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Kidney and Adrenal Gland

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Atlas of Fine Needle Aspiration Cytology

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Abstract

Fine-needle aspiration (FNA) biopsy of the kidney is a valuable diagnostic modality for radiographically indeterminate mass lesions, for workup of systemic diseases, and for establishing a malignant diagnosis in nonsurgical candidates. Recent advances in imaging, interventional radiology, and cytologic ancillary techniques have enhanced the accuracy of renal FNA. Adrenal masses are a common finding in abdominal image studies. Using CT, US, and more recently endoscopic US (EUS) guidance, FNA biopsy is effective in distinguishing primary, mostly benign adrenal nodules from metastatic tumors during staging workups. It can also be used in establishing the diagnosis of some systemic infectious diseases.

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References

  1. Silverman SG, Gan YU, Mortele KJ, Tuncali K, Cibas ES. Renal masses in the adult patient: the role of percutaneous biopsy. Radiology. 2006;240:6–22.

    Article  Google Scholar 

  2. Roh MH, Dal Cin P, Silverman SG, Cibas ES. The application of cytogenetics and fluorescence in situ hybridization to fine–needle aspiration in the diagnosis and subclassification of renal neoplasms. Cancer Cytopathol. 2010;118:137–45.

    Article  Google Scholar 

  3. Phe V, Yates DR, Renard-Penna R, Cussenot O, Roupret M. Is there a contemporary role for percutaneous needle biopsy in the era of small renal masses? BJU Int. 2012;109:867–72.

    Article  Google Scholar 

  4. Herrera GA, Turbat-Herrera EA. Ancillary diagnostic techniques in the evaluation of adult epithelial renal neoplasms: indications, caveats, and pitfalls. Appl Immunohistochem Mol Morphol AIMM Off Publ Soc Appl Immunohistochem. 2014;22(2):77–98.

    Article  CAS  Google Scholar 

  5. Burlingame OO, Kesse KO, Silverman SG, Cibas ES. On-site adequacy evaluations performed by cytotechnologists: correlation with final interpretations of 5241 image-guided fine-needle aspiration biopsies. Cancer Cytopathol. 2012;120(3):177–84.

    Article  Google Scholar 

  6. Yang CS, Choi E, Idrees MT, Chen S, Wu HH. Percutaneous biopsy of the renal mass: FNA or core needle biopsy? Cancer Cytopathol. 2017;125(6):407–15.

    Article  Google Scholar 

  7. Truong LD, Shen SS. Immunohistochemical diagnosis of renal neoplasms. Arch Pathol Lab Med. 2011;135:92–109.

    PubMed  Google Scholar 

  8. Schmitt F, Barroca H. Role of ancillary studies in fine–needle aspiration from selected tumors. Cancer Cytopathol. 2012;120:145–60.

    Article  CAS  Google Scholar 

  9. Fulciniti F, Mascolo M, Insabato L, et al. Massive infarction of papillary carcinoma of the kidney after fine needle aspiration biopsy: report of a case with cytohistologic correlation. Acta Cytol. 2006;50:563–6.

    Article  Google Scholar 

  10. Turbiner J, Amin MB, Humphrey PA, Srigley JR, De Leval L, Radhakrishnan A, et al. Cystic nephroma and mixed epithelial and stromal tumor of kidney: a detailed clinicopathologic analysis of 34 cases and proposal for renal epithelial and stromal tumor (REST) as a unifying term. Am J Surg Pathol. 2007;31:489–500.

    Article  Google Scholar 

  11. Yusenko MV. Molecular pathology of renal oncocytoma: a review. Int J Urol. 2010;17:602–12.

    Article  Google Scholar 

  12. Conner JR, Hirsch MS, Jo VY. HNF1beta and S100A1 are useful biomarkers for distinguishing renal oncocytoma and chromophobe renal cell carcinoma in FNA and core needle biopsies. Cancer Cytopathol. 2015;123(5):298–305.

    Article  Google Scholar 

  13. Zhou H, Guo M, Gong Y. Challenge of FNA diagnosis of angiomyolipoma: a study of 33 cases. Cancer Cytopathol. 2017;125(4):257–66.

    Article  Google Scholar 

  14. 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.

    Article  Google Scholar 

  15. Patel NP, Geisinger KR, Zagoria RJ, Bergman S. Fine needle aspiration biopsy of metanephric adenoma: a case report. Acta Cytol. 2009;53:327–31.

    Article  Google Scholar 

  16. Olgac S, Hutchinson B, Tickoo SK, Reuter VE. Alpha–methylacyl–CoA racemase as a marker in the differential diagnosis of metanephric adenoma. Mod Pathol. 2006;19:218–24.

