M. Baliga et al., ALTERATION OF WILMS-TUMOR STAGING BY CYTOLOGIC DETECTION OF MALIGNANT-CