Renal and Adrenal Tumors: Pathology, Radiology, Ultrasonography, Magnetic Resonance (Mri), Therapy, Immunology

ISBN-13: 9783642712098 / Angielski / Miękka / 2011 / 275 str.

Eberhard L. Hr; Lutz-Dietrich Leder; R. Ackermann

Opis

After the positive response which followed the first edition of this book 6 years ago, the editors were encouraged to prepare a completely reworked second edition that includes the modern advances in this field. There has been a complete change of diagnostic procedure in the detection of renal tumors, which is now based on sonography, computed tomography, and nuclear magnetic resonance imaging, pushing intravenous urography and angiography completely into the background. Also, new methods of treat ment with radionuclides using embolisation are incorporated. The description of morphological structures forms the basis for under standing and recognising pathology of the kidneys and adrenals. The con tents of pathological morphology could be extended, as we are of the opinion that the detection and therapy of renal and adrenal tumors are derived from different areas of diagnostic science. We are indebted to Springer-Verlag for the excellent book production. On behalf of all the authors, we would like to thank our colleagues and associates for their cooperation in the realisation of this project. The editors hope that this volume will be of interest to radiologists, pa thologists, urologists, pediatrists, and also radiotherapists. Essen, April 1987 EBERHARD LOHR LUTZ-DIETRICH LEDER Table of Contents Pathology of Renal and Adrenal Neoplasms LEDER, L.-D., RICHTER, H.l."