    Article  CAS  Google Scholar 

  17. Charles AK, Mall S, Watson J, Berry PJ. Expression of the Wilms’ tumour gene WT1 in the developing human and in paediatric renal tumours: an immunohistochemical study. Mol Pathol. 1997;50:138–44.

    Article  CAS  Google Scholar 

  18. Sugie S, Tanaka T, Nishikawa A, Yoshimi N, Kato K, Mori H, et al. Fine–needle aspiration cytology of xanthogranulomatous pyelonephritis. Urology. 1991;37:376–9.

    Article  CAS  Google Scholar 

  19. Li L, Parwani AV. Xanthogranulomatous pyelonephritis. Arch Pathol Lab Med. 2011;135:671–4.

    PubMed  Google Scholar 

  20. Eble JN, Togashi K, Pisani P. Renal cell carcinoma. In: Eble JN, Sauter G, Epstein JI, Sesterhenn IA, editors. Pathology and genetics of tumors of the urinary system and male genital organs world health organization classification of tumors. Lyon: IARC Press; 2004. p. 12–4.

    Google Scholar 

  21. Lopez-Beltran A, Montironi R, Egevad L, Caballero-Vargas MT, Scarpelli M, Kirkali Z, et al. Genetic profiles in renal tumors. Int J Urol. 2010;17:6–19.

    Article  CAS  Google Scholar 

  22. Srigley JR, Delahunt B. Uncommon and recently described renal carcinomas. Mod Pathol. 2009;22:S2–23.

    Article  Google Scholar 

  23. Kovacs G, Akhtar M, Beckwith BJ, Bugert P, Cooper CS, Delahunt B, et al. The Heidelberg classification of renal cell tumours. J Pathol. 1997;183:131–3.

    Article  CAS  Google Scholar 

  24. Storkel S, Eble JN, Adlakha K, Amin M, Blute ML, Bostwick DG, et al. Classification of renal cell carcinoma: workgroup no. 1. Union Internationale Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer. 1997;80:987–9.

    Article  CAS  Google Scholar 

  25. Aydin H, Chen L, Cheng L, Vaziri S, He H, Ganapathi R, et al. Clear cell tubulopapillary renal cell carcinoma: a study of 36 distinctive low–grade epithelial tumors of the kidney. Am J Surg Pathol. 2010;34:1608–21.

    PubMed  Google Scholar 

  26. Amin MB, MacLennan GT, Gupta R, Grignon D, Paraf F, Vieillefond A, et al. Tubulocystic carcinoma of the kidney: clinicopathologic analysis of 31 cases of a distinctive rare subtype of renal cell carcinoma. Am J Surg Pathol. 2009;33:384–92.

    Article  Google Scholar 

  27. Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: renal, penile, and testicular tumours. Eur Urol. 2016;70(1):93–105.

    Article  Google Scholar 

  28. 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.

    Article  Google Scholar 

  29. Renshaw AA, Lee KR, Madge R, Granter SR. Accuracy of fine needle aspiration in distinguishing subtypes of renal cell carcinoma. Acta Cytol. 1997;41:987–94.

    Article  CAS  Google Scholar 

  30. 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.

    PubMed  Google Scholar 

  31. Cheville JC, Lohse CM, Sukov WR, Thompson RH, Leibovich BC. Chromophobe renal cell carcinoma: the impact of tumor grade on outcome. Am J Surg Pathol. 2012;36:851–6.

    Article  Google Scholar 

  32. Adley BP, Schafernak KT, Yeldandi AV, Yang XJ, Nayar R. Cytologic and histologic findings in multiple renal hybrid oncocytic tumors in a patient with Birt–Hogg–Dube syndrome: a case report. Acta Cytol. 2006;50:584–8.

    Article  Google Scholar 

  33. Petersson F, Gatalica Z, Grossmann P, Perez Montiel MD, Alvarado Cabrero I, Bulimbasic S, et al. Sporadic hybrid oncocytic/chromophobe tumor of the kidney: a clinicopathologic, histomorphologic, immunohistochemical, ultrastructural, and molecular cytogenetic study of 14 cases. Virchows Arch. 2010;456:355–65.

    Article  Google Scholar 

  34. Argani P, Ladanyi M. Renal carcinoma associated with Xp11.2 translocations/TFE3 fusions. In: Eble JN, Sauter G, Epstein JI, Sesterhenn IA, editors. Pathology and genetics of tumors of the urinary system and male genital organs world health organization classification of tumors. Lyon: IARC Press; 2004. p. 37–8.

