Renal cell carcinomas: Sonographic appearance depenDing on size and histologic type

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives-Prior studies have demonstrated that approximately 10% of malignant renal cell carcinomas are as echogenic as angiomyolipomas on sonography. However, a recent presentation suggested that small (<1-cm) echogenic renal masses are always angiomyolipomas or other benign entities. We therefore examined our own cases of renal cell carcinoma, with corresponDing sonography, to confirm that some renal cell carcinomas may also be detected as hyperechoic masses on sonography. Methods-Institutional Review Board approval and Health Insurance Portability and Accountability Act compliance were maintained for this retrospective review of 91 pathologically proven cases of renal cell carcinoma, with corresponDing sonography. Tumors were first differentiated by histologic cell type (clear cell, papillary, and chromophobe). Tumors were then stratified accorDing to 2 size group parameters, falling into those that were 3 cm or larger and those that were smaller than 3 cm in diameter, with the less than 3-cm group further subdivided into 2 cm or smaller and greater than 2 cm. Tumor echogenicity was graded on a 5-point scale with respect to the renal parenchyma. Results-Forty-six tumors (51%) were 3 cm in diameter or smaller, and most were found to be either isoechoic (35%) or mildly hyperechoic (26%) to the surrounDing renal parenchyma. Of tumors smaller than 2 cm, most were either mildly hyperechoic (29%) or as hyperechoic as renal sinus fat (very hyperechoic; 29%). Tumors larger than 3 cm were found most often to be either isoechoic (49%) or mildly hyperechoic (33%), with only 4% found to be very hyperechoic. Conclusions-The sonographic appearances of renal cell carcinomas include a small population that are very hyperechoic on sonography and thus could potentially be misdiagnosed as angiomyolipomas.

Original languageEnglish (US)
Pages (from-to)311-320
Number of pages10
JournalJournal of Ultrasound in Medicine
Volume35
Issue number2
DOIs
StatePublished - Feb 1 2016

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Renal Cell Carcinoma
Ultrasonography
Angiomyolipoma
Kidney
Neoplasms
Health Insurance Portability and Accountability Act
Research Ethics Committees
Diagnostic Errors
Fats
Population

Keywords

  • Angiomyolipoma
  • Echogenicity
  • Kidney neoplasm
  • Renal cell carcinoma
  • Renal mass
  • Sonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Renal cell carcinomas : Sonographic appearance depenDing on size and histologic type. / Sidhar, Kunal; McGahan, John P; Early, Heather M.; Corwin, Michael T; Fananapazir, Ghaneh; Gerscovich, Eugenio O.

In: Journal of Ultrasound in Medicine, Vol. 35, No. 2, 01.02.2016, p. 311-320.

Research output: Contribution to journalArticle

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title = "Renal cell carcinomas: Sonographic appearance depenDing on size and histologic type",
abstract = "Objectives-Prior studies have demonstrated that approximately 10{\%} of malignant renal cell carcinomas are as echogenic as angiomyolipomas on sonography. However, a recent presentation suggested that small (<1-cm) echogenic renal masses are always angiomyolipomas or other benign entities. We therefore examined our own cases of renal cell carcinoma, with corresponDing sonography, to confirm that some renal cell carcinomas may also be detected as hyperechoic masses on sonography. Methods-Institutional Review Board approval and Health Insurance Portability and Accountability Act compliance were maintained for this retrospective review of 91 pathologically proven cases of renal cell carcinoma, with corresponDing sonography. Tumors were first differentiated by histologic cell type (clear cell, papillary, and chromophobe). Tumors were then stratified accorDing to 2 size group parameters, falling into those that were 3 cm or larger and those that were smaller than 3 cm in diameter, with the less than 3-cm group further subdivided into 2 cm or smaller and greater than 2 cm. Tumor echogenicity was graded on a 5-point scale with respect to the renal parenchyma. Results-Forty-six tumors (51{\%}) were 3 cm in diameter or smaller, and most were found to be either isoechoic (35{\%}) or mildly hyperechoic (26{\%}) to the surrounDing renal parenchyma. Of tumors smaller than 2 cm, most were either mildly hyperechoic (29{\%}) or as hyperechoic as renal sinus fat (very hyperechoic; 29{\%}). Tumors larger than 3 cm were found most often to be either isoechoic (49{\%}) or mildly hyperechoic (33{\%}), with only 4{\%} found to be very hyperechoic. Conclusions-The sonographic appearances of renal cell carcinomas include a small population that are very hyperechoic on sonography and thus could potentially be misdiagnosed as angiomyolipomas.",
keywords = "Angiomyolipoma, Echogenicity, Kidney neoplasm, Renal cell carcinoma, Renal mass, Sonography",
author = "Kunal Sidhar and McGahan, {John P} and Early, {Heather M.} and Corwin, {Michael T} and Ghaneh Fananapazir and Gerscovich, {Eugenio O}",
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AU - Sidhar, Kunal

