There are a number of kidney cancer diagnostic tests (including imaging studies) that can be used to diagnose a kidney cancer. Kidney cysts can be visualized with ultrasonography, CT and MRI scan.
Excretory urography (also called “intravenous pyelogram”) is often used to show the abnormality, but it is also useful to show that the other kidney is functioning normally. However, because cancer is a cytological diagnosis, an analysis of the cyst content needs to be done. This is accomplished by “percutaneous cyst puncture”.
It means in plain English that a needle is used under CT scan guidance to puncture the kidney cyst in order to obtain fluid for cytology
(= cell analysis).
When the sample is removed a small amount of dye is injected to see the exact outline of the cyst and potential cancer structures in it. Enzymes(LDH) and various chemicals are analyzed from the cyst fluid and the pathologist reports about the cells obtained.
At times the old standard X ray of a renal arteriogram is still used, where a dye is injected via a femoral catheter into the main kidney artery. This shows tortuous tumor vessels. However, nowadays the arteriogram has largely been replaced by CT scans, as this will also show not only the details of the kidney cancer, but also the surrounding tissue and the local lymph gland metastases. MRI scanning is important for scanning the inferior vena cava (the main body vein of the lower body half). Kidney blood tests and other organ function tests complement the imaging findings (Ref. 1 and 2).
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2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cancer of the kidney and ureter.
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