CT texture analysis for differential diagnosis of renal chromophobe cell carcinoma and renal oncocytoma / 中国医学影像技术

Objective: To investigate the value of texture analysis based on enhanced renal CT for identification of chromophobe cell renal carcinoma (CCRC) and renal oncocytoma (RO). Methods: CT images of 64 patients with CCRC and 31 with RO were retrospectively analyzed. ITK-SNAP version 4.11.0 software was used to delineate the region of interest, and A.K.Version v3.0.0.R software was used to extract texture features. Random forest model was established using texture features included in random forest algorithm. Logistic regression was used to evaluate the discriminative the efficacy of the established models for differential diagnosis of CCRC and RO. Results: The first 20 texture parameters selected with random forest algorithm from corticomedullary phase, nephrographic phase and both of them, with weight values from high to low, were evaluated with Logistic regression, and the AUC values were 0.876, 0.861 and 0.945, respectively. Conclusion: Texture analysis based on enhanced renal CT images has clinical value in differential diagnosis of CCRC and RO.

A renal oncocytoma in a Maltese dog with renal cysts / 대한수의학회지

A renal oncocytoma was diagnosed in an 8-year-old female Maltese dog with a history of renal cysts. Tumor cells were not detected until six months after observation of renal cysts. Nephrectomy was performed to treat the neoplasia. Tumor-like masses with numerous nodules were observed in the inner surface of cysts present in the caudal part of the left kidney. Histologically, the tumor consisted of cells with abundant eosinophilic cytoplasm. The diagnosis was based on histological features, periodic acid-Schiff reaction, and immunohistochemical cytokeratin staining. Based on a literature review, this is the first canine renal oncocytoma case reported in Korea.

CT analysis and differentiation of clear cell renal cell carcinoma and renal oncocytoma / 实用放射学杂志

Objective To probe the difference of MSCT features between clear cell renal cell carcinoma (ccRCC)and renal oncocytoma (RO),to improve the diagnostic accuracy.Methods 31 cases of ccRCC and 16 cases of RO which were confirmed by pathology were analyzed retrospectively,and the difference in some CT features including the morphology and CT value of plain scanning and three phases of enhancement scanning were analyzed.Results The diameter of the tumor of the ccRCC group was (5.04 ± 1.9 1 4)cm,meanwhile that of the RO group was (3.5 9±2.1 6)cm,exhibiting statistically significant difference in the diameter which was bigger in ccRCC group than that in RO group (P＝0.023).There were 90.32% (28/31)of cases with cystic necrosis in the ccRCC group and 18.75%(3/16)in the RO group,which was statistically significant that the patients with cystic deterioration in the ccRCC group were more than those in the RO group (P＜0.001).35.48% (11/31)of cases with peritumoral or intratumoral neovascularization in the ccRCC group and no cases in the RO group were found,and there was a statistically significant difference (P＝0.009).The enhancement degree in the ccRCC group was greater than that in the RO group in cortical phase and excretory phase,but lower in parenchy phase.However, there was no significant difference in the enhancement degree and the enhancement index in three phases of enhancement scanning (P＞0.05). Conclusion MSCT can demonstrate the renal tumor with or without cystic necrosis and neovascularization around or inside the tumor,which is helpful to differentiate ccRCC from RO.

MRI features of renal oncocytoma / 中华放射学杂志

Objective To investigate the MRI features of renal oncocytoma(RO). Methods We retrospectively analyzed the data of 26 patients by histologically confirmed with RO in Chinese PLA General Hospital from September 2006 to May 2017 and performed pre-operative MRI and dynamic contrast-enhanced MRI.Lesions were divided into two groups based on the diameter:large group with large than 3 cm(16 cases,16 lesions)and small group with less than 3 cm(10 cases,11 lesions).Features of each lesion were analyzed, including location, pseudocapsules, lipids and other 11 indicators. Tumor imaging features were compared between two groups by univariate and multivariate logistic regression analysis. Results Of 27 RO lesions, 12 were located in the left kidney and 15 in the right kidney. Twenty five lesions appeared exophytic(92.6%,25/27),10 lesions showed exophytic angular interface(37.0%,10/27), 25 lesions showed pseudocapsule(92.6%,25/27),4 lesions appeared lipid(14.8%,4/27),2 lesions showed cystic degeneration or necrosis(7.4%,2/27),1 lesion showed hemorrhage(3.7%,1/27),13 lesions appeared fibrous scar(48.1%,13/27),19 lesions with moderate or intense enhancement in the corticomedullary phase (70.4%, 19/27), 9 lesions with wheel-spoke-like enhancement (33.3%, 9/27), and 2 lesions showed segmental enhancement inversion (7.4%, 2/27). Univariate logistic regression exhibited statistically significant correlation between exophytic angular interface with renal parenchyma,fibrous scar,moderate or intense enhancement in the corticomedullary phase,and wheel-spoke-like enhancement of the tumors both in small and large RO groups with OR value of 0.054, 9.898, 8.400 and 10.000, respectively. In the multivariate logistic regression analysis, exophytic angular interface with renal parenchyma and intense enhancement in the corticomedullary phase were found to be high risk factors with OR value of 0.033 and 15.381,respectively.Conclusions The main manifestation of RO on MRI is that both kidneys can occur, with many exogenesis, pseudocapsules, but less lipids, cystic degeneration, necrosis, hemorrhage and segmental enhanced reversal;smaller lesions(diameter<3 cm)tend to conical interface,while larger lesions (diameter≥3 cm)may have fibrous scars,spoke-shaped enhancement,moderate and significantly enhanced cortical phase characteristics.

Analysis of CT features and misdiagnosis of renal oncocytoma / 实用放射学杂志

Objective To investigate the CT features of renal oncocytoma(RO),and to analyze the causes of misdiagnosis.Methods CT and clinical data of 1 2 patients with RO confirmed by surgery and pathology were analyzed retrospectively,the CT features and the causes of misdiagnosis before operation were analyzed and summarized.Results According to CT features before operation,among the 1 2 cases of RO,9 were misdiagnosed as renal carcinoma,3 were considered as benign occupying lesions.There were 6 cases located in the left kidney and 6 in the right kidney.Seven cases showed round mass and 5 showed irregular mass.Plain CT showed homogeneous masses in 6 cases and heterogeneous masses in 6 cases.Enhanced CT showed masses with homogeneous enhancement in 2 cases and masses with progressive enhancement in 10 cases.The attenuation value of parenchymal enhancement ranged from 41 to 143 HU (mean 90.17 HU).Seven cases had central scar syndrome,of which 1 case had calcification in the scar.One case showed segmental enhancement inversion,8 showed conical interface and 5 had holding ball signs.Conclusion The CT features of RO is central scar syndrome, segmental enhancement inversion,conical interface and holding ball sign,etc,but the definitive diagnosis still rely on pathology.

Diagnosis and differential diagnosis of the renal oncocytoma by CT and MRI / 实用放射学杂志

Objective To evaluate the CT and MR features of renal oncocytoma in order to improve the ability for recognition and ima-gingdiagnosis.Methods The CT and MR findings of renal oncocytoma in 12 patients proved by pathology were retrospectively analyzed.Results CT scans were performed in 12 patients,one of which was accompanied with the contralateral renal angiomyoliptoma.In all lesions, seven were in the right kidney and five in the left.The lesions were round or oval in shape with the diameter 1.5 cm-12.3 cm.On pre-contrast scan,the homogeneous density was found in 3,calcification in 2,and central scar tissue in 5.On post-contrast images,the parenchyma of tumor was obviously enhanced in the cortical phase.However,the enhancement was attenuated in the parenchymal phase.Seven patients underwent MRI at the same time,exhibiting iso-or hypointensity on T1 WI in 4 and heterogenous hyperintensity on T2 WI in 5.Dynamic contrast enhanced MRI demonstrated homogenous enhancement in 1 and heterogenous enhancement in others with delayed enhancement of the central scar.Conclusion Most renal oncocytomas show certain characteristics on CT or MRI, which are helpful for preoperative diagnosis and surgical therapy.

