Abstract
Fine needle aspiration (FNA) has high sensitivity (80–100%), specificity (91.9–100%), positive predictive value (89.9%), negative predictive value (94%), and efficacy (92.2%) in the diagnosis of malignant neoplasms of the kidney. As such, cytologic evaluation of renal lesions provides accurate and critical information for appropriate patient management.
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References
Garcia-Solano J, Acosta-Ortega J, Perez-Guillermo M, Benedicto-Orovitg JM, Jimenez-Penick FJ. Solid renal masses in adults: image-guided fine-needle aspiration cytology and imaging techniques–“two heads better than one?”. Diagn Cytopathol. 2008;36:8–12.
Schmidbauer J, Remzi M, Memarsadeghi M, Haitel A, Klingler HC, Katzenbeisser D, et al. Diagnostic accuracy of computed tomography-guided percutaneous biopsy of renal masses. Eur Urol. 2008;53:1003–1.
Zardawi IM. Renal fine needle aspiration cytology. Acta Cytol. 1999;43:184–90.
Andonian S, Okeke Z, Vanderbrink BA, Okeke DA, Sugrue C, Wasserman PG, et al. Aetiology of non-diagnostic renal fine-needle aspiration cytologies in a contemporary series. BJU Int. 2008;103(1):28–32.
Raso DS, Greene WB, Finley JL, Silverman JF. Morphology and pathogenesis of Liesegang rings in cyst aspirates: report of two cases with ancillary studies. Diagn Cytopathol. 1998;19:116–9.
Truong LD, Todd TD, Dhurandhar B, Ramzy I. Fine-needle aspiration of renal masses in adults: analysis of results and diagnostic problems in 108 cases. Diagn Cytopathol. 1999;20:339–49.
Todd TD, Dhurandhar B, Mody D, Ramzy I, Truong LD. Fine-needle aspiration of cystic lesions of the kidney. Morphologic spectrum and diagnostic problems in 41 cases. Am J Clin Pathol. 1999;111:317–28.
Sahni VA, Ly A, Silverman SG. Usefulness of percutaneous biopsy in diagnosing benign renal masses that mimic malignancy. Abdom Imaging. 2011;36:91–101.
Katabathina VS, Vikram R, Nagar AM, Tamboli P, Menias CO, Prasad SR. Mesenchymal neoplasms of the kidney in adults: imaging spectrum with radiologic-pathologic correlation. Radiographics. 2010;30:1525–40.
Jinzaki M, Silverman SG, Akita H, Nagashima Y, Mikami S, Oya M. Renal angiomyolipoma: a radiological classification and update on recent developments in diagnosis and management. Abdom Imaging. 2014;39:588–604.
Kennelly MJ, Grossman HB, Cho KJ. Outcome analysis of 42 cases of renal angiomyolipoma. J Urol. 1994;152(6 Pt 1):1988–91.
Steiner MS, Goldman SM, Fishman EK, Marshall FF. The natural history of renal angiomyolipoma. J Urol. 1993;150:1782–6.
Tong YC, Chieng PU, Tsai TC, Lin SN. Renal angiomyolipoma: report of 24 cases. Br J Urol. 1990;66:585–9.
Hindman N, Ngo L, Genega EM, Melamed J, Wei J, Braza JM, et al. Angiomyolipoma with minimal fat: can it be differentiated from clear cell renal cell carcinoma by using standard MR techniques? Radiology. 2012;265:468–77.
Crapanzano JP. Fine-needle aspiration of renal angiomyolipoma: cytological findings and diagnostic pitfalls in a series of five cases. Diagn Cytopathol. 2005;32:53–7.
Masoom S, Venkataraman G, Jensen J, Flanigan RC, Wojcik EM. Renal FNA-based typing of renal masses remains a useful adjunctive modality: evaluation of 31 renal masses with correlative histology. Cytopathology. 2009;20:50–5.
Cristallini EG, Paganelli C, Bolis GB. Role of fine-needle aspiration biopsy in the assessment of renal masses. Diagn Cytopathol. 1991;7:32–5.
Lieber MM. Renal oncocytoma. Urol Clin North Am. 1993;20:355–9.
Perez-Ordonez B, Hamed G, Campbell S, Erlandson RA, Russo P, Gaudin PB, et al. Renal oncocytoma: a clinicopathologic study of 70 cases. Am J Surg Pathol. 1997;21:871–83.
Hes O, Moch H, Reuter VE. Oncocytoma. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. WHO classification of tumours of the urinary system and male genital organs. Lyon: International Agency for Research on Cancer; 2016. p. 43–4.
Wu J, Zhu Q, Zhu W, Chen W, Wang S. Comparative study of CT appearances in renal oncocytoma and chromophobe renal cell carcinoma. Acta Radiol. 2016;57:500–6.
Liu J, Fanning CV. Can renal oncocytomas be distinguished from renal cell carcinoma on fine-needle aspiration specimens? A study of conventional smears in conjunction with ancillary studies. Cancer. 2001;93:390–7.
Bishop JA, Hosler GA, Kulesza P, Erozan YS, Ali SZ. Fine-needle aspiration of renal cell carcinoma: is accurate Fuhrman grading possible on cytologic material? Diagn Cytopathol. 2011;39:168–71.
Zhu B, Rohan SM, Lin X. Immunoexpression of napsin A in renal neoplasms. Diagn Pathol. 2015;10:4.
Zhou M, Roma A, Magi-Galluzzi C. The usefulness of immunohistochemical markers in the differential diagnosis of renal neoplasms. Clin Lab Med. 2005;25:247–57.
Lin X. Cytomorphology of clear cell papillary renal cell carcinoma. Cancer Cytopathol. 2017;125:48–54.
Moch H, Humphrey PA, Ulbright TM, Reuter VE. WHO classification of tumours of the urinary system and male genital organs. Lyon: International Agency for Research on Cancer; 2016.
Lopez-Beltran A, Carrasco JC, Cheng L, Scarpelli M, Kirkali Z, Montironi R. 2009 update on the classification of renal epithelial tumors in adults. Int J Urol. 2009;16:432–43.
Hoffmann NE, Gillett MD, Cheville JC, Lohse CM, Leibovich BC, Blute ML. Differences in organ system of distant metastasis by renal cell carcinoma subtype. J Urol. 2008;179:474–7.
Low G, Huang G, Fu W, Moloo Z, Girgis S. Review of renal cell carcinoma and its common subtypes in radiology. World J Radiol. 2016;8:484–500.
Cheville JC, Lohse CM, Zincke H, Weaver AL, Blute ML. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol. 2003;27:612–24.
Gurel S, Narra V, Elsayes KM, Siegel CL, Chen ZE, Brown JJ. Subtypes of renal cell carcinoma: MRI and pathological features. Diagn Interv Radiol. 2013;19:304–11.
Moch H, Amin MB, Argani P, Cheville J, Delahunt B, Martignoni G, Medeiros LJ, Srigley JR, Tan PH, Tickoo SK. Renal cell tumours. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. WHO classification of tumours of the urinary system and male genital organs. Lyon: International Agency for Research on Cancer; 2016. p. 12–7.
Parkin D, Whelan S, Ferlay J, Teppo L, Thomas D. Cancer incidence in five continents. Lyon: IARC Scientific Publications No 155. IARC Press; 2003.
Sufrin G, Chasan S, Golio A, Murphy GP. Paraneoplastic and serologic syndromes of renal adenocarcinoma. Semin Urol. 1989;7:158–71.
Prasad SR, Humphrey PA, Catena JR, Narra VR, Srigley JR, Cortez AD, et al. Common and uncommon histologic subtypes of renal cell carcinoma: imaging spectrum with pathologic correlation. Radiographics. 2006;26:1795–806; discussion, 806–10.
