Can we improve the biopsy quality of upper urinary tract urothelial tumors? Single-center preliminary results of a new biopsy forceps

Urol Int. 2014;93(1):34-7. doi: 10.1159/000354875. Epub 2014 Mar 15.

Abstract

Objective: Our aim was to evaluate the biopsy quality of upper urinary tract urothelial transitional cell carcinoma with a new biopsy forceps (BIGopsy®, Cook Medical) compared to a classic biopsy forceps (Piranha®, Boston Scientific).

Patients and methods: From December 2009 to December 2011, 20 patients with upper urinary tract urothelial transitional cell carcinoma underwent conservative treatment endoscopically. All lesions were evaluated and biopsied with 3 Fr cup forceps using both types of forceps (BIGopsy and Piranha). A single pathologist blindly analyzed the specimens in order to determine the optimal biopsy for each patient. Specimen histopathology results were graded; however, they were staged if the lamina propria was not invaded (T1) or if the tumor was detected at the lamina propria (T1+).

Results: Of the 20 upper urinary tract lesions, 12 (60%) were in the renal pelvis, 3 (15%) in the upper calyx, 1 (5%) in the middle calyx, 1 (5%) in the lower calyx, 1 (5%) in the upper third of the ureter and 2 (10%) in the middle third of the ureter. We did not detect T1 in all biopsies. One patient had no valid biopsies by both forceps. A diagnosis of urothelial carcinoma was made in 17 BIGopsy biopsies compared to 7 Piranha biopsies.

Conclusion: Despite the limited number of cases, our study demonstrated the advantage of the new forceps (BIGopsy) in obtaining a valid biopsy of upper urinary tract urothelial tumors. Therefore, we recommend it in evaluating this pathology for optimal treatment.

MeSH terms

  • Biopsy / methods*
  • Carcinoma, Transitional Cell / diagnosis
  • Carcinoma, Transitional Cell / pathology*
  • Endoscopy / instrumentation*
  • Endoscopy / methods
  • Humans
  • Kidney Pelvis / pathology
  • Lasers
  • Mucous Membrane / pathology
  • Prospective Studies
  • Surgical Instruments*
  • Ureter / pathology
  • Ureteral Neoplasms / diagnosis
  • Ureteral Neoplasms / pathology*
  • Ureteroscopy
  • Urinary Tract / pathology
  • Urologic Neoplasms / diagnosis
  • Urologic Neoplasms / pathology*
  • Urothelium / pathology*