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Kidney, Adrenal Gland, and Retroperitoneum

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Practical Cytopathology

Part of the book series: Practical Anatomic Pathology ((PAP))

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Abstract

Fine needle aspiration (FNA) biopsy of kidney, adrenal, and retroperitoneal lesions yields challenging specimens in cytology due to the variety of diagnostic entities that can be encountered and their relative infrequency. Familiarity with the clinical and radiologic context is key to answer pertinent clinical questions at the time of rapid on-site evaluation (ROSE) and to render the complete final diagnosis for the case. This chapter is intended to provide a practical guide to cytopathologists evaluating these specimens in real time. It provides guidance on which entities to expect at the time of biopsy, how to allocate fresh specimen to maximize diagnostic yield, important information to convey at the time of ROSE, and key points that should be addressed in the final report, including classification and grading. An emphasis is placed on radiologic correlation, new entities and updates in recent WHO Classifications, ancillary testing, and potential pitfalls.

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Abbreviations

CT:

Computed tomography

EUS:

Endoscopic ultrasound

FISH:

Fluorescence in situ hybridization

FFPE:

Formalin-fixed paraffin-embedded

FNA:

Fine needle aspiration

GIST:

Gastrointestinal stromal tumor

HLRCC:

Hereditary leiomyomatosis and renal cell carcinoma syndrome

IHC:

Immunohistochemistry

MR:

Multiparametric magnetic resonance

N/C:

Nuclear to cytoplasmic ratio

ROSE:

Rapid on-site evaluation

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Pathology, Stanford University, Palo Alto, CA, USA

    Alarice C. Lowe

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  1. VA Boston Healthcare System, Boston, MA, USA

    Huihong Xu

  2. Brigham and Women’s Hospital, Boston, MA, USA

    Xiaohua Qian

  3. Robert Wood Johnson University Hospital, New Brunswick, NJ, USA

    He Wang

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Lowe, A.C. (2020). Kidney, Adrenal Gland, and Retroperitoneum. In: Xu, H., Qian, X., Wang, H. (eds) Practical Cytopathology . Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-24059-2_18

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