Renshaw AA, Granter SR. Fine needle aspiration of chromophobe renal cell carcinoma. Acta Cytol. 1996;40:867–72.
Layfield LJ. Fine-needle aspiration biopsy of renal collecting duct carcinoma. Diagn Cytopathol. 1994;11:74–8.
Lin X. Cytomorphology of clear cell papillary renal cell carcinoma. Cancer. 2017;125:48–54.
Al-Ahmadie HA, Alden D, Fine SW, Gopalan A, Touijer KA, Russo P, et al. Role of immunohistochemistry in the evaluation of needle core biopsies in adult renal cortical tumors: an ex vivo study. Am J Surg Pathol. 2011;35:949–61.
Adeniran AJ, Al-Ahmadie H, Iyengar P, Reuter VE, Lin O. Fine needle aspiration of renal cortical lesions in adults. Diagn Cytopathol. 2010;38:710–5.
Grignon DJ, Al-Ahmadie H, Algaba F, Amin MD, Comperat E, Dyrskjot L, Epstein JI, Hansel DE, Knuchel R, Lloreta J, Lopez-Beltran A, McKenney JK, Netto GJ, Paner G, Reuter VE, Shen SS, Van der Kwast T. Urothelial tumours. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. WHO classification of tumours of the urinary system and male genital organs. Lyon: International Agency for Research on Cancer; 2016. p. 77–98.
Raza SA, Sohaib SA, Sahdev A, Bharwani N, Heenan S, Verma H, et al. Centrally infiltrating renal masses on CT: differentiating intrarenal transitional cell carcinoma from centrally located renal cell carcinoma. Am J Roentgenol. 2012;198:846–53.
Zhu B, Rohan SM, Lin X. Urine cytomorphology of micropapillary urothelial carcinoma. Diagn Cytopathol. 2013;41:485–91.
Lin X, Zhu B, Villa C, Zhong M, Kundu S, Rohan SM, et al. The utility of p63, p40, and GATA-binding protein 3 immunohistochemistry in diagnosing micropapillary urothelial carcinoma. Hum Pathol. 2014;45:1824–9.
Argani P, Bruder E, Dehner L, Vujanic GM. Nephroblastic and cystic tumours occurring mainly in children. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. WHO classification of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2004. p. 48–53.
Ravindra S, Kini U. Cytomorphology and morphometry of small round-cell tumors in the region of the kidney. Diagn Cytopathol. 2005;32:211–6.
Dey P, Radhika S, Rajwanshi A, Rao KL, Khajuria A, Nijhawan R, et al. Aspiration cytology of Wilms’ tumor. Acta Cytol. 1993;37:477–82.
Khayyata S, Grignon DJ, Aulicino MR, Al-Abbadi MA. Metanephric adenoma vs. Wilms’ tumor: a report of 2 cases with diagnosis by fine needle aspiration and cytologic comparisons. Acta Cytol. 2007;51:464–7.
Quijano G, Drut R. Cytologic characteristics of Wilms’ tumors in fine needle aspirates. A study of ten cases. Acta Cytol. 1989;33:263–6.
Nayak A, Iyer VK, Agarwala S. The cytomorphologic spectrum of Wilms tumour on fine needle aspiration: a single institutional experience of 110 cases. Cytopathology. 2011;22:50–9.
Aras M, Dede F, Ones T, Inanir S, Erdil TY, Turoglu HT. Is the value of FDG PET/CT in evaluating renal metastasis underestimated? A case report and review of the literature. Mol Imaging Radionuc Ther. 2013;22:109–12.
Shimko MS, Jacobs SC, Phelan MW. Renal metastasis of malignant melanoma with unknown primary. Urology. 2007;69:384.e9–10.
Israel GM, Bosniak MA. Pitfalls in renal mass evaluation and how to avoid them. Radiographics. 2008;28:1325–38.
Quayle FJ, Spitler JA, Pierce RA, Lairmore TC, Moley JF, Brunt LM. Needle biopsy of incidentally discovered adrenal masses is rarely informative and potentially hazardous. Surgery. 2007;142:497–502; discussion, 502–4.
