CT-guided core-needle biopsy of the renal masses: how many Specimens are neccessary?

Purpose: To analyze the diagnostic yield for each specimen obtained at 16-gauge CT - guided renal biopsy and compare these finding with mass, procedural, and specimen characteristics that could affect yield. Patients, Materials and Forty nine consecutive biopsies of renal masses were performed by using a 16-gauge needle. Each specimen was graded for whether it was non-fragmented or fragmented and for whether it sank or floated, and each pass was graded for whether or not the needle passed through the lesion. Each specimen was mounted on a seqarate slide. A pathologist who was unaware of the final diagnoses reviewed the slides in random order. A diagnosis was determined for each specimen whenever possible and diagnostic yield was calculated as a function of number or passes. thirty-nine [79.6%] lesions were malignant and 10 [20.4%] were benign. Cells indicating the final diagnosis were contained in 164 [75%] of 218 specimens. Cells indicating the diagnosis were contauned in the first specimen in 38 [77.5%] lesions, in the second specimen in 45 [92%], in the third specimen in 47 [96%], and in the fourth specimen in 49 [100%]. Of the 39 malignancies, 36 [93%] were diagnosed with cells contained in the first or second specimen, one cancer [renal cell carcinoma in situ] was diagnosed with sells contained in the forth specimen. Specimens that were non-fragmented [P<. 001] and sank [P<.001] showed correlation with being diagnostic, but needle visualization within the lesion did not. A minimum of four specimens, preferably those that are non-fragmented and that sink, should be obtained with 14-gauge CT-guided renal biopsy

Estimation of serum and vitreous levels of soluble Fas and soluble Fas ligand in Egyptian insulin dependent diabetic patients with neuropathy or retinopathy

Apoptosis is a physiological process observed in many organs and cells which may also occur in pathological conditions. The most important mechanism of apoptosis is the Fas- system. Beta-cell apoptosis has been associated with the onset of insulin dependent diabetes mellitus. The aim of this work is to estimate the serum and vitreous levels of soluble Fas [sFas] and soluble Fas ligand [sFasL] in insulin dependent diabetics with retinopathy and the serum level of s.Fas and s.FasL in insulin dependent diabetics with neuropathy and to compare the results with those obtained from non diabetic and non complicated diabetic subjects. The study revealed a significant increase in the vitreous and serum levels of sFas and sFasL in diabetic patients with retinopathy and a more significant increase of the serum level of sFas and sFasL in diabetics with neuropathy. So, the disregulation of the Fas system may be one of the mechanisms of the pathogenesis of diabetic complications and complementary studies are required to treat or prevent the occuranc of these complications