Comparison of computed tomography findings between renal oncocytomas and chromophobe renal cell carcinomas

PURPOSE: To investigate and distinguish the computed tomography (CT) characteristics of chromophobe renal cell carcinoma (chRCC) and renal oncocytoma. MATERIALS AND METHODS: Fifty-one patients with renal oncocytoma and 120 patients with chRCC, diagnosed by surgery between November 2005 and June 2015, were studied retrospectively. Two observers, who were urologists and unaware of the pathological results, reviewed the preoperative CT images. The tumors were evaluated for size, laterality, tumor type (ball or bean pattern), central stellate scar, segmental enhancement inversion, and angular interface pattern and tumor complexity. To accurately analyze the mass-enhancing pattern of renal mass, we measured Hounsfield units (HUs) in each phase and analyzed the mean, maximum, and minimum HU values and standard deviations. RESULTS: There were 51 renal oncocytomas and 120 chRCCs in the study cohort. No differences in clinical and demographic characteristics were observed between the two groups. A central stellate scar and segmental enhancement inversion were more likely in oncocytomas. However, there were no differences in ball-/bean-type categorization, enhancement pattern, and the shape of the interface between the groups. Higher HU values tended to be present in the corticomedullary and nephrogenic phases in oncocytomas than in chRCC. Receiver-operating characteristic curve analysis showed that the presence of a central stellate scar and higher mean HU values in the nephrogenic phase were highly predictive of renal oncocytoma (area under the curve=0.817, p<0.001). CONCLUSIONS: The appearance of a central stellate scar and higher mean HU values in the nephrogenic phase could be useful to distinguish renal oncocytomas from chRCCs.

Expresión de renina en oncocitomas renales / Renin expression in renal oncocytomas

Introducción: algunos tumores renales han sido asociados con secreción de hormonas, incluyendo renina. Nuestro objetivo fue investigar la frecuencia de expresión de esta hormona en un tumor renal epitelial infrecuente, el oncocitoma, y si esta expresión se asocia con hipertensión arterial sistémica (HTA).Métodos: examinamos una serie de 13 oncocitomas (provenientes de igual número de pacientes) usando un anticuerpo monoclonal para detectar la hormona por inmunohistoquímica, y su asociación con HTA. Las características de la inmunotinción se evaluaron microscópicamente. Obtuvimos, de los archivos de historias, las características clínicas y de la presión arterial sistémica antes y después de la resección tumoral. Resultados: ocho de los 13 tumores (61,5 por ciento) tenían inmunorreactividad para renina, en todos ellos difusa. En tres casos la inmunomarcación fue como un punto paranuclear (dot-like) y en otros tres estaba en la porción apical del citoplasma de las células neoplásicas. En tres de los ocho casos con expresión de renina (37,5 por ciento) y en tres de los cinco sin dicha expresión (60,0 por ciento) se detectó HTA (p = 0,59). Después de la resección tumoral ninguno de los pacientes con expresión de renina e HTA mostró remisión de esta. Conclusión: la renina se expresa frecuentemente en oncocitomas renales pero es clínicamente inactiva. Serán necesarios más estudios para conocer las implicaciones de esta expresión en la presentación clínica, el diagnóstico y la histogénesis.

