ABSTRACT
We have compared the diagnostic accuracy of image-guided 25G-FNA (fine-needle aspiration) and imaging modalities in a group of 31 patients with solid space-occupying renal lesions. All patients had undergone total nephrectomy and histologic sections were available for review. By FNA there were 24 malignant diagnoses, I benign diagnosis, and 6 cases with yield inadequate for diagnosis. The FNA accuracy for malignancy was 100% with no false positive cases; cancer typing by FNA matched the final histologic diagnoses in 91.6% of cases. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 14%, 80%, and 14%, respectively. Radiologically there were 26 diagnoses of malignancy, I of benignity, and 4 indeterminate lesions (IL). Accuracy for malignancy was 100%, with one false positive case; cancer typing matched the final histologic diagnoses in 84%. Sensitivity of imaging modalities was 86%, specificity 17%, positive predictive value 83%, and negative predictive value 20%. Four IL corresponded to renal cell carcinoma in the final histologic report: two IL had a previous diagnosis of malignancy by FNA, and the yield of two was inadequate for cytologic diagnosis. Both techniques have 100% accuracy for the diagnosis of malignancy. The sensitivity, specificity, positive predictive value, and negative predictive value of imaging techniques are slightly higher than those obtained by FNA. Imaging techniques and FNA of solid renal masses complement each other in IL and in nondiagnostic FNAs.
Subject(s)
Carcinoma, Renal Cell/diagnosis , Kidney Neoplasms/diagnosis , Kidney/diagnostic imaging , Kidney/pathology , Adult , Aged , Aged, 80 and over , Biopsy, Fine-Needle , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/pathology , False Positive Reactions , Female , Humans , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/pathology , Male , Middle Aged , Radiography , Sensitivity and SpecificityABSTRACT
OBJECTIVES: To evaluate the influence of receptor's age on the outcomes of kidney transplants with organs from donors below the age of three years and/or weighting less than 15 Kg. METHODS: We retrospectively studied the renal transplants with organs from donors below the age of three years and/or weighting less than 15 Kg performed at the Hospital Clínico San Carlos between 1991 and 1999. Receptors were divided into two groups depending on the age at the time of transplantation; group I included patients younger than 50 years and group II patients older than 50. RESULTS: We study 49 kidney transplants with pediatric donors (8.6%); 22 of them were included in group I and 27 in group II. There were no deaths among receptors younger than 50 years. Five-year survival for group II was 75.99%. Five-year graft survival what's 81.82% for group I, and 88.89% for group II (p 0.45). CONCLUSIONS: Receptor's age does not seem to influence graft survival when this kind of organs are used; we consider that the lower incidence of acute rejection in patients older than 50 years may explain the excellent response.
Subject(s)
Kidney Transplantation/statistics & numerical data , Tissue Donors , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Adult , Age Factors , Body Weight , Child, Preschool , Female , Follow-Up Studies , Graft Survival , Humans , Infant , Kidney Transplantation/mortality , Male , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Survival Rate , Thrombosis/epidemiology , Thrombosis/etiology , Treatment OutcomeABSTRACT
OBJETIVO: Examinar la influencia que ejerce la edad del receptor en la evolución del trasplante renal realizado con órganos procedentes de donantes con una edad inferior a los 3 años de edad y/o 15 kilos de peso. MÉTODO: Estudio retrospectivo de los trasplantes realizados con órganos procedentes de donantes menores de 3 años de edad y/o 15 kilos de peso, en el Hospital Clínico San Carlos entre los años 1991 y 1999. Los receptores fueron divididos según su edad en el momento del trasplante en dos grupos, el primero por debajo de los 50 años (grupo I) y el segundo por encima de dicha edad (grupo II). RESULTADOS: Se estudian 49 trasplantes renales realizados con donantes infantiles (8,6 por ciento), de ellos 22 pertenecían al grupo I y 27 al grupo II. No se observaron fallecimientos en los receptores menores de 50 años. La supervivencia en el grupo II a los 5 años era del 75,99 por ciento. Respecto a la supervivencia del injerto en el primer grupo a los 5 años es del 81,82 por ciento y en el grupo II del 88,89 por ciento. (p 0,45). CONCLUSIONES: La edad del receptor no parece influir en la supervivencia del injerto cuando se utilizan este tipo de órganos, se considera que la menor presencia de rechazo agudo en pacientes mayores de 50 años puede explicar esta excelente respuesta (AU)
