. The identification of a subset of spindle cell tumors as synovial sarcoma, on the basis of the presence of a characteristic genetic translocation, has facilitated the correct classification of a number of tumors previously labeled as fibrosarcoma, malignant fibrous histiocytoma, or more recently cystic embryonal sarcoma. In this review, we have detailed the spectrum of both benign and malignant stromal tumors of the adult kidney, described the gross and microscopic features, with an emphasis on immunoexpression and the differential diagnosis of each tumor type.

Giant metanephric adenoma, benign tumor with features of clinical and radiological malignancy

Abstract Introduction Metanephric adenoma (MA) is a rare benign neoplasm, accounting for 0.2% of adult renal epithelial neoplasms. This neoplasm mainly occurs in patients aged 50–60 years. Aim The aim of this study was presentation of rare kidney tumor assessment to elaborate proper postoperative decisions and further patient's recommendation. Material and methods The case of a 64-year-old woman with MA is presented. Radiological, intraoperative and pathomorphological evaluations of this neoplasm were performed and compared. Results and discussion Primarily performed CT imaging analyzed this tumor as a malignant neoplasm; organ destruction and evident mass invasion in the calyx and kidney pelvis region were noticeable. Regardless of the initial radiological and clinical characteristic, postoperative pathomorphological analyses recognized the benign nature of this tumor; regularly located tubules and small cell regular outlook were observable. Attention was given to a solid fibrous capsule, which separated neoplasm from the rest of the healthy kidney structure. The patient was not qualified for adjuvant therapy, based on the pathomorphological evaluation due to characteristic nature of the benign kidney tumor. Nevertheless, in view of the initial observations (radiological and clinical) and because cases of metastases in the course of MA are described in the literature, a further periodic follow-up was strongly suggested to the patient. Conclusions The evaluation of neoplasm tumor requires many analyses. In this rare tumor lack of correlation was observed between radiological and pathomorphological examinations. The clinical decision connected with the patient's recommendation should be based on complete results, especially pathomorphological diagnosis. The patient is now under clinical observation and in six months follow-up has had no neoplasm recurrence or metastasis.

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Mesenchymal tumors of the kidney, although infrequently encountered, constitute a wide spectrum of lesions. The relative rarity of these tumors means that in some instances criteria to differentiate between benign and malignancy are currently incompletely defined. More recently a variety of novel stromal tumors have been characterized, with hemangioblastoma and myopericytoma being notable examples. The identification of a subset of spindle cell tumors as synovial sarcoma, on the basis of the presence of a characteristic genetic translocation, has facilitated the correct classification of a number of tumors previously labeled as fibrosarcoma, malignant fibrous histiocytoma, or more recently cystic embryonal sarcoma. In this review, we have detailed the spectrum of both benign and malignant stromal tumors of the adult kidney, described the gross and microscopic features, with an emphasis on immunoexpression and the differential diagnosis of each tumor type.

What Is The New Tumor Marker For Detection Of Different Kidney Tumors? Modern Study To Isolation, Purification, And Characterization Of Galactose Binding Lectin From Sera Of Patients With Kidney Cancer

The present study was designed to investigate lectins in sera of patients with kidney tumors, in addition to non tumoral kidney disease patients. Fifty five patients of malignant kidney tumors were enrolled in addition to 23 patients of benign kidney tumors, and 18 patients of non tumoral kidney diseases used as control groups, in addition to 46 healthy individuals were also investigated. The age of patients and healthy individuals were 10-90 years. The measurement of total serum proteins revealed significant (p < 0.001) decrease in patients of malignant tumors when compared with those of benign, non tumoral diseases, and healthy individuals. The conditions of the hemagglutination assay of serum lectin activity were optimized. They were Tris buffer of 20 mM and pH 7.4, 60 mM CaCl2, 800 µg of defatted serum, 30 ˚C for serum samples, 60 minutes for serum samples, and human blood of group A+ suspension with 1.4 optical density. The measurement of the specific hemagglutination activity of lectins demonstrated significant (p < 0.001) elevation in patients of malignant tumors when compared with those of other patients and healthy individuals. Lectin activity was pointed out to be significantly (r = 0.767 at p < 0.0005) positively correlated with stage of malignancies. The cutoff value of the specific hemagglutination activity was found to equal 6 SHU for discriminatory malignant kidney tumors. Serum lectins activity were indicated to be inhibited by galactose, mannose, lactose, and N-acetyl galactosamine. Purification of lectin from sera of patients with malignant kidney tumors by affinity chromatography with the use of silver stain revealed galactose binding lectin (GalBL). The purified folds and the yield was 132 with 22.1. The polyacrylamide gel electrophoresis (PAGE) of purified lectin demonstrated one band consisted lectin activity. The approximate molecular weight of GalBL was determined and found to be 98.40. Purified lectin was characterized through the assessment of the capability to agglutinate RBCs, inhibition by EDTA, pH dependency, thermal dependent, and carbohydrate contents. GalBL was observed to be calcium independence lectins. These results suggest that the diagnosis of the specific hemagglutination activity of lectin is a promising biomarker for discrimination of malignant kidney tumor patients and the purified lectin could be introduced in the field of biomarkers.

