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Mercken K, Van Berkel B, De Wever L. Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) Syndrome. J Belg Soc Radiol 2024; 108:79. [PMID: 39282017 PMCID: PMC11396326 DOI: 10.5334/jbsr.3687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 08/22/2024] [Indexed: 09/18/2024] Open
Abstract
In hereditary leiomyomatosis and renal cell carcinoma syndrome, fumarate hydratase-deficient renal cell carcinomas typically present as aggressive, unilateral, often cystic masses with heterogeneous enhancement. These tumors can metastasize early, making appropriate imaging and staging critical for diagnosis and management. Teaching point: When a renal lesion suspected of RCC is identified in a patient with cutaneous and uterine leiomyomas, HLRCC should be evaluated, which is important for future genetic counseling.
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Affiliation(s)
- Karel Mercken
- Department Radiology, UZ Leuven, campus Gasthuisberg, Leuven, Belgium Herestraat Leuven, Belgium
| | - Brecht Van Berkel
- Department Radiology, UZ Leuven, campus Gasthuisberg, Leuven, Belgium Herestraat Leuven, Belgium
| | - Liesbeth De Wever
- Department Radiology, UZ Leuven, campus Gasthuisberg, Leuven, Belgium Herestraat Leuven, Belgium
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Chaurasia A, Turkbey EB, Firouzabadi FD, Singh S, Samimi S, Gopal N, Millo C, Ball MW, Linehan WM, Malayeri AA. Imaging finding of renal masses associated with pathogenic variation in succinate dehydrogenase subunit B gene. Clin Imaging 2024; 115:110280. [PMID: 39260085 DOI: 10.1016/j.clinimag.2024.110280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 08/26/2024] [Accepted: 09/02/2024] [Indexed: 09/13/2024]
Abstract
PURPOSE Succinate dehydrogenase (SDH)-deficient renal cell carcinoma (RCC) is a newly defined, rare subtype of renal cancer, associated with pathogenic variations in the Succinate Dehydrogenase Subunit B (SDHB) gene. Our aim is to investigate the imaging findings of SDHB-associated renal tumors, utilizing cross-sectional and FDG-PET imaging in patients with pathogenic variations in SDHB gene, to facilitate accurate tumor characterization. METHODS Twenty SDH-deficient tumors from 16 patients with pathogenic variations in SDHB gene were retrospectively evaluated using cross-sectional and FDG-PET imaging. Clinical findings such as demographics, family history, extra-renal findings and metastases were recorded. Tumor imaging characteristics on CT/MRI included were laterality, size, homogeneity, morphology, margins, internal content, T1/T2 signal intensity, enhancement features, and restricted diffusion. RESULTS Sixteen patients (median age 31 years, IQR 19-41, 8 males) were identified with 68.8 % of patients having a known family history of SDHB variation. 81.3 % of lesions were solitary and majority were solid (86.7 % on CT, 87.5 % on MRI) with well-defined margins in >62.5 % of lesions, without evidence of internal fat, calcifications, or vascular invasion. 100 % of lesions demonstrated restricted diffusion and avid enhancement, with degree >75 % for most lesions on CT and MRI. On FDG-PET, all renal masses showed increased radiotracer uptake. 43.8 % of patients demonstrated extra-renal manifestations and 43.8 % had distant metastasis. CONCLUSION SDHB-associated RCC is predominantly noted in young patients with no gender predilection. On imaging, SDH-deficient RCC are frequently unilateral, solitary, and solid with well-defined margins demonstrating avid enhancement with variability in enhancement pattern and showing restricted diffusion.
