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Small renal mass biopsy – how, what and when: report from an international consensus panel
Author(s) -
Tsivian Matvey,
Rampersaud Edward N.,
Pilar Laguna Pes Maria,
Joniau Steven,
Leveillee Raymond J.,
Shingleton William B.,
Aron Monish,
Kim Charles Y.,
DeMarzo Angelo M.,
Desai Mihir M.,
Meler James D.,
Donovan James F.,
Klingler Hans Christoph,
Sopko David R.,
Madden John F.,
Marberger Michael,
Ferrandino Michael N.,
Polascik Thomas J.
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12470
Subject(s) - medicine , biopsy , renal mass , watchful waiting , radiology , medical physics , pathological , intensive care medicine , general surgery , kidney , pathology , nephrectomy , prostate cancer , cancer
To discuss the use of renal mass biopsy ( RMB ) for small renal masses ( SRMs ), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point. Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: ‘non‐diagnostic samples’ should refer to insufficient material, inconclusive and normal renal parenchyma. For non‐diagnostic samples, a repeat biopsy is recommended. Fine‐needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB : biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful‐waiting candidates. We report the results of an international consensus meeting on the use of RMB for SRMs , defining the technique, pathological interpretation and indications.