Mesenchymal tumors of adult kidney

Mesenchymal tumors of the kidney, although infrequently encountered, constitute a wide spectrum of lesions. The relative rarity of these tumors means that in some instances criteria to differentiate between benign and malignancy are currently incompletely defined. More recently a variety of novel stromal tumors have been characterized, with hemangioblastoma and myopericytoma being notable examples. The identification of a subset of spindle cell tumors as synovial sarcoma, on the basis of the presence of a characteristic genetic translocation, has facilitated the correct classification of a number of tumors previously labeled as fibrosarcoma, malignant fibrous histiocytoma, or more recently cystic embryonal sarcoma. In this review, we have detailed the spectrum of both benign and malignant stromal tumors of the adult kidney, described the gross and microscopic features, with an emphasis on immunoexpression and the differential diagnosis of each tumor type.

Vimentin 3, the new hope, differentiating RCC versus oncocytoma.

Vimentin is currently used to differentiate between malignant renal carcinomas and benign oncocytomas. Recent reports showing Vimentin positive oncocytomas seriously question the validity of this present diagnostic approach. Vimentin 3 is a spliced variant and ends with a unique C-terminal ending after exon 7 which differentiates it from the full length version that has 9 exons. Therefore, the protein size is different; the full length Vimentin version has a protein size of ~57 kDa and the truncated version of ~47 kDa. We designed an antibody, called Vim3, against the unique C-terminal ending of the Vimentin 3 variant. Using immune histology, immune fluorescence, Western blot, and qRT-PCR analysis, a Vim3 overexpression was detectable exclusively in oncocytoma, making the detection of Vim3 a potential specific marker for benign kidney tumors. This antibody is the first to clearly differentiate benign oncocytoma and the mimicking eosinophilic variants of the RCCs. This differentiation between malignant and benign RCCs is essential for operative planning, follow-up therapy, and patients' survival. In the future the usage of Vimentin antibodies in routine pathology has to be applied with care. Consideration must be given to Vimentin specific binding epitopes otherwise a misdiagnosis of the patients' tumor samples may result.

PD-L1 expression in non-clear cell renal cell carcinoma and benign kidney tumors.

4526 Background: Programmed death-1 (PD-1) receptor negatively regulates T cell-mediated responses.PD-1 ligand (PD-L1) is aberrantly expressed in clear cell renal cell carcinoma (ccRCC) and is asso...

MiR-129-3p, as a diagnostic and prognostic biomarker for renal cell carcinoma, attenuates cell migration and invasion via downregulating multiple metastasis-related genes.

Downregulation of miRNA expression has been identified as a novel feature of renal cell carcinoma (RCC). Recently, miR-129-2 is well known to be frequently reduced by DNA methylation and has anti-tumor effects in various tumors but so far not in RCC. The aim of this study was to investigate the clinical significance and the role of it in RCC. The expression levels of miR-129-3p and miR-129-5p, two mature products of miR-129-2, were determined by real-time quantitative reverse transcription PCR in 69 cases of paired different kidney tumors and normal tissues and clear cell RCC (ccRCC) cell lines. The roles of them in RCC cells were assessed by functional analyses. Protein expression was detected by Western blot. miR-129-3p, but not miR-129-5p, was widely attenuated in human ccRCC, and chromophobe RCC. miR-129-3p could yield 73.5 % accuracy in discriminating ccRCCs from normal tissues. The relative miR-129-3p expression significantly differed between malignant and benign kidney tumors. Importantly, low miR-129-3p levels were associated with short disease-free and overall survival. Ectopic expression of miR-129-3p robustly impaired RCC cell migratory and invasive properties, but had no impact on cell viability and cell cycle distribution. Finally, miR-129-3p decreased multiple metastasis-related genes in RCC cells, including SOX4, phosphorylation of focal adhesion kinase and MMP-2/9 expression. miR-129-3p may act as a promising diagnostic biomarker for discriminating ccRCC from benign tumors and normal tissues and an independent prognostic biomarker in ccRCC. miR-129-3p may exert its anti-metastatic function through modulating multiple targets.