AU - McGahan, John P

AU - Early, Heather M.

AU - Corwin, Michael T

AU - Fananapazir, Ghaneh

AU - Gerscovich, Eugenio O

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N2 - Objectives-Prior studies have demonstrated that approximately 10% of malignant renal cell carcinomas are as echogenic as angiomyolipomas on sonography. However, a recent presentation suggested that small (<1-cm) echogenic renal masses are always angiomyolipomas or other benign entities. We therefore examined our own cases of renal cell carcinoma, with corresponDing sonography, to confirm that some renal cell carcinomas may also be detected as hyperechoic masses on sonography. Methods-Institutional Review Board approval and Health Insurance Portability and Accountability Act compliance were maintained for this retrospective review of 91 pathologically proven cases of renal cell carcinoma, with corresponDing sonography. Tumors were first differentiated by histologic cell type (clear cell, papillary, and chromophobe). Tumors were then stratified accorDing to 2 size group parameters, falling into those that were 3 cm or larger and those that were smaller than 3 cm in diameter, with the less than 3-cm group further subdivided into 2 cm or smaller and greater than 2 cm. Tumor echogenicity was graded on a 5-point scale with respect to the renal parenchyma. Results-Forty-six tumors (51%) were 3 cm in diameter or smaller, and most were found to be either isoechoic (35%) or mildly hyperechoic (26%) to the surrounDing renal parenchyma. Of tumors smaller than 2 cm, most were either mildly hyperechoic (29%) or as hyperechoic as renal sinus fat (very hyperechoic; 29%). Tumors larger than 3 cm were found most often to be either isoechoic (49%) or mildly hyperechoic (33%), with only 4% found to be very hyperechoic. Conclusions-The sonographic appearances of renal cell carcinomas include a small population that are very hyperechoic on sonography and thus could potentially be misdiagnosed as angiomyolipomas.

AB - Objectives-Prior studies have demonstrated that approximately 10% of malignant renal cell carcinomas are as echogenic as angiomyolipomas on sonography. However, a recent presentation suggested that small (<1-cm) echogenic renal masses are always angiomyolipomas or other benign entities. We therefore examined our own cases of renal cell carcinoma, with corresponDing sonography, to confirm that some renal cell carcinomas may also be detected as hyperechoic masses on sonography. Methods-Institutional Review Board approval and Health Insurance Portability and Accountability Act compliance were maintained for this retrospective review of 91 pathologically proven cases of renal cell carcinoma, with corresponDing sonography. Tumors were first differentiated by histologic cell type (clear cell, papillary, and chromophobe). Tumors were then stratified accorDing to 2 size group parameters, falling into those that were 3 cm or larger and those that were smaller than 3 cm in diameter, with the less than 3-cm group further subdivided into 2 cm or smaller and greater than 2 cm. Tumor echogenicity was graded on a 5-point scale with respect to the renal parenchyma. Results-Forty-six tumors (51%) were 3 cm in diameter or smaller, and most were found to be either isoechoic (35%) or mildly hyperechoic (26%) to the surrounDing renal parenchyma. Of tumors smaller than 2 cm, most were either mildly hyperechoic (29%) or as hyperechoic as renal sinus fat (very hyperechoic; 29%). Tumors larger than 3 cm were found most often to be either isoechoic (49%) or mildly hyperechoic (33%), with only 4% found to be very hyperechoic. Conclusions-The sonographic appearances of renal cell carcinomas include a small population that are very hyperechoic on sonography and thus could potentially be misdiagnosed as angiomyolipomas.

KW - Angiomyolipoma

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KW - Kidney neoplasm

KW - Renal cell carcinoma

KW - Renal mass

KW - Sonography

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