Introduction: Renal cell tumors have been shown to be associated with secretory products, including renin. Our aim was to investigate the frequency of renin expression in an infrequent kind of epithelial renal neoplasm, the oncocytoma, and to find out if this expression was associated to systemic high blood pressure. Methods: We examined a series of 13 tumors (from 13 patients) using a monoclonal antiserum to detect the hormone by immunohistochemistry (IHC), and its association with hypertension. IHC features were evaluated. Systemic blood pressure information before and after neoplasm resection was obtained from clinical charts.Results: We found that eight of the 13 tumors (61.5 percent) were immunoreactive for renin, all of them with diffuse staining. In three cases the immunolabeling was paranuclear dot-like and in three more it was found in the apical portion of the cytoplasm. Systemic hypertension was detected in three of the eight (37.5 percent) patients with renin expression and in three of the five (60.0 percent) without it (p = 0.59). After tumor resection none of the patients with renin expression and high blood pressure showed remission of the hypertension.Conclusion: Renin is frequently expressed in renal oncocytomas, but it appears to be clinically inactive. More studies will be necessary in order to define the implications of this expression on clinical presentation, diagnosis and histogenesis.

CT Diagnosis of Renal Oncocytoma / 医学研究杂志

Objective To study the renal oncocytoma CT eosinophil performance,improve the rate of correct diagnosis.Methods Retrospective analysis of seven cases confirmed by pathology of renal oncocytoma CT.Results Tumor cortex to the growth mainly three cases to the pelvis grow mainly two cases,two cases are located entirely within the renal parenchyma.Plain;Four cases of tumor performance for the more homogeneous density.Three cases density uniform,which show two cases within Stelletta tenui Lindgren-sharp edge,low-density,one cases show multiple internal circular low-density category,there calcification in 2 cases.Enhanced cortex and medulla period was more homogeneous strengthen four cases,three cases heterogeneous enhance and strengthen below the renal cortex.Pelvis period density decreased,but the level not lower than the same muscle density,and normal kidney tissue clear,two cases showed a complete fake capsule.Conclusions Renal oncocytoma scar except center outside homogeneous enhancement,pelvis with a period of not less than muscle density levels,and normal kidney tissue.Coated with a complete sham and center when scar more precise diagnosis.Other typical performance required when combined with clinical analysis.

Diagnosis and treatment of renal oncocytoma and chromophobe cell renal carcinoma / 基础医学与临床

Objective To evaluate the clinical characteristic,diagnosis and treatment procedures for renal oncocytoma and chromophobe cell renal carcinoma.Methods Eight cases of renal oncocytoma and 5 cases of chromophobe cell renal carcinoma were analysed.The average of oncocytoma was 58.8 years old(23～74),and mean tumor size was 5.1 cm(range,3～7 cm);The mean age of chromophobe cell renal carcinoma was 54.5 years old(35～72),and mean tumor size was 5.8 cm(range,3～8 cm).Doppler ultrasonography and CT scan were performed in all patients.All cases accepted surgical operation and were confirmed by pathology.Results Renal oncocytoma was characterized by homogeneous round cell containing aboundant axyphil pellets.Color Doppler ultrasonography show isoechoic or hypoechoic masses.CT scan revealed that the tumors were homogeneous solid masses,and most of them were visualized as homogeneous enhancement.All the patients were followed up for 10 to 53 months,and no recurrence or metastasis was noted.Color Doppler ultrasonography show mainly hyperechoic masses,CT scan revealed most of the tumors were heterogeneous enhancement.All the patients were followed up for 12 to 49 months,and 1 case died from metastasis after 1 year.Conclusion Renal oncocytoma and chromophobe cell renal carcinoma can be differentiated by clinical characteristic,ultrasonic and CT scan examination.The diagnosis is confirmed by pathology.Partial nephrectomy is good for renal oncocytoma,while radical nephrectomy is still the first choice for chromophobe cell renal carcinoma.

