A comparative study of clear cell sarcoma of the kidney and Wilms’ tumor in children by contrast-enhanced computed tomography

Abstract:

Objective：To compare the major computed tomography（CT） imaging features between clear cell sarcoma of the kidney（CCSK） and favorable histology（FH） Wilms’ tumor（WT） in children，and to identify imaging features for distinguishing between these two diseases. Methods：The clinical，imaging，and pathological data were collected from 22 children pathologically diagnosed with CCSK in our hospital from March 2013 to June 2018. Within the same period，44 consecutive children with WT（FH） were used as controls. Eight major CT imaging features were identified and analyzed in the two groups. The statistical analysis of the data was performed by chi-square test using SPSS 17.0. P-values were adjusted by Bonferroni adjustment. The pathological tissue sections that were significantly different from others were further reviewed. Results：Among the eight major CT imaging features，only the incidence of the sign of “dilated peritumoral cysts” showed a significant difference between the two groups（?字2=7.857，Bonferroni-adjusted P=0.040，95% confidence interval：0.32-0.77 for CCSK and 0.08-0.33 for WT），suggesting that this feature might have clinical signifi－cance in distinguishing between CCSK and WT. The pathological study demonstrated that the structure of the small cyst was a liquid-containing cavity with monolayer or multilayer epithelial cells lining the cyst wall，which accorded with the anatomical features of col－lecting tubules or renal pelvis. Conclusion：It is hard to distinguish CCSK from WT（FH） in preoperative diagnosis because they share many common CT imaging features. “Dilated peritumoral cysts” may be a CT feature with potential significance in the diagnosis of CCSK.