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PERITUMORAL PSEUDO CAPSULE FEATURES ON COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF RENAL CELL CARCINOMA
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Abstract
Objective: To describe the imaging characteristics of the pseudocapsule of renal cell carcinoma (RCC) on computed tomography (CT) and to evaluate the diagnostic value of CT in detecting tumor pseudocapsules in RCC. Methods: A retrospective study was conducted on 145 confirmed cases of RCC diagnosed at Binh Dan Hospital from January 2022 to April 2024. Results: The mean age of the study population was 58 ± 12 years, with the most commonly affected age group being 50–70 years (63,5%). Males (62,8%) predominated with a male-to-female ratio of 1,68:1. Histopathological results revealed that clear cell RCC was the most common subtype, accounting for 69 out of 145 cases (48%). The presence of a tumor pseudocapsule on CT was detected in 85 out of 145 cases (58,6%), with the corticomedullary phase yielding the highest detection rate (44,8%). The study found no correlation between tumor size and the characteristics of the pseudocapsule. However, there was a correlation between the presence of a pseudocapsule and renal capsular invasion, perinephric fat invasion, renal sinus fat invasion, and vascular invasion. On CT, the corticomedullary phase had the highest sensitivity for pseudocapsule detection, with a sensitivity of 57%, specificity of 98%, positive predictive value (PPV) of 96%, and negative predictive value (NPV) of 50%. In terms of histologic subtypes, CT showed diagnostic value in detecting the pseudocapsule with the following performance: for clear cell RCC: sensitivity 95%, specificity 59%, PPV 78%, NPV 84%; for papillary RCC: sensitivity 96%, specificity 55%, PPV 72%, NPV 91%, for chromophobe RCC: sensitivity 90%, specificity 50%, PPV 73%, NPV 66%. Conclusion: CT imaging plays a significant role in evaluating the tumor pseudocapsule in RCC. It aids clinicians in predicting the histologic subtype (benign vs malignant features), assessing tumor invasion into adjacent structures, staging, and determining the feasibility of tumor enucleation—thereby guiding appropriate surgical planning.
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Keywords
Computed tomography, renal cell carcinoma, pseudocapsule, histopathology.
References
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