A Case of Renal Oncocytomatosis with Chronic Renal Failure / 대한신장학회잡지

Renal oncocytomas account for approximately 5% of renal parenchymal tumors. Usually it has unilateral solitary oncocytic nodule, but bilateral multifocal renal oncocytomasis is rare. The term renal oncocytoma should be used to characterize a well-differentiated renal epithelial tumor with eosinophilic granular cytoplasm that has benign behavior and favourable progress. Also, multiple oncocytoma distributed diffusely in both kidneys is termed renal oncocytomatosis Because of the benign nature, multicentricity, possible bilaterality and absence of pathognomonic radiographic features, renal oncocytomas should be considered in differential diagnosis of solid masses, especially renal cell carcinoma. We report a patient with bilaleral multifocal renal oncocytomatosis, who had progressive renal failure. Renal oncocytomatosis was diagnosed pathologically after bilateral nephrectomy.

Establishment and Characterization of New Human Renal Oncocytoma Cell Line(CURO) / 대한비뇨기과학회지

PURPOSE: Renal oncocytoma has been a focus of interest in urologic oncology. The biologic and molecular characteristics of this disease remains ill defined due to paucity of ideal in vitro model. In this present study a new cell line of human renal oncocytoma, CURO, has been established and characterized. MATERIALS AND METHOD: The CURO cells were cultured from tissues obtained from radical nephrectomy specimen of incidentally found renal oncocytoma. The cellular and molecular biological characleristics of CURO cells were analyzed. RESULTS: CURO cells grew in monolayer with a rapid doubling time of 20 hours. The cells showed abundant mitochondria and well developed microvilli, and expressed cytokeratin, epithelial membrane antigen, and lectins of distal renal tubular and collecting duct origin. The cells showed aneuploidy with high proportion of cells in G2+M phase(27%) on flow cytometric analysis. Karyotyping study revealed clonal heterogeneity: Majority showed normal 46XX, whereas, 12% of cells showed deletion or translocation of chromosome 19, but none of the cells showed abnormality of 3p. The cells neither showed mutation of p53 gene and nor expressed two major angiogenic factors of renal cell carcinoma: vascular endothelial growth factor and basic fibroblast growth factor. The CURO cells didn't show tumorigenecity in athymic nude mouse on either subcutaneous or subrenal capsular implantation. CONCLUSIONS: The results of this study suggest that CURO may be a valuable model to study renal oncocytoma. Renal oncocytoma may be a benign tumor of distal renal tubular or collecting duct origin, but it may contain clone with high proliferative activity. Change of chromosome 19 may be a marker of development or proliferation of renal oncocytoma.

Renal Oncocytoma: Two cases / 대한비뇨기과학회지

Renal oncocytomas are neoplasms consisting of oncocytes, which are large epithelial cells with finely granular eosinophilic cytoplasm. The incidence of these tumors are unknown and exceedingly rare but believed to range between 5 and 10% of renal cortical tumors. Although renal oncocytomas are considered benign neoplasms, they are difficult to differentiate from renal cell carcinomas and easily misdiagnosed as carcinomas. We report a case that are indistinguishable from renal cell carcinoma preoperatively and another case showing apparently benign nature, despite its large size, 17 x 15cm and 8 years long history. So a provisional diagnosis of renal oncocytoma was made after renal computed tomography demonstrated characteristic appearance of this tumor and the diagnosis was confirmed with electron microscopy.

A Case of Renal Oncocytoma Associated with Angio-invasion / 대한비뇨기과학회지

Renal oncocytoma is an epithelial tumor of the kidney with a particularly good prognosis and is composed entirely of uniform packets of eosinophilic granular cells so-called 'Oncocytic cells' The cytoplasm of the oncocytoma cells is packed with mitochondria and contains few other organelles. At present time 4 cases have been reported in Korean literature without any identifiable angioinvasive lesions. We report a case of renal oncocytoma associated with angioinvasion that was suspected preoperatively and confirmed by pathologic examination including electron microscopy postoperatively. The pathology, diagnosis and treatment of this uncomrnon entity is discussed.