Answer:

A kidney biopsy is an invasive procedure where a small tissue sample is taken from the kidney. This sample is then observed under a microscope and stained for immunohistochemical analysis to identify specific kidney pathologies and determine the malignancy or benign nature of the tumor.

Doctors usually order a kidney biopsy when a patient exhibits unusual kidney symptoms, and other diagnostic methods (ultrasound, CT scan, MRI) cannot clearly determine the cause or severity of the kidney tumor. A kidney biopsy may be indicated for persistent blood in the urine, persistent protein in the urine that doesn't improve with treatment, or severe kidney function decline with an unknown cause. This procedure is also performed to assess post-transplant kidney status and diagnose diseases such as glomerulonephritis, IgA nephropathy (also known as Berger's disease), lupus nephritis, and Goodpasture syndrome (anti-glomerular basement membrane disease).

However, not all kidney tumors require a biopsy. You have a 3 cm kidney tumor, and the nature of the tumor is unclear. Your doctor may order additional imaging tests such as CT scans and MRIs, which can help diagnose the benign or malignant nature of the tumor with 90-95% accuracy.

Specialist Doctor II Pham Thanh Truc consults with a patient at the Department of Urology. *Illustrative photo: Tam Anh General Hospital*

Typically, for kidney tumors under 4 cm, urologists perform laparoscopic surgery to remove the tumor while preserving as much healthy tissue as possible to maximize kidney function. This optimal approach is indicated for small tumors and early-stage cancer because early intervention yields high effectiveness for patients.

A biopsy is only performed if your kidney tumor is suspected to be a metastasis from cancer cells in another organ that have spread to the kidney, or if the tumor is too large for surgery. The biopsy helps determine the nature of the tumor before deciding on cancer treatment methods such as radiation therapy or chemotherapy.

There are two methods for kidney biopsies: percutaneous kidney biopsy, performed under ultrasound or CT guidance, and laparoscopic kidney biopsy, performed as minor surgery. After the kidney biopsy, the tissue sample is analyzed, and results are usually available within 7 days.

Whether or not you should have a biopsy depends on your doctor's recommendation and your physical condition. A kidney biopsy is contraindicated in certain cases, such as individuals with only one kidney, polycystic kidney disease, hydronephrosis, severe infection, and those taking medication after a heart attack or stroke.

Specialist Doctor II Pham Thanh Truc

Department of Urology

Center for Urology - Nephrology - Andrology

Tam Anh General Hospital, Ho Chi Minh City