Wilms' tumor diagnostic study of choice: Difference between revisions
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{{CMG}}; {{AE}}{{SSW}} | {{CMG}}; {{AE}}{{SSW}} | ||
== Overview == | == Overview == | ||
Histology of the biopsy sample taken during surgery is the gold standard for the diagnosis of wilms tumor. Most of the tumors of the kidney have a favorable histology(90%).If [[Anaplasia|anaplastic]] changes(3-7%) are found then the outcome is poor. If a case of wilms tumor is suspected in North America, then [[nephrectomy]] is done immediately. Contralateral kidney is also explored to check for disease and lymph node biopsies done. If tumor spill occurs then whole abdomen [[Radiation therapy|radiotherapy]] has to be done. | Histology of the biopsy sample taken during surgery is the [[Gold standard (test)|gold standard]] for the diagnosis of wilms tumor. Most of the tumors of the kidney have a favorable histology (90%).If [[Anaplasia|anaplastic]] changes(3-7%) are found then the outcome is poor. If a case of wilms tumor is suspected in North America, then [[nephrectomy]] is done immediately. Contralateral kidney is also explored to check for disease and [[Lymph nodes|lymph node]] [[biopsies]] done. If tumor spill occurs then whole abdomen [[Radiation therapy|radiotherapy]] has to be done. | ||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
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* [[Anaplasia|Anaplastic]] changes | * [[Anaplasia|Anaplastic]] changes | ||
* Most of the tumors of the kidney have a favorable histology(90%). | * Most of the tumors of the kidney have a favorable histology(90%). | ||
* If [[Anaplasia|anaplastic]] changes(3-7%) are found then the outcome is poor.<ref name="pmid15738594">{{cite journal |vauthors=Stefanowicz J, Sierota D, Balcerska A, Stoba C |title=[Wilms' tumour of unfavorable histology--results of treatment with the SIOP 93-01 protocol at the Gdańsk centre. Preliminary report] |language=Polish |journal=Med Wieku Rozwoj |volume=8 |issue=2 Pt 1 |pages=197–200 |date=2004 |pmid=15738594 |doi= |url=}}</ref> | * If [[Anaplasia|anaplastic]] changes(3-7%) are found then the outcome is poor.<ref name="pmid15738594">{{cite journal |vauthors=Stefanowicz J, Sierota D, Balcerska A, Stoba C |title=[Wilms' tumour of unfavorable histology--results of treatment with the SIOP 93-01 protocol at the Gdańsk centre. Preliminary report] |language=Polish |journal=Med Wieku Rozwoj |volume=8 |issue=2 Pt 1 |pages=197–200 |date=2004 |pmid=15738594 |doi= |url=}}</ref> | ||
[[File:Wilms tumour - very high mag.jpg|center|thumb|450x450px|Wilms tumor histology | |||
The images show the characteristic three components: | |||
1.Blastema component - Malignant small round (blue) cells ~ 2x the size of resting lymphocyte. | |||
2.Epithelial component - Tubular structures/rosettes. | |||
3.Stromal component - Loose paucicellular stroma with spindle cells. | |||
'''Source''':By Nephron [CC BY-SA 3.0 (<nowiki>https://creativecommons.org/licenses/by-sa/3.0</nowiki>) or GFDL (<nowiki>http://www.gnu.org/copyleft/fdl.html</nowiki>)], from Wikimedia Commons<ref>https://librepathology.org/wiki/File:Wilms_tumour_-_low_mag.jpg#filelinks</ref> | |||
]] | |||
===== Sequence of Diagnostic Studies ===== | ===== Sequence of Diagnostic Studies ===== | ||
The surgical examination and biopsy must be performed when: | The surgical examination and biopsy must be performed when: | ||
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* Transcutaneous biopsy samples are almost never taken to prevent: | * Transcutaneous biopsy samples are almost never taken to prevent: | ||
** Tumor spill - If this occurs then whole abdomen [[Radiation therapy|radiotherapy]] has to be done. | ** Tumor spill - If this occurs then whole abdomen [[Radiation therapy|radiotherapy]] has to be done. | ||
[[File:Wilms Tumour nephrectomy.jpg|center|thumb|405x405px|•Tumor is seen in the upper pole of the kidney. | |||
•Well circumscribed lesion is seen with multiple necrotic, hemorrhagic and cystic changes. | |||
'''Source:'''By Abepathology [CC BY-SA 4.0 (<nowiki>https://creativecommons.org/licenses/by-sa/4.0</nowiki>)], from Wikimedia Commons<ref>https://upload.wikimedia.org/wikipedia/commons/a/a8/Wilms_Tumour.jpg</ref> | |||
]] | |||
==References== | ==References== | ||
Latest revision as of 05:33, 10 July 2018
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Wilms' tumor Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Wilms' tumor diagnostic study of choice On the Web |
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American Roentgen Ray Society Images of Wilms' tumor diagnostic study of choice |
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Risk calculators and risk factors for Wilms' tumor diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sargun Singh Walia M.B.B.S.[2]
Overview
Histology of the biopsy sample taken during surgery is the gold standard for the diagnosis of wilms tumor. Most of the tumors of the kidney have a favorable histology (90%).If anaplastic changes(3-7%) are found then the outcome is poor. If a case of wilms tumor is suspected in North America, then nephrectomy is done immediately. Contralateral kidney is also explored to check for disease and lymph node biopsies done. If tumor spill occurs then whole abdomen radiotherapy has to be done.
Diagnostic Study of Choice
Study of choice
- Histology of the biopsy sample taken during surgery is the gold standard for the diagnosis of wilms tumor.[1][2]
Diagnostic results
The following result of histology is confirmatory of wilms tumor:[3]
- Triphasic histology comprising -
- Anaplastic changes
- Most of the tumors of the kidney have a favorable histology(90%).
- If anaplastic changes(3-7%) are found then the outcome is poor.[4]
Sequence of Diagnostic Studies
The surgical examination and biopsy must be performed when:
- If a case of wilms tumor is suspected in North America, then nephrectomy is done immediately.
- Contralateral kidney is also explored to check for disease and lymph node biopsies done.
- Transcutaneous biopsy samples are almost never taken to prevent:
- Tumor spill - If this occurs then whole abdomen radiotherapy has to be done.
References
- ↑ Tentzeris M, Fritz G (May 1973). "[Suction and irrigation drainage in the therapy of acute and chronic osteomyelitis]". Zentralbl Chir (in German). 98 (21): 771–4. PMID 4728859.
- ↑ Stefanowicz J, Sierota D, Balcerska A, Stoba C (2004). "[Wilms' tumour of unfavorable histology--results of treatment with the SIOP 93-01 protocol at the Gdańsk centre. Preliminary report]". Med Wieku Rozwoj (in Polish). 8 (2 Pt 1): 197–200. PMID 15738594.
- ↑ Hansz J, Prazmowska-Owczarek B, Nowicka G (1979). "[Granulocyte adherence in advanced Hodgkin's disease and its dependence on antiproliferative drugs used]". Acta Haematol Pol (in Polish). 10 (1): 7–12. PMID 373364.
- ↑ Stefanowicz J, Sierota D, Balcerska A, Stoba C (2004). "[Wilms' tumour of unfavorable histology--results of treatment with the SIOP 93-01 protocol at the Gdańsk centre. Preliminary report]". Med Wieku Rozwoj (in Polish). 8 (2 Pt 1): 197–200. PMID 15738594.
- ↑ https://librepathology.org/wiki/File:Wilms_tumour_-_low_mag.jpg#filelinks
- ↑ https://upload.wikimedia.org/wikipedia/commons/a/a8/Wilms_Tumour.jpg