What Is The New and Sensitive Tumor Marker for Detection of Different Kidney Tumors? Modern Study to Isolation, Purification and Characterization of N-Acetyl Galactosamine Binding Lectin From Sera Of Patients With Kidney Cancer

The present study was designed to investigate lectins in sera of patients with kidney tumors, in addition to non tumoral kidney disease patients. Fifty five patients of malignant kidney tumors were enrolled in addition to 23 patients of benign kidney tumors, and 18 patients of non tumoral kidney diseases used as control groups, in addition to 46 healthy individuals were also investigated. The age of patients and healthy individuals were 10-90 years. The measurement of total serum proteins revealed significant (p &lt; 0.001) decrease in patients of malignant tumors when compared with those of benign, non tumoral diseases, and healthy individuals. The conditions of the hemagglutination assay of serum lectin activity were optimized. They were Tris buffer of 20 mM and pH 7.4, 60 mM CaCl2, 800 µg of defatted serum, 30 ˚C for serum samples, 60 minutes for serum samples, and human blood of group A+ suspension with 1.4 optical density. The measurement of the specific hemagglutination activity of lectins demonstrated significant (p &lt; 0.001) elevation in patients of malignant tumors when compared with those of other patients and healthy individuals. Lectin activity was pointed out to be significantly (r = 0.767 at p &lt; 0.0005) positively correlated with stage of malignancies. The cutoff value of the specific hemagglutination activity was found to equal 6 SHU for discriminatory malignant kidney tumors. Serum lectins activity were indicated to be inhibited by galactose, mannose, lactose, and N-acetyl galactosamine. Purification of lectin from sera of patients with malignant kidney tumors by affinity chromatography with the use of silver stain revealed N-Acetyl Galactosamine Binding Lectin (GalNAcBL). The purified folds and the yield was 178 with 32.4%. The polyacrylamide gel electrophoresis (PAGE) of purified lectin demonstrated one band consisted lectin activity. The approximate molecular weight of GalNAcBL was determined and found to be 63.83. Purified lectin was characterized through the assessment of the capability to agglutinate RBCs, inhibition by EDTA, pH dependency, thermal dependent, and carbohydrate contents. GalNAcBL were observed to be calcium dependence lectins (C-type). These results suggest that the diagnosis of the specific hemagglutination activity of lectin is promising biomarker for discrimination of malignant kidney tumor patients and the purified lectin could be introduced in the field of biomarkers.

The Properties of Protease Isolated from Tissues of Benign and Malignant Kidney Tumors Patients

The research includes the study of some protease properties in seven patients diagnosed with kidney tumors. Three of them were benign and the others were malignant. The samples were collected from the patients directly after undergoing the surgery in Al-Jamhoory hospital in Nineveh Governorate, Iraq. Protease enzyme was isolated using different biochemical techniques, like ammonium sulphate precipitation, dialysis and gel filtration chromatography on sephadex G-100. The comparative molecular weight of protease was determined using gel filtration and was found to be (72000 and 75000 ± 2000) dalton for benign and malignant tumors respectively. The results showed that there was a (55%) increase in the specific activity of protease in malignant kidney tumors than benign. The optimum conditions for protease activity were obtained using sodium borate buffer at pH (8.8) for (1) minute incubation at (40°C) and (0.4) mM of casein as a substrate Vmax and Km were found to be (0.87 U/ml) and (0.22 mM) respectively by Linweaver-Burk plot. Finally, the effect of some chemical compounds like iodoacetamide, mercurous chloride, zinc sulphate showed an inhibition impact on protease activity while calcium sulphate and magnesium chloride demonstrated an increase effect on the protease activity.

739 CLINICAL CHARACTERISTICS OF VON HIPPEL-LINDAU DISEASE IN CHINESE PATIENTS

cases in 2001 and 44,455 cases in 2010. Benign kidney neoplasm rates (nephrectomy specimen) were 5.3% in 2001 and 4.4% in 2010; malignancy rates were 94.7% in 2001 and 95.6% in 2010. Partial nephrectomy cases increased from 5,607 (2001) to 18,492 (2010). Benign kidney neoplasm rates for partial nephrectomy cases were 16% in both 2001 and 2010, while averaging 17% over the time period. Malignancy rates for partial nephrectomy cases were 84% in both 2001 and 2010. Benign kidney tumor rates (overall) based on gender and age are shown in the Table below.