    Google Scholar 

  35. Schinstine M, Filie AC, Torres-Cabala C, Abati A, Linehan WM, Merino M. Fine–needle aspiration of a Xp11.2 translocation/TFE3 fusion renal cell carcinoma metastatic to the lung: report of a case and review of the literature. Diagn Cytopathol. 2006;34:751–6.

    Article  Google Scholar 

  36. Yamaguchi T, Kuroda N, Imamura Y, Hes O, Kawada T, Nakayama K. Imprint cytologic features in renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion in an adult: a case report. Acta Cytol. 2009;53:693–7.

    Article  Google Scholar 

  37. Mansouri D, Dimet S, Couanet D, Terrier-Lacombe MJ, Vasiliu V, Khalifa C, et al. Renal cell carcinoma with an Xp11.2 translocation in a 16–year–old girl: a case report with cytological features. Diagn Cytopathol. 2006;11:757–60.

    Article  Google Scholar 

  38. Srigley J. Mucinous tubular and spindle cell carcinoma. In: Eble JN, Sauter G, Epstein JI, Sesterhenn IA, editors. Pathology and genetics of tumors of the urinary system and male genital organs world health organization classification of tumors. Lyon: ARC Press; 2004. p. 40.

    Google Scholar 

  39. Parwani AV, Husain AN, Epstein JI, Beckwith JB, Argani P. Low–grade myxoid renal epithelial neoplasms with distal nephron differentiation. Hum Pathol. 2001;32:506–12.

    Article  CAS  Google Scholar 

  40. MacLennan GT, Farrow GM, Bostwick DG. Low–grade collecting duct carcinoma of the kidney: report of 13 cases of low–grade mucinous tubulocystic renal carcinoma of possible collecting duct origin. Urology. 1997;50:679–84.

    Article  CAS  Google Scholar 

  41. Ortega JA, Solano JG, Perez-Guillermo M. Cytologic aspect of mucinous tubular and spindle–cell renal carcinoma in fine–needle aspirates. Diagn Cytopathol. 2006;34:660–2.

    Article  Google Scholar 

  42. Owens CL, Argani P, Ali SZ. Mucinous tubular and spindle cell carcinoma of the kidney: cytopathologic findings. Diagn Cytopathol. 2007;35:593–6.

    Article  Google Scholar 

  43. Marks-Jones DA, Zynger DL, Parwani AV, Cai G. Fine needle aspiration biopsy of renal mucinous tubular and spindle cell carcinoma: report of two cases. Diagn Cytopathol. 2009;38:51–5.

    Google Scholar 

  44. Sun W, McGregor DK, Ordonez NG, Ayala AG, Caraway NP. Fine needle aspiration cytology of a low grade myxoid renal epithelial neoplasm: a case report. Acta Cytol. 2005;49:525–9.

    Article  Google Scholar 

  45. Srigley JR, Eble JN. Collecting duct carcinoma of kidney. Semin Diagn Pathol. 1998;15:54–67.

    CAS  PubMed  Google Scholar 

  46. Layfield LJ. Fine–needle aspiration biopsy of renal collecting duct carcinoma. Diagn Cytopathol. 1994;11:74–8.

    Article  CAS  Google Scholar 

  47. Ono K, Nishino E, Nakamine H. Renal collecting duct carcinoma. Report of a case with cytologic findings on fine needle aspiration. Acta Cytol. 2000;44:380–4.

    Article  CAS  Google Scholar 

  48. Albadine R, Schultz L, Illei P, Ertoy D, Hicks J, Sharma R, et al. PAX8 (+)/p63 (−) immunostaining pattern in renal collecting duct carcinoma (CDC): a useful immunoprofile in the differential diagnosis of CDC versus urothelial carcinoma of upper urinary tract. Am J Surg Pathol. 2010;34:965–9.

    Article  Google Scholar 

  49. Hunter S, Samir A, Eisner B, Gervais D, Maher M, Hahn P, et al. Diagnosis of renal lymphoma by percutaneous image guided biopsy: experience with 11 cases. J Urol. 2006;176:1952–6; discussion 6.

    Article  Google Scholar 

  50. Lin X. Cytomorphology of clear cell papillary renal cell carcinoma. Cancer Cytopathol. 2017;125(1):48–54.

    Article  CAS  Google Scholar 

  51. Truong LD, Caraway N, Ngo T, Laucirica R, Katz R, Ramzy I. Renal lymphoma. The diagnostic and therapeutic roles of fine–needle aspiration. Am J Clin Pathol. 2001;115:18–31.