Spis treści

Pathology of Renal and Adrenal Neoplasms.- 1 Tumors and Tumorlike Lesions of the Kidney in the Adult.- 1.1 General Remarks.- 1.2 Heterotopic Tissue.- 1.2.1 Adrenal Tissue.- 1.2.2 Endometriosis.- 1.2.3 Cartilaginous Islands.- 1.3 Benign Mesenchymal Tumors.- 1.3.1 Leiomyoma and Lipoma.- 1.3.2 Angiomyolipoma.- 1.3.3 Hemangioma.- 1.3.4 Juxtaglomerular Tumor.- 1.3.5 Lymphangioma.- 1.3.6 Fibroma (Renomedullary Interstitial Cell Tumor).- 1.3.7 Neurogenic Tumors.- 1.4 Malignant Mesenchymal Tumors.- 1.4.1 Leiomyosarcoma.- 1.4.2 Rhabdomyosarcoma.- 1.4.3 Liposarcoma.- 1.4.4 Angiosarcoma (Hemangioendothelioma).- 1.4.5 Hemangiopericytoma.- 1.4.6 Fibrosarcoma.- 1.4.7 Fibroxanthosarcoma and Malignant Fibrous Histiocytoma.- 1.4.8 Osteogenic Sarcoma and Chondrosarcoma.- 1.4.9 Hemoblastoses.- 1.5 Epithelial Tumors.- 1.5.1 Renal “Adenoma”.- 1.5.2 Renal Cell Oncocytoma.- 1.5.3 Renal Carcinoid.- 1.5.4 Renal Adenocarcinoma.- 2 Renal Neoplasias of Infancy and Childhood.- 2.1 Nephroblastoma.- 2.1.1 General Remarks.- 2.1.2 Epidemiology.- 2.1.3 Cause.- 2.1.4 Gross Pathology.- 2.1.5 Histopathology.- 2.1.6 Special Histologic Variants.- 2.1.7 Grading.- 2.1.8 Staging.- 2.1.9 Spread and Biologic Behavior.- 2.2 Nodular Renal Blastema and Nephroblastomatosis.- 3 Tumors of the Renal Pelvis.- 3.1 General Remarks.- 3.2 Papilloma.- 3.3 Inverted Papilloma.- 3.4 Fibroepithelial Polyp.- 3.5 Carcinoma.- 3.5.1 Introduction.- 3.5.2 Causes.- 3.5.3 Epidemiology.- 3.5.4 Transitional Cell Carcinoma.- 3.5.5 Squamous Epithelial Carcinoma.- 3.5.6 Adenocarcinoma.- 3.5.7 Undifferentiated Carcinoma and Carcinosarcoma.- 3.5.8 Grading.- 3.5.9 Staging.- 3.5.10 Spread.- 3.5.11 Prognosis.- 4 Tumors of the Adrenal.- 4.1 Introduction.- 4.2 Tumors of the Adrenal Cortex.- 4.2.1 General Remarks.- 4.2.2 Adenomas.- 4.2.3 Primary Carcinoma.- 4.2.4 Secondary Carcinoma.- 4.3 Tumors of the Adrenal Medulla.- 4.3.1 General Remarks.- 4.3.2 Neuroblastoma and Ganglioneuroblastoma.- 4.3.3 Ganglioneuroma.- 4.3.4 Pheochromocytoma.- 4.4 Myelolipoma and Cysts.- 4.4.1 Myelolipoma.- 4.4.2 Cysts.- Ultrasound Diagnosis of Renal and Pararenal Tumors.- 1 Introduction.- 2 Method.- 2.1 Apparatus.- 2.2 Technique of Examination.- 3 The Abnormal Kidney.- 3.1 Cysts.- 3.1.1 Simple Cysts.- 3.1.2 Atypical Cysts.- 3.1.3 Parapelvic Cysts.- 3.1.4 Adult Polycystic Disease.- 3.1.5 Infantile and Juvenile Polycystic Disease.- 3.2 Solid Tumors.- 3.2.1 Renal Cell Carcinoma.- 3.2.2 “Adenomas” and Oncocytomas.- 3.2.3 Angiomyolipoma.- 3.2.4 Metastases.- 3.2.5 Wilms’ Tumor.- 3.2.6 Transitional Cell Carcinoma of the Kidney.- 3.3 Perirenal Lesions.- 3.3.1 Hematomas.- 3.3.2 Abscesses.- 3.3.3 Lymphoceles.- 3.3.4 Pancreatic Pseudocysts.- 4 Extrarenal Lesions.- 5 Diagnostic Procedure in Renal Tumors.- Computed-Body-Tomography of Renal Carcinoma and Perirenal Masses.- 1 Introduction.- 2 Anatomy.- 3 Methods.- 3.1 General Considerations.- 3.2 Positioning of the Patient.- 3.3 Contrast.- 3.4 CT Enhancement Values.- 3.5 Levels of Confidence.- 4 Renal Carcinoma.- 4.1 Staging.- 4.2 CT Findings.- 4.3 Tumor Spread.- 4.4 Tumor Invading Vena Cava.- 5 Clear Cell Carcinoma.- 6 Metastases Simulating Primary Renal Carcinoma.- 7 Malignant Tumors of Different Histologic Pattern.- 8 Benign Tumors.- 8.1 Lipomas.- 8.2 Angiomyolipomas.- 8.3 Angiomas, Aneurysms.- 9 Tumors of the Collecting System, Transitional Cell Carcinoma.- 10 Retroperitoneal Lymphomas.- 11 Neuroblastoma and Nephroblastoma.- 12 Differential Diagnostic Considerations: Pseudotumorous Mass Lesions vs Renal Tumor.- 12.1 Peri- and Paranephritic Abscesses.- 12.2 Xanthogranulomatous Nephritis.- 12.3 Hyperdense Cysts.- 12.4 Pseudotumors of Different Origin.- Magnetic Resonance Imaging of Renal Mass Lesions.- 1 Introduction.- 2 Equipment.- 3 Technique of Examination.- 3.1 Normal Kidney.- 4 Benign Lesions.- 4.1 Renal Edema.- 4.2 Hydronephrosis.- 4.3 Cysts.- 4.4 Renal Abscess.- 4.5 Renal Hemorrhage.- 4.6 Benign Renal Tumors.- 4.7 Renal Sinus Fibrolipomatosis.- 5 Renal Malignancies.- 5.1 Renal Cell Carcinoma.- 5.1.1 The Primary Tumor.- 5.1.2 Staging and Metastases.- 5.2 Transitional Cell Carcinoma.- 5.3 Renal Sarcoma.- 5.4 Renal Lymphoma.- 5.5 Metastatic Renal Tumors.- 6 Differential Diagnosis — Malignant vs Benign Lesions.- 7 Conclusion.- 125I Embolotherapy of Renal Tumors.- 1 Introduction.- 2 Concepts Governing Transcatheter Interstitial Radiation Therapy.- 3 Technique.- 4 Clinical Results.- Adrenal Mass Lesions in Infants and Children.