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Affiliation(s)
- Aditi Chaurasia
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bldg. 10, 10 Center Drive, Bethesda, MD 20892, USA
| | - Evrim B Turkbey
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Fatemeh Dehghani Firouzabadi
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Shiva Singh
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Safa Samimi
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Nikhil Gopal
- Depatment of Urology, College of Medicine, University of Tennessee, 910 Madison Avenue, Memphis, TN 38163, USA
| | - Corina Millo
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Mark W Ball
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bldg. 10, 10 Center Drive, Bethesda, MD 20892, USA
| | - W Marston Linehan
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bldg. 10, 10 Center Drive, Bethesda, MD 20892, USA
| | - Ashkan A Malayeri
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
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Chen YB. Update on Selected High-grade Renal Cell Carcinomas of the Kidney: FH-deficient, ALK-rearranged, and Medullary Carcinomas. Adv Anat Pathol 2024; 31:118-125. [PMID: 38145398 PMCID: PMC11232671 DOI: 10.1097/pap.0000000000000426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
High-grade renal cell carcinoma (RCC), often diagnosed at advanced stages, significantly contributes to renal cancer-related mortality. This review explores the progress in understanding specific subtypes of high-grade RCC, namely fumarate hydratase (FH)-deficient RCC, anaplastic lymphoma kinase (ALK)-rearranged RCC, and SMARCB1-deficient renal medullary carcinoma, all of which are now recognized as molecularly defined entities in the WHO classification system (2022). While these entities each exhibit a morphologic spectrum that overlaps with other high-grade RCC, ancillary tools developed based on their distinctive molecular alterations can help establish a specific diagnosis, underscoring the importance of integrating molecular findings into diagnostic paradigms. It is important to exclude these specific tumor types in cases with similar morphologic spectrum before rendering a diagnosis of high-grade papillary RCC, collecting duct carcinoma, or RCC, NOS. Several gray areas exist within the spectrum of high-grade uncommon types of RCC, necessitating continued research to enhance diagnostic precision and therapeutic options.
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Affiliation(s)
- Ying-Bei Chen
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Bai J, Li X, Wen Y, Lu Q, Chen R, Liu R, Shangguan T, Ye Y, Lin J, Cai W, Kang D, Chen J. The clinicopathologic and molecular features, and treatment outcome of fumarate hydratase-deficient renal cell carcinoma: a retrospective comparison with type 2 papillary renal cell carcinoma. Aging (Albany NY) 2024; 16:3631-3646. [PMID: 38376408 PMCID: PMC10929833 DOI: 10.18632/aging.205549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND To compare clinicopathologic, molecular features, and treatment outcome between fumarate hydratase-deficient renal cell carcinoma (FH-dRCC) and type 2 papillary renal cell carcinoma (T2 pRCC). METHODS Data of T2 pRCC patients and FH-dRCC patients with additional next-generation sequencing information were retrospectively analyzed. The cancer-specific survival (CSS) and disease-free survival (DFS) were primary endpoint. RESULTS A combination of FH and 2-succino-cysteine (2-SC) increased the rate of negative predictive value of FH-dRCC. Compared with T2 pRCC cases, FH-dRCC cases displayed a greater prevalence in young patients, a higher frequency of radical nephrectomy. Seven FH-dRCC and two T2 pRCC cases received systemic therapy. The VEGF treatment was prescribed most frequently, with an objective response rate (ORR) of 22.2% and a disease control rate (DCR) of 30%. A combined therapy with VEGF and checkpoint inhibitor reported an ORR of 40% and a DCR of 100%. FH-dRCC cases showed a shortened CSS (P = 0.042) and DFS (P < 0.001). The genomic sequencing revealed 9 novel mutations. CONCLUSIONS Coupled with genetic detection, immunohistochemical biomarkers (FH and 2-SC) can distinguish the aggressive FH-dRCC from T2 pRCC. Future research is awaited to illuminate the association between the novel mutations and the clinical phenotypes of FH-dRCC in the disease progression.
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Affiliation(s)
- Junjie Bai
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Xiaoyan Li
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Yahui Wen
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Qing Lu
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Ru Chen
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Rong Liu
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Tong Shangguan
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Yushi Ye
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Jun Lin
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Weizhong Cai
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Deyong Kang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Jianhui Chen
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
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MRI Characteristics of Pediatric and Young-Adult Renal Cell Carcinoma: A Single-Center Retrospective Study and Literature Review. Cancers (Basel) 2023; 15:cancers15051401. [PMID: 36900194 PMCID: PMC10000563 DOI: 10.3390/cancers15051401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Pediatric renal cell carcinoma (RCC) is a rare malignancy. Magnetic resonance imaging (MRI) is the preferred imaging modality for assessment of these tumors. The previous literature has suggested that cross-sectional-imaging findings differ between RCC and other pediatric renal tumors and between RCC subtypes. However, studies focusing on MRI characteristics are limited. Therefore, this study aims to identify MRI characteristics of pediatric and young-adult RCC, through a single-center case series and literature review. Six identified diagnostic MRI scans were retrospectively assessed, and an extensive literature review was conducted. The included patients had a median age of 12 years (63-193 months). Among other subtypes, 2/6 (33%) were translocation-type RCC (MiT-RCC) and 2/6 (33%) were clear-cell RCC. Median tumor volume was 393 cm3 (29-2191 cm3). Five tumors had a hypo-intense appearance on T2-weighted imaging, whereas 4/6 were iso-intense on T1-weighted imaging. Four/six tumors showed well-defined margins. The median apparent diffusion coefficient (ADC) values ranged from 0.70 to 1.20 × 10-3 mm2/s. In thirteen identified articles focusing on MRI characteristics of MiT-RCC, the majority of the patients also showed T2-weighted hypo-intensity. T1-weighted hyper-intensity, irregular growth pattern and limited diffusion-restriction were also often described. Discrimination of RCC subtypes and differentiation from other pediatric renal tumors based on MRI remains difficult. Nevertheless, T2-weighted hypo-intensity of the tumor seems a potential distinctive characteristic.