    Article  CAS  Google Scholar 

  52. Balachandran I, Walker JW Jr, Broman J. Fine needle aspiration cytology of ALK1(−), CD30+ anaplastic large cell lymphoma post renal transplantation: a case report and literature review. Diagn Cytopathol. 2010;38:213–6.

    PubMed  Google Scholar 

  53. Hollmann TJ, Hornick JL. INI1–deficient tumors: diagnostic features and molecular genetics. Am J Surg Pathol. 2011;35:e47–63.

    Article  Google Scholar 

  54. Katz RL, Shirkhoda A. Diagnostic approach to incidental adrenal nodules in the cancer patient. Results of a clinical, radiologic, and fine–needle aspiration study. Cancer. 1985;55:1995–2000.

    Article  CAS  Google Scholar 

  55. 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.

    Article  Google Scholar 

  56. Eloubeidi MA, Black KR, Tamhane A, Eltoum IA, Bryant A, Cerfolio RJ. A large single–center experience of EUS–guided FNA of the left and right adrenal glands: diagnostic utility and impact on patient management. Gastrointest Endosc. 2010;71:745–53.

    Article  Google Scholar 

  57. Gupta N, Arora SK, Rajwanshi A, Nijhawan R, Srinivasan R. Histoplasmosis: cytodiagnosis and review of literature with special emphasis on differential diagnosis on cytomorphology. Cytopathology. 2010;21:240–4.

    Article  CAS  Google Scholar 

  58. de Agustin P, Lopez-Rios F, Alberti N, Perez-Barrios A. Fine–needle aspiration biopsy of the adrenal glands: a ten–year experience. Diagn Cytopathol. 1999;21:92–7.

    Article  Google Scholar 

  59. Fassina AS, Borsato S, Fedeli U. Fine needle aspiration cytology (FNAC) of adrenal masses. Cytopathology. 2000;11:302–11.

    Article  CAS  Google Scholar 

  60. Dusenbery D, Dekker A. Needle biopsy of the adrenal gland: retrospective review of 54 cases. Diagn Cytopathol. 1996;14:126–34.

    Article  CAS  Google Scholar 

  61. Lumachi F, Borsato S, Brandes AA, Boccagni P, Tregnaghi A, Angelini F, et al. Fine-needle aspiration cytology of adrenal masses in noncancer patients: clinicoradiologic and histologic correlations in functioning and nonfunctioning tumors. Cancer. 2001;93:323–9.

    Article  CAS  Google Scholar 

  62. Haseganu LE, Diehl DL. Left adrenal gland hemorrhage as a complication of EUS-FNA. Gastrointest Endosc. 2009;69:e51–2.

    Article  Google Scholar 

  63. 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.

    Article  Google Scholar 

  64. Voravud N, Shin DM, Dekmezian RH, et al. Implantation metastasis of carcinoma after percutaneous fine-needle aspiration biopsy. Chest. 1992;102:313–5.

    Article  CAS  Google Scholar 

  65. Wu HH, Cramer HM, Kho J, Elsheikh TM. Fine needle aspiration cytology of benign adrenal cortical nodules. A comparison of cytologic findings with those of primary and metastatic adrenal malignancies. Acta Cytol. 1998;42:1352–8.

    Article  CAS  Google Scholar 

  66. 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.

    Article  Google Scholar 

  67. McNicol AM. Update on tumours of the adrenal cortex, phaeochromocytoma and extra–adrenal paraganglioma. Histopathology. 2011;58:155–68.

    Article  Google Scholar 

  68. Saboorian MH, Katz RL, Charnsangavej C. Fine needle aspiration cytology of primary and metastatic lesions of the adrenal gland. A series of 188 biopsies with radiologic correlation. Acta Cytol. 1995;39:843–51.

    CAS  PubMed  Google Scholar 

  69. Lam KY, Lo CY. Metastatic tumours of the adrenal glands: a 30–year experience in a teaching hospital. Clin Endocrinol. 2002;56:95–101.

    Article  Google Scholar 

  70. Wadih GE, Nance KV, Silverman JF. Fine–needle aspiration cytology of the adrenal gland. Fifty biopsies in 48 patients. Arch Pathol Lab Med. 1992;116:841–6.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Brigham & Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, 02115, MA, USA

    Xiaohua Qian

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  1. Xiaohua Qian
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  1. Department of Pathology, Skåne University Hospital, Lund, Sweden

    Henryk A. Domanski

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Qian, X. (2019). Kidney and Adrenal Gland. In: Domanski, H. (eds) Atlas of Fine Needle Aspiration Cytology. Springer, Cham. https://doi.org/10.1007/978-3-319-76980-6_13

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  • DOI: https://doi.org/10.1007/978-3-319-76980-6_13

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