Upper Tract Tumors

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Diagnosis

Diagnosis of upper tract tumors requires physical examination to detect tumors that are able to be felt with the fingers (palpable), laboratory tests, and imaging procedures.

Laboratory tests include the following:

• Urinalysis (to detect microscopic hematuria)
• Urine cytology (to examine tissue cells found in urine for abnormalities)
• Urine culture (to rule out urinary tract infection)

Imaging procedures include computed tomography (CT scan) and intravenous pyelogram (IVP). CT scan uses x-rays to provide images of the urinary tract. It is used to distinguish kidney stones from upper tract tumors and to determine if a tumor has spread (metastasized).

Intravenous pyelogram is performed to detect a blockage in the urinary tract. In this procedure, a contrast agent (radiopaque dye) is administered intravenously and x-rays are taken as the dye moves through the urinary tract.

If an upper tract tumor is suspected, ureteroscopy and brush biopsy may be performed. Anesthesia is administered and a thin, telescope-like tube with a tiny camera attached (ureteroscope) is inserted into the ureter to allow the physician to detect abnormalities.

In a brush biopsy, a catheter is inserted into the ureter and tissue samples of suspicious lesions are taken using a small brush. The cells are examined under a microscope and the disease is staged if cancer is detected.

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