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The value of ultrastructural evaluation in the diagnosis of renal tumors: a general overview.

The understanding of renal neoplasia has advanced significantly in the last 20 years. New challenges have arisen as a consequence of prolonged dialysis and renal transplantation becoming the therapeutic modes to deal with chronic renal disease. Immunosuppression resulting from primary disease processes or as a result of clinical intervention has resulted in an increase in neoplasia in general and changes in manifestations and clinical behavior of tumors. Special techniques such as immunocytochemistry and electron microscopy have provided information that has resulted in refinement of diagnostic and conceptual issues. The variable gross and histological manifestation of many of the renal neoplasms can be explained at least in part by reflecting on the new fundamental knowledge that has been acquired regarding renal developmental biology. A more aggressive approach from a therapeutic point of view placing emphasis on specific treatment protocols for the various nosologic entities further emphasizes the need to understand the advances that have taken place in the field. This article provides an overview of the subject, with emphasis on an overall conceptual understanding, to serve as a practical framework. The articles that follow address the specific current role of ultrastructure in the diagnosis and understanding of renal neoplasms.