Lumachi F, Borsato S, Tregnaghi A, Marino F, Fassina A, Zucchetta P, et al. High risk of malignancy in patients with incidentally discovered adrenal masses: accuracy of adrenal imaging and image-guided fine-needle aspiration cytology. Tumori. 2007;93:269–74.
Nurnberg D. Ultrasound of adrenal gland tumours and indications for fine needle biopsy (uFNB). Ultraschall Med. 2005;26:458–69.
Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Investig. 2006;29:298–302.
Herrera MF, Grant CS, van Heerden JA, Sheedy PF, Ilstrup DM. Incidentally discovered adrenal tumors: an institutional perspective. Surgery. 1991;110:1014–21.
Tikkakoski T, Taavitsainen M, Paivansalo M, Lahde S, Apaja-Sarkkinen M. Accuracy of adrenal biopsy guided by ultrasound and CT. Acta Radiol. 1991;32:371–4.
Lumachi F, Borsato S, Tregnaghi A, Basso SM, Marchesi P, Ciarleglio F, et al. CT-scan, MRI and image-guided FNA cytology of incidental adrenal masses. Eur J Surg Oncol. 2003;29:689–92.
Fassina AS, Borsato S, Fedeli U. Fine needle aspiration cytology (FNAC) of adrenal masses. Cytopathology. 2000;11:302–11.
Lattin GE, Sturgill ED, Tujo CA, Marko J, Sanchez-Maldonado KW, Craig WD, et al. From the radiologic pathology archives: adrenal tumors and tumor-like conditions in the adult: radiologic-pathologic correlation. Radiographics. 2014;34:805–29.
Olsson CA, Krane RJ, Klugo RC, Selikowitz SM. Adrenal myelolipoma. Surgery. 1973;73:665–70.
Kenney PJ, Wagner BJ, Rao P, Heffess CS. Myelolipoma: CT and pathologic features. Radiology. 1998;208:87–95.
Lam KY, Lo CY. Adrenal lipomatous tumours: a 30 year clinicopathological experience at a single institution. J Clin Pathol. 2001;54:707–12.
Settakorn J, Sirivanichai C, Rangdaeng S, Chaiwun B. Fine-needle aspiration cytology of adrenal myelolipoma: case report and review of the literature. Diagn Cytopathol. 1999;21:409–12.
Stewart PM. The adrenal cortex. In: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS, editors. Williams textbook of endocrinology. 10th ed. Philadelphia: WB Saunders; 2002. p. 491–551.
Lloyd RV, Osamura RY, Kloppel G, Rosai J. Tumours of the adrenal cortex. In: Lloyd RV, Osamura RY, Kloppel G, Rosai J, editors. WHO classification of Tumours of endocrine organs. Lyon: International Agency for Research on Cancers; 2016. p. 161–78.
Elsayes KM, Mukundan G, Narra VR, Lewis JS, Shirkhoda A, Farooki A, et al. Adrenal masses: MR imaging features with pathologic correlation. Radiographics. 2004;24(Suppl 1):S73–86.
Stelow EB, Debol SM, Stanley MW, Mallery S, Lai R, Bardales RH. Sampling of the adrenal glands by endoscopic ultrasound-guided fine-needle aspiration. Diagn Cytopathol. 2005;33:26–30.
Jorda M, De MB, Nadji M. Calretinin and inhibin are useful in separating adrenocortical neoplasms from pheochromocytomas. Appl Immunohistochem Mol Morphol. 2002;10:67–70.
Allolio B, Fassnacht M. Clinical review: Adrenocortical carcinoma: clinical update. J Clin Endocrinol Metab. 2006;91:2027–37.
Wooten MD, King DK. Adrenal cortical carcinoma. Epidemiology and treatment with mitotane and a review of the literature. Cancer. 1993;72:3145–55.
