Fine needle aspiration of renal cortical lesions in adults

Abstract

The role of fine needle aspiration (FNA) biopsy of renal cortical lesions was controversial in the past because the result of the FNA did not affect clinical management. All renal cortical lesions, except metastasis, were subject to surgical resection. However, with the advances in neoadjuvant targeted therapies, knowledge of the renal cortical tumor histological subtype is critical for tailoring clinical trials and follow-up strategies. At present, there are clinical trials involving the use of novel kinase inhibitors for conventional (clear cell) and papillary renal cell carcinoma. We studied 143 consecutive cases of renal cortical lesions, evaluated after radical or partial nephrectomies over a 2-year period. An air-dried smear and a Thinprep® slide were prepared in all cases. The slides were Diff-Quick and Papanicolaou stained, respectively. The cytology specimens were reviewed and the results were then compared with the histologic diagnosis. Cytology was highly accurate to diagnose conventional RCC, while the accuracy for papillary RCC, chromophobe RCC, and papillary urothelial carcinoma was much lower. Our results indicate that ancillary studies might have an important role in the subclassification of renal cortical neoplasms for targeted treatment.

Typing of renal tumors by morphological and immunocytochemical evaluation of fine needle aspirates

“…However, it has been reported that PRCC is frequently misdiagnosed in FNAB samples in routine diagnostic work-up [8][9][10]. In contrast, we found that the majority (82.3%) of PRCC with immunocytochemical staining (VIM+, CK7+, P504S+) had accurate cytological diagnosis (Fig.…”

“…Other studies have reported good or even excellent concordance between FNAB and histological diagnosis for CRCC although their diagnoses were based only on cytomorphology [8][9][10]. Although the cytological characteristics of CRCC are well defined, limited cytological material with only few cell groups precluded definite diagnosis of carcinoma-as a general rule in cytology-on FNAB in seven of 23 cases in our study.…”

“…Alternatively, a surgical approach may be altered (radical vs. partial nephrectomy) even though it is still mostly influenced by the size and location of the tumor. While FNAB has proved accurate for differentiating malignant from benign renal lesions, it is less reliable for subtyping renal carcinomas [7][8][9][10]. Immunohistochemistry has been shown to be helpful for accurate subtyping in core biopsies but there are only a few reports on the use of immunocytochemistry on FNAB samples of small series of renal tumors [11][12][13][14][15].…”

A rare tumor mimicking breast carcinoma

“…GCT of the breast is rare, with an incidence of 5-8%, and occurs in approximately 1 in every 1,000 breast cancers (2). Patients with GCT of the breast are usually middle-aged, premenopausal women, although rare examples have been reported in males (3).…”

“…The lesion usually presented as a painless, firm, mobile mass in the upper inner quadrant of the breast, corresponding to the cutaneous sensory territory of the supraclavicular nerve, which thought to derive from Schwann cells (2). When there is fixation to the pectoral fascia, chest wall or skin, there can be dimpling, retraction or edema which can simulate cancer that originated from breast or ectopic gland (4).…”