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Kidney, Adrenal Gland, and Retroperitoneum

  • Alarice C. LoweEmail author
Chapter
Part of the Practical Anatomic Pathology book series (PAP)

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.

Keywords

Kidney Adrenal Retroperitoneum FNA Biopsy Cytology Cancer Diagnosis ROSE 

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. 1.Department of PathologyStanford UniversityPalo AltoUSA

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