From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
Arch Pathol Lab Med. 2019 Jun;143(6):705-710. doi: 10.5858/arpa.2018-0272-RA. Epub 2019 Apr 10.
CONTEXT.—: Core biopsy has been increasingly used for clinical decision-making in the management of patients with renal masses. The sensitivity and specificity of histologic diagnoses of renal mass biopsies depend on many factors such as adequate sampling and tissue processing, diagnostic skill and experience, and appropriate use of ancillary techniques.
OBJECTIVE.—: To review the indications, emphasize the importance of obtaining adequate diagnostic material, and introduce a general diagnostic approach, in conjunction with immunohistochemistry, in diagnosis of renal mass biopsies.
DATA SOURCES.—: Literature review and personal experiences in daily practice and consultation diagnosis of renal masses in a large tertiary medical center.
CONCLUSIONS.—: For renal mass biopsies, it is critical to obtain adequate diagnostic material and establish a standard laboratory procedure in working with small biopsy specimens. The key for the diagnosis is to be familiar with different tumor entities with characteristic morphology and to understand the wide spectrum of tumor heterogeneity. By developing a systematic approach, one can categorize the tumor and create a sensible differential diagnosis based on the growth pattern and cellular morphology. Immunohistochemistry is particularly helpful for renal mass biopsy diagnosis in selected situations.
核心活检越来越多地用于指导肾肿块患者的临床决策。肾肿块活检的组织学诊断的灵敏度和特异性取决于许多因素，如充分的采样和组织处理、诊断技能和经验，以及辅助技术的适当应用。
回顾适应证，强调获得足够诊断材料的重要性，并结合免疫组织化学，介绍一般诊断方法，用于诊断肾肿块活检。
在大型三级医疗中心的日常实践和会诊诊断肾肿块中，文献复习和个人经验。
对于肾肿块活检，获得足够的诊断材料并建立与小活检标本一起工作的标准实验室程序至关重要。诊断的关键是熟悉具有特征形态的不同肿瘤实体，并了解肿瘤异质性的广泛谱。通过开发系统的方法，可以根据生长模式和细胞形态对肿瘤进行分类，并建立合理的鉴别诊断。在某些情况下，免疫组织化学对肾肿块活检诊断特别有帮助。
