Wilms' tumor diagnostic study of choice

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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]


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 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons[5]
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.
•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 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons[6]

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. https://librepathology.org/wiki/File:Wilms_tumour_-_low_mag.jpg#filelinks
  6. https://upload.wikimedia.org/wikipedia/commons/a/a8/Wilms_Tumour.jpg



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