Schteingart DE, Doherty GM, Gauger PG, Giordano TJ, Hammer GD, Korobkin M, et al. Management of patients with adrenal cancer: recommendations of an international consensus conference. Endocr Relat Cancer. 2005;12:667–80.
Roman S. Adrenocortical carcinoma. Curr Opin Oncol. 2006;18:36–42.
Ng L, Libertino JM. Adrenocortical carcinoma: diagnosis, evaluation and treatment. J Urol. 2003;169:5–11.
Venkatesh S, Hickey RC, Sellin RV, Fernandez JF, Samaan NA. Adrenal cortical carcinoma. Cancer. 1989;64:765–9.
Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB, et al. Adrenocortical carcinoma: the range of appearances on CT and MRI. Am J Roentgenol. 2011;196:W706–14.
Ren R, Guo M, Sneige N, Moran CA, Gong Y. Fine-needle aspiration of adrenal cortical carcinoma: cytologic spectrum and diagnostic challenges. Am J Clin Pathol. 2006;126:389–98.
Jimenez-Heffernan JA, Vicandi B, Lopez-Ferrer P, Gonzalez-Peramato P, Perez-Campos A, Viguer JM. Cytologic features of pheochromocytoma and retroperitoneal paraganglioma: a morphologic and immunohistochemical study of 13 cases. Acta Cytol. 2006;50:372–8.
Handa U, Khullar U, Mohan H. Pigmented pheochromocytoma: report of a case with diagnosis by fine needle aspiration. Acta Cytol. 2005;49:421–3.
Lloyd RV, Kawashima A, Tischler AS. Secondary tumors. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C, editors. Pathology and genetics: tumors of endocrine organs. Lyon: IARC Press; 2004. p. 172–3.
Willis RV. The spread of tumors in the human body. 3rd ed. London: Butterworth; 1973.
Mayo-Smith WW, Boland GW, Noto RB, Lee MJ. State-of-the-art adrenal imaging. Radiographics. 2001;21:995–1012.
Abrams HL, Spiro R, Goldstein N. Metastases in carcinoma; analysis of 1000 autopsied cases. Cancer. 1950;3:74–85.
Leite NP, Kased N, Hanna RF, Brown MA, Pereira JM, Cunha R, et al. Cross-sectional imaging of extranodal involvement in abdominopelvic lymphoproliferative malignancies. Radiographics. 2007;27:1613–34.
Chong S, Lee KS, Kim HY, Kim YK, Kim BT, Chung MJ, et al. Integrated PET-CT for the characterization of adrenal gland lesions in cancer patients: diagnostic efficacy and interpretation pitfalls. Radiographics. 2006;26:1811–24; discussion, 24–6.
Rashidi A, Fisher SI. Primary adrenal lymphoma: a systematic review. Ann Hematol. 2013;92:1583–93.
Gong Y, DeFrias DV, Nayar R. Pitfalls in fine needle aspiration cytology of extraadrenal paraganglioma. A report of 2 cases. Acta Cytol. 2003;47:1082–6.
Varma K, Jain S, Mandal S. Cytomorphologic spectrum in paraganglioma. Acta Cytol. 2008;52:549–56.
Absher KJ, Witte DA, Truong LD, Ramzy I, Mody DR, Ostrowski ML. Aspiration biopsy of osseous metastasis of retroperitoneal paraganglioma. Report of a case with cytologic features and differential diagnostic considerations. Acta Cytol. 2001;45:249–53.
Rana RS, Dey P, Das A. Fine needle aspiration (FNA) cytology of extra-adrenal paragangliomas. Cytopathology. 1997;8:108–13.
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Lin, X., Peevey, J.F., Habib, A., Mora, R., Riaz, A. (2020). Kidney, Adrenal Gland, and Paraganglia. In: Nayar, R., Lin, X., Paintal, A., Gupta, R., Nemcek Jr., A. (eds) Atlas of Cytopathology and Radiology. Springer, Cham. https://doi.org/10.1007/978-3-030-24756-0_5
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