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Wu G, Liu G, Wang J, Pan S, Luo Y, Xu Y, Kong W, Sun P, Xu J, Xue W, Zhang J. MR Spectroscopy for Detecting Fumarate Hydratase Deficiency in Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome. Radiology 2022; 305:631-639. [PMID: 35943337 DOI: 10.1148/radiol.212984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Noninvasive in vivo detection of fumarate accumulation may help identify fumarate hydratase deficiency in renal cancer related to hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome. Purpose To investigate the feasibility of MR spectroscopy (MRS) in detecting elevated fumarate levels in HLRCC-associated renal cancers. Materials and Methods This study included an experimental xenograft mouse model and prospective clinical cohort. First, MRS was performed on patient-derived tumor xenograft models and control models to detect fumarate. Then, consecutive participants with clinical suspicion of HLRCC-associated renal tumors were enrolled. For the detection of fumarate, MRS results were classified as detected, borderline, undetected, or technical failure. The sensitivity, specificity, and accuracy of MRS for diagnosing HLRCC-associated renal cancer were assessed. The signal-to-noise ratio (SNR) of the fumarate peak was calculated and evaluated with receiver operating characteristic curve analysis. Results Fumarate peaks were detected at 6.54 parts per million in all three patient-derived xenograft models. A total of 38 participants (21 men; mean age, 47 years [range, 18-71 years]) with 46 lesions were analyzed. All primary HLRCC-associated renal cancers showed a fumarate peak; among the seven metastatic HLRCC-associated lesions, a fumarate peak was detected in three lesions and borderline in two. When only detected peaks were regarded as positive findings, the sensitivity, specificity, and accuracy of MRS at the lesion level were 69% (nine of 13 lesions), 100% (33 of 33 lesions), and 91% (42 of 46 lesions), respectively. When borderline peaks were also included as a positive finding, the sensitivity, specificity, and accuracy reached 85% (11 of 13 lesions), 88% (29 of 33 lesions), and 87% (40 of 46 lesions), respectively. The SNR of fumarate showed an area under the receiver operating characteristic curve of 0.87 for classifying HLRCC-associated tumors. Conclusion MR spectroscopy of fumarate was sensitive and specific for hereditary leiomyomatosis and renal cell carcinoma-associated tumors. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Guangyu Wu
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Guiqin Liu
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Jianfeng Wang
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Shihang Pan
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Yuansheng Luo
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Yunze Xu
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Wen Kong
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Peng Sun
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Jianrong Xu
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Wei Xue
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
| | - Jin Zhang
- From the Departments of Radiology (G.W., G.L., S.P., Y.L., J.X.) and Urology (J.W., Y.X., W.K., W.X., J.Z.), Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Rd, 200127 Shanghai, China; and Clinical & Technical Solutions, Philips Healthcare, Beijing, China (P.S.)