FDG PET or PET/CT in Evaluation of Renal Angiomyolipoma

ObjectiveAngiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML.Materials and MethodsThe study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clinical and radiographic features.ResultsSix men and 15 women were included in our study. The mean age of the patients was 57.14 ± 9.67 years old. The mean diameter of 21 renal AML on CT scans was 1.76 ± 1.00 cm (Min: 0.6 cm; Max: 4.4 cm). CT scans illustrated renal masses typical of AMLs, and the corresponding FDG PET scans showed minimal FDG activities in the area of the tumors. None of the 21 AMLs showed a maximum standardized uptake value (SUVmax) greater than 1.98. No statistically significant correlation was present between SUVmax and tumor size.ConclusionRenal AMLs demonstrate very low to low uptake on FDG PET and PET/CT imaging in this study. When a fat-containing tumor in the kidney is found on a CT scan, it is critical to differentiate an AML from a malignant tumor including an RCC, liposarcoma, and Wilms tumor. This study suggests that FDG PET or PET/CT imaging is useful for differentiating a renal AML from a fat-containing malignant tumor.

Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: Safety and imaging follow-up in 222 patients

ObjectiveMicrowave ablation is a minimally invasive technique that has been used to treat benign and malignant tumors of liver, lung and kidney. Towards thyroid nodules, only a few cases are reported so far. The aim of the study was to investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules with a large sample. Materials and methodsA total of 477 benign thyroid nodules in 222 patients underwent microwave ablation in our department from July 2009 to March 2012. Microwave ablation was carried out using microwave antenna (16G) under local anesthesia. Nodule volume, thyroid function and clinical symptoms were evaluated before treatment and at 1, 3, more than 6 months. The study was ethics committee approved and written informed consents were obtained from all patients. ResultsAll thyroid nodules significantly decreased in size after microwave ablation. A 6-month follow-up was achieved in 254 of 477 nodules, and the mean decrease in the volume of thyroid nodules was from 2.13±4.42ml to 0.45±0.90ml, with a mean percent decrease of 0.65±0.65. A volume-reduction ratio greater than 50% was observed in 82.3% (209/254) of index nodules, and 30.7% (78/254) of index nodules disappeared 6-month after the ablation. The treatment was well tolerated and no major complications were observed except pain and transient voice changes. ConclusionsMicrowave ablation seems to be a safe and effective technique for the treatment of benign thyroid nodules. Further prospective randomized studies are needed to define the role of the procedure in the treatment of thyroid nodules.

A Biochemical Study for Evaluation and Analysis of Serum Protein of Patients with Different Kidney Tumors

The amount of protein in the serum depends on the balance between the rate of its synthesis, and that of its catabolism or loss. Abnormal metabolism may result from nutritional deficiency, enzyme deficiency, abnormal secretion of hormones, or the actions of drugs and toxins. Renal cancer is the third most common malignancy of the genitourinary system, and accounts for 3% of adult malignancies globally. Total serum proteins were measured in malignant kidney tumor, benign kidney tumors, and non tumoral kidney diseases patient groups, as well as in healthy individuals. A significant decrease (p&lt; 0.001) of total serum protein levels in patients with malignant kidney tumors when compared with those of benign tumors, non tumoral diseases, and healthy individuals. The lowest serum protein levels were found in patients with stage IV, regardless their genders. Analysis of total serum proteins using PAGE revealed clear differences in the number and shape of the bands in patients with different kidney diseases compared with healthy controls.

A Biochemical Study for Evaluation and Analysis of Serum Protein of Patients with Different Kidney Tumors

The amount of protein in the serum depends on the balance between the rate of its synthesis, and that of its catabolism or loss. Abnormal metabolism may result from nutritional deficiency, enzyme deficiency, abnormal secretion of hormones, or the actions of drugs and toxins. Renal cancer is the third most common malignancy of the genitourinary system, and accounts for 3% of adult malignancies globally. Total serum proteins were measured in malignant kidney tumor, benign kidney tumors, and non tumoral kidney diseases patient groups, as well as in healthy individuals. A significant decrease (p&lt; 0.001) of total serum protein levels in patients with malignant kidney tumors when compared with those of benign tumors, non tumoral diseases, and healthy individuals. The lowest serum protein levels were found in patients with stage IV, regardless their genders. Analysis of total serum proteins using PAGE revealed clear differences in the number and shape of the bands in patients with different kidney diseases compared with healthy controls.

Hypertension Secondary to Reninoma Treated With Laparoscopic Nephron-sparing Surgery in a Child

Reninoma is an extremely rare, renin-secreting, benign kidney tumor that can cause hypertension. We present a case of hypertension secondary to reninoma treated with laparoscopic nephron-sparing surgery in a 15-year-old girl and review some relevant published literature. Laparoscopic retroperitoneal nephron-sparing surgery was performed and the tumor was removed intact. The histopathologic examination showed the characteristic of reninoma with positive CD34 staining immunohistochemically. The patient's blood pressure and level of serum potassium remained normal at 1-month follow-up examination.

