Fine Needle Aspiration Cytology in the Diagnosis of Solid Renal and Adrenal Masses

Orell, S. R.; Langlois, Suzanne Le P.; Marshall, Villis R.

doi:10.3109/00365598509180256

Cited by 57 publications

(33 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Malig nancy, both primary and metastatic, was detected with nearly the same sensitivity in all organ systems of the abdomen and the chest (table 2). Similar data are reported in the recent liter ature for ultrasonically guided FNAC of the liver [2,[15][16][17], the pancreas [18][19][20], the kidneys [21,22], and the chest or gans [4,11],…”

Section: Validitysupporting

confidence: 84%

Fine-Needle Aspiration Guided by Ultrasound in Suspected Cancer

Schoengen

Binder²,

Schiffelholz

et al. 1994

Oncol Res Treat

View full text Add to dashboard Cite

Background: Imaging often detects lesions suggestive of malignancy which need further diagnostic clarification. Methods: 527 fine-needle aspiration cytologies (FNAC), guided by ultrasound, carried out from 1986 through 1992 on 432 consecutive patients with abdominal and thoracic masses suspicious of malignancy, were reviewed. 222 tests were confirmed by histology and 305 by clinical follow-up. Results: 89% (n=469) of the samples were sufficient for interpretation, 6.8% (n=36) were questionable by our standards, 4.2% (n=22) were non-diagnostic. 377 true-positive, 131 true-negative, 1 false-positive and 18 false-negative results were obtained, with 95.4% sensitivity, 99.2% specificity, 96.4% accuracy, 99.7% positive and 87.9% negative predictive values. 267 examinations were done in patients with an unknown malignancy, 260 in patients with known malignancies yielding a sensitivity of 94.5 and 96.5%, respectively. The sensitivity in 183 liver, 127 retroperitoneal, 142 other abdominal, and 75 thoracic examinations was 96.8, 95.8, 93.4 and 95.1%, respectively. Out of 110 primary diagnostic procedures in which a final histologic diagnosis was available, FNAC was able to determine histogenesis in 72 cases; in 30 cases a correct generic diagnosis was made. Major surgery was avoided in 78 cases, a basis for treatment was established in 48 cases by FNAC alone, and a new approach to further management was taken in 37 cases. In 452 abdominal examinations no complications occurred, in 75 thoracic examinations 5 cases of pneumothorax occurred, one of them requiring chest drainage. Conclusions: Provided that there is sufficient experience in performing the aspiration technique, in specimen procurement and cytologic interpretation, ultrasonically guided FNAC of abdominal or thoracic masses is a reliable, easy-to-perform method with low risk. It yields valuable diagnostic information which may render more invasive procedures unnecessary, thus improving the quality of life of the cancer patient.

show abstract

Section: Validitysupporting

confidence: 84%

Fine-Needle Aspiration Guided by Ultrasound in Suspected Cancer

Schoengen

Binder²,

Schiffelholz

et al. 1994

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

“…In a systematic review, Lane et al (14) found no falsepositive results in seven series reported since 2001, with a total of 172 pathologically confi rmed lesions ( 27,(31)(32)(33)(34)(35)(36). False-positive pathologic results that have been reported in the literature (eg, misdiagnosis of an angiomyolipoma [ 63 ] or a multilocular cystic nephroma [ 64 ] as a malignancy) were predominantly reported more than 2 decades ago ( 9 ). A lack of recent reports is thought to be owing to interval advances in specimen procurement and characterization ( 9 ).…”

Section: Modeling Outcomes Of Patients Treated With Nssmentioning

confidence: 99%

Renal Mass Biopsy to Guide Treatment Decisions for Small Incidental Renal Tumors: A Cost-effectiveness Analysis

Pandharipande

Gervais²,

Hartman³

et al. 2010

Radiology

View full text Add to dashboard Cite

Purpose:To evaluate the effectiveness, cost, and cost-effectiveness of using renal mass biopsy to guide treatment decisions for small incidentally detected renal tumors. Materials and Methods:A decision-analytic Markov model was developed to estimate life expectancy and lifetime costs for patients with small ( Յ 4-cm) renal tumors. Two strategies were compared: renal mass biopsy to triage patients to surgery or imaging surveillance and empiric nephron-sparing surgery. The model incorporated biopsy performance, the probability of track seeding with malignant cells, the prevalence and growth of benign and malignant tumors, treatment effectiveness and costs, and patient outcomes. An incremental cost-effectiveness analysis was performed to identify strategy preference under a willingness-to-pay threshold of $75 000 per quality-adjusted life-year (QALY). Effects of changes in key parameters on strategy preference were evaluated in sensitivity analysis. Results:Under base-case assumptions, the biopsy strategy yielded a minimally greater quality-adjusted life expectancy (4 days) than did empiric surgery at a lower lifetime cost ($3466), dominating surgery from a cost-effectiveness perspective. Over the majority of parameter ranges tested in one-way sensitivity analysis, the biopsy strategy dominated surgery or was cost-effective relative to surgery based on a $75 000-per-QALY willingness-to-pay threshold. In twoway sensitivity analysis, surgery yielded greater life expectancy when the prevalence of malignancy and propensity for biopsy-negative cancers to metastasize were both higher than expected or when the sensitivity and specifi city of biopsy were both lower than expected. Conclusion:The use of biopsy to guide treatment decisions for small incidentally detected renal tumors is cost-effective and can prevent unnecessary surgery in many cases.q RSNA, 2010Supplemental material: http://radiology.rsna.org/lookup /suppl

show abstract

“…LUTS were also improved at 1 month after the injection. However, the effect of BTX-A does not seem to be limited solely to large prostates; Chuang et al [8] reported a therapeutic effect in patients with prostate volumes of <30 mL. That study consisted of a small group of 16 men with BPH refractory to treatment with an α-blocker.…”

Section: Clinical Studiesmentioning

confidence: 99%