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Jikuya R, Murakami K, Nishiyama A, Kato I, Furuya M, Nakabayashi J, Ramilowski JA, Hamanoue H, Maejima K, Fujita M, Mitome T, Ohtake S, Noguchi G, Kawaura S, Odaka H, Kawahara T, Komeya M, Shinoki R, Ueno D, Ito H, Ito Y, Muraoka K, Hayashi N, Kondo K, Nakaigawa N, Hatano K, Baba M, Suda T, Kodama T, Fujii S, Makiyama K, Yao M, Shuch BM, Schmidt LS, Linehan WM, Nakagawa H, Tamura T, Hasumi H. Single-cell transcriptomes underscore genetically distinct tumor characteristics and microenvironment for hereditary kidney cancers. iScience 2022; 25:104463. [PMID: 35874919 PMCID: PMC9301876 DOI: 10.1016/j.isci.2022.104463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/05/2022] [Accepted: 05/17/2022] [Indexed: 11/26/2022] Open
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Yang L, Li XM, Hu YJ, Zhang MN, Yao J, Song B. Multidetector CT Characteristics of Fumarate Hydratase-Deficient Renal Cell Carcinoma and Papillary Type II Renal Cell Carcinoma. Korean J Radiol 2021; 22:1996-2005. [PMID: 34668351 PMCID: PMC8628156 DOI: 10.3348/kjr.2021.0212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 06/08/2021] [Accepted: 07/20/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To investigate the multidetector computed tomography (MDCT) features of fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) with germline or somatic mutations, and compare them with those of papillary type II RCC (pRCC type II). MATERIALS AND METHODS A total of 24 patients (mean ± standard deviation, 40.4 ± 14.7 years) with pathologically confirmed FH-deficient RCC (15 with germline and 9 with somatic mutations) and 54 patients (58.6 ± 12.6 years) with pRCC type II were enrolled. The MDCT features were retrospectively reviewed and compared between the two entities and mutation subgroups, and were correlated with the clinicopathological findings. RESULTS All the lesions were unilateral and single. Compared with pRCC type II, FH-deficient RCC was more prevalent among younger patients (40.4 ± 14.7 vs. 58.6 ± 12.6, p < 0.001) and tended to be larger (8.1 ± 4.1 vs. 5.4 ± 3.2, p = 0.002). Cystic solid patterns were more common in FH-deficient RCC (20/24 vs. 16/54, p < 0.001), with 16 of the 20 (80.0%) cystic solid tumors having showed typical polycystic and thin smooth walls and/or septa, with an eccentric solid component. Lymph node (16/24 vs. 16/54, p = 0.003) and distant (11/24 vs. 3/54, p < 0.001) metastases were more frequent in FH-deficient RCC. FH-deficient RCC and pRCC type II showed similar attenuation in the unenhanced phase. The attenuation in the corticomedullary phase (CMP) (76.3% ± 25.0% vs. 60.2 ± 23.6, p = 0.008) and nephrographic phase (NP) (87.7 ± 20.5, vs. 71.2 ± 23.9, p = 0.004), absolute enhancement in CMP (39.0 ± 24.8 vs. 27.1 ± 22.7, p = 0.001) and NP (50.5 ± 20.5 vs. 38.2 ± 21.9, p = 0.001), and relative enhancement ratio to the renal cortex in CMP (0.35 ± 0.26 vs. 0.24 ± 0.19, p = 0.001) and NP (0.43 ± 0.24 vs. 0.29 ± 0.19, p < 0.001) were significantly higher in FH-deficient RCC. No significant difference was found between the FH germline and somatic mutation subgroups in any of the parameters. CONCLUSION The MDCT features of FH-deficient RCC were different from those of pRCC type II, whereas there was no statistical difference between the germline and somatic mutation subgroups. A kidney mass with a cystic solid pattern and metastatic tendency, especially in young patients, should be considered for FH-deficient RCC.
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Affiliation(s)
- Ling Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xue-Ming Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ya-Jun Hu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Meng-Ni Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Yao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
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Edney E, Davenport MS, Curci N, Schieda N, Krishna S, Hindman N, Silverman SG, Pedrosa I. Bosniak classification of cystic renal masses, version 2019: interpretation pitfalls and recommendations to avoid misclassification. Abdom Radiol (NY) 2021; 46:2699-2711. [PMID: 33484283 DOI: 10.1007/s00261-020-02906-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/01/2020] [Accepted: 12/06/2020] [Indexed: 12/22/2022]
Abstract
The purpose of this review is to describe the potential sources of variability or discrepancy in interpretation of cystic renal masses under the Bosniak v2019 classification system. Strategies to avoid these pitfalls and clinical examples of diagnostic approaches are also presented. Potential pitfalls in the application of Bosniak v2019 are divided into three categories: interpretative, technical, and mass related. An organized, comprehensive review of possible discrepancies in interpreting Bosniak v2019 cystic masses is presented with pictorial examples of difficult clinical cases and proposed solutions. The scheme provided can guide readers to consistent, precise application of the classification system. Radiologists should be aware of the possible sources of misinterpretation of cystic renal masses when applying Bosniak v2019. Knowing which features and types of cystic masses are prone to interpretive errors, in addition to the inherent trade-offs between the CT and MR techniques used to characterize them, can help radiologists avoid these pitfalls.
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Affiliation(s)
- Elizabeth Edney
- Department of Radiology, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Matthew S Davenport
- Departments of Radiology and Urology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nicole Curci
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Satheesh Krishna
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - Nicole Hindman
- Department of Radiology, New York University Langone Medical Center, New York, USA
| | - Stuart G Silverman
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ivan Pedrosa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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