Renal angiomyolipoma with coexistent hemorrhagic aneurysm formation and fatty thrombus in inferior vena cava: a rare presentation

Angiomyolipoma (AML) is known as the most common benign mesenchymal tumor of kidney. Usually AMLs present as benign lesions without local invasion or complication. However, few cases of renal AML have been reported with complications such as tumor thrombus extension into inferior vena cava (IVC) or hemorrhagic aneurysm formation. We report a complicated case of renal AML with CT and angiography evidence of hemorrhagic aneurysm formation and IVC thrombus, treated by a combination of selective arterial embolization, radical nephrectomy and thrombectomy. Radiologists and clinicians should be aware that AMLs could have such aggressive behaviors.

Detection, Isolation, Purification, and Characterization of Mannose Binding Lectin (ManBL) from Patients with Different Kidney Diseases and Healthy Individuals

The present study was designed to investigate the presence of mannose binding lectin (ManBL) in the sera and tissue samples of patients with tumoral (benign & malignant) kidney in addition to patients with non tumoral kidney affection, in order to establish the possibility of using serum and tissue ManBL test for diagnosis and epidemiological testing of kidney cancers. Participants of the present study were 96 patients at the age range 12-80 years; they were attending by different hospitals in Najaf (basically) and Karbala, and 46 healthy individuals within the same age range of the studying patients groups. Specific hemagglutination activity levels were revealed a significant increased (p < 0.001) in the sera and tissues of the patients with the malignant tumors specimens in comparison to that of pathological controls and healthy individuals. Serum and tissue hemagglutination activity levels were significantly higher (p < 0.001) in patients with metastatic disease compared with patients with localized tumors. While, the levels of the hemagglutination activity were approximate at patients with the end malignant kidney tumors stages. Upon electrophoresis of the study samples, the results reflected presence of changes in some proteins and glycoproteins bands presents in these samples. Using hydrophobic affinity chromatography, ManBLs were purified from sera of malignant, benign kidney tumors and non tumoral kidney diseases in addition to healthy individuals groups. The purified lectins were found to be glycoprotein with 77.45 KD as an approximate molecular weight and its sugar content was equal to13.5%. The maximum concentration of purified ManBL was found at patients with malignant kidney tumors.The results revealed that the highest hemagglutination activity of purified ManBL occurred with O + RBCs, at pH 7.4, and 37˚C. ManBL (regardless of its origin) lost the hemagglutination activity, completely, in the presence of EDTA. A result that indicates that the present purified the human ManBLs is a calcium dependent type.

Circulating Tumor M2 Pyruvate Kinase and Thymidine Kinase 1 Are Potential Predictors for Disease Recurrence in Renal Cell Carcinoma After Nephrectomy

Pyruvate kinase type M2 (TuM2-PK) and thymidine kinase 1 (TK1) are the key enzymes involved in tumor cells metabolism and proliferation. We explored the association of their preoperative circulating levels with disease recurrence in patients with renal cell carcinoma (RCC). We measured the plasma levels of TuM2-PK levels and serum TK1 activity preoperatively in patients with RCC, using a quantitative ELISA, and correlated the results with clinicopathological parameters. Significantly higher levels of TuM2-PK and TK1 were found in 116 patients with RCC compared with 20 healthy participants (P < .001 and P = .03), but not compared with 27 patients with benign kidney tumors (P = .13 and P = .72). There was a significant association between the level of TuM2-PK and of TK1 activity with T stage (P = .01 and P = .04). Of 2 markers only TuM2-PK was significantly associated with tumor grade (P = .001). The presence of extensive tumor necrosis (> 50%) was associated with high TuM2-PK (P = .001) and low TK1 (P = .03). The 5-year recurrence-free survival for patients with elevated TuM2-PK or TK1 was significantly lower compared with those for patients with normal marker levels (55% vs 94%, P < .001 and 21% vs 90%, P = .002). Multivariate Cox Proportional Hazard analysis demonstrated that TuM2-PK and TK1, adjusted for stage, grade and tumor necrosis were retained as independent predictors of disease recurrence (HR = 7.3, P = .04 and HR = 3.8, P = .03). The measurements of 2 circulating biomarkers, TuM2-PK and TK1, in RCC patients before nephrectomy can be useful for predicting recurrence and stratifying the patients into risk groups for possible adjuvant treatment.