- 1 Introduction.- 2 Imaging Techniques.- 2.1 Abdominal Radiography.- 2.2 Excretory Urography.- 2.3 Ultrasound.- 2.4 Computed Tomography.- 2.5 Radionuclide Imaging.- 2.6 Angiography.- 2.7 Magnetic Resonance Imaging.- 3 Normal Adrenal Glands.- 4 Pathological Lesions.- 4.1 Congenital Adrenal Hyperplasia.- 4.2 Adrenal Hemorrhage.- 4.3 Wolman’s Disease.- 4.4 Neuroblastoma.- 4.5 Adrenocortical Tumors.- 4.6 Pheochromocytoma.- Computed Tomography of the Adrenal Glands.- 1 Introduction.- 2 Techniques of Examination.- 3 Anatomy.- 4 Location.- 4.1 Right Adrenal Gland.- 4.2 Left Adrenal Gland.- 5 Morphology.- 6 Size.- 7 Pathology.- 7.1 Cortical Abnormalities.- 7.1.1 Cushing’s Syndrome.- 7.1.2 Primary Aldosteronism (Conn’s Syndrome).- 7.1.3 Nonfunctioning Adrenal Adenoma and Carcinoma.- 7.1.4 Myelolipoma and Adenolipoma.- 7.2 Medullary Abnormalities.- 7.2.1 Pheochromocytoma.- 7.2.2 Neuroblastoma.- 7.3 Secondary Neoplasms.- 7.4 Unusual Primary Tumors.- 7.5 Adrenal Cysts.- 7.6 Miscellaneous Abnormalities.- 7.6.1 Infection.- 7.6.2 Hypoadrenalism.- 7.6.3 Acromegaly.- Scintigraphic Studies of Renal and Adrenal Function.- 1 Introduction.- 2 Radiopharmaceuticals.- 2.1 Renal Imaging Agents.- 2.2 Adrenal Imaging Agents.- 2.2.1 Adrenal Cortical Imaging Agents.- 2.2.2 Adrenal Medulla Imaging Agents.- 3 Functional Scintigraphy of the Kidneys.- 3.1 Measurement of Glomerular Filtration.- 3.2 Renal Tubular Function Studies.- 3.3 Dynamic Renography.- 3.4 Radionuclide Renal Localization.- 4 Adrenal Cortical Scintigraphy.- 4.1 Normal Adrenal Imaging.- 4.2 Quantification of Adrenal Gland Radiocholesterol Uptake.- 4.3 Adrenal Cortical Tumor Imaging.- 4.3.1 Lesions Producing Cushing’s Syndrome.- 4.3.2 Adrenal Lesions Producing Aldosteronism.- 4.3.3 Adrenal Lesions Producing Hyperandrogenism.- 4.3.4 Scintigraphic Evaluation of Clinically Silent Adrenal Masses.- 5 Adrenal Medulla Scintigraphy.- 5.1 Normal mIBG Scintigraphy.- 5.2 Scintigraphic Localization of Lesions Resulting in Catecholamine Excess.- 5.2.1 Localization of Pheochromocytomas.- 5.2.2 Localization of Neuroblastomas.- 5.3 Scintigraphic Localization of Lesions Other than Adrenergic Tumors.- 5.3.1 Localization of Carcinoid Tumors.- 5.3.2 Localization of Medullary Carcinoma of the Thyroid.- 5.3.3 Other Tumors Imaged with mIBG.- Surgical Management of Renal Cell Carcinoma.- 1 Radical Nephrectomy.- 2 Preoperative Embolization.- 3 Regional and Radical Lymphadenectomy.- 4 Tumor Extension into the Inferior Vena Cava.- 5 Partial Nephrectomy in Renal Cell Carcinoma.- 6 Surgery for Disseminated Disease.- 7 Adjunctive Nephrectomy.- 8 Future Prospects.- Operative Therapy of Nephroblastoma.- 1 Introduction.- 1.1 Incidence, Age, and Sex Distribution.- 1.2 Pathology.- 1.3 Presentation and Clinical Symptoms.- 1.4 Tumor Stages.- 1.5 Diagnostic Procedures.- 2 Treatment.- 2.1 Preoperative Treatment.- 2.2 Operative Technique.- 2.2.1 Tumor Enucleation.- 2.2.2 Extrarenal Wilms’ Tumors.- 2.2.3 Surgery of Metastases.- 2.2.4 Intraoperative Complications.- 2.2.5 Postoperative Complications.- 2.3 Postoperative Treatment.- 2.3.1 Follow-up.- 2.3.2 Recurrent Disease.- Nonoperative Treatment of Renal Cell Carcinoma.- 1 Introduction.- 2 Radiotherapy.- 3 Chemotherapy.- 4 Hormone Therapy.- Prenatal Wilms’ Tumor.- 1 Introduction.- 2 Development of Prenatal Wilms’ Tumor.- 3 Diagnosis.- 3.1 Case 1.- 3.2 Case 2.- 3.3 Case 3.- 4 Related Disorders.- 5 Therapy and Complications.- 6 Prognosis.- Congenital Neuroblastoma.- 1 Introduction.- 2 Case Studies.- 2.1 Case 1.- 2.2 Case 2.- 2.3 Case 3.- 2.4 Case 4.- 2.5 Case 5.- 2.6 Case 6.- 2.7 Cases in the Literature.- Neuroblastoma.- 1 Introduction.- 2 Etiology.- 3 Pathologic Anatomy.- 4 Immunology.- 5 Biochemistry.- 6 Clinical Aspects.- 7 Metastases.- 8 X-ray Findings.- 9 Differential Diagnosis.- 10 Diagnosis.- 11 Therapy.- 12 Prognosis.- Nonsurgical Management of Wilms’ Tumor.- 1 Introduction.- 2 Prognostic Factors Influencing the Treatment Plan.- 3 Radiation Therapy.- 4 Chemotherapy.- 5 Planning Patient Treatment.- 6 Treatment of Bilateral Wilms’ Tumor.- 7 Treatment of Metastases at Diagnosis.- 8 Treatment of Recurrent Disease.- 9 Outlook for Further Development in the Treatment of Wilms’ Tumor.- Immunologic Aspects of Malignant Renal Disease.- 1 General Immunologic Considerations.- 2 Humoral Immunity in Renal Cell Carcinoma.- 3 Cell-Mediated Immunity in Renal Cell Carcinoma.- 4 Renal Carcinoma Antigens Defined by Monoclonal Antibodies.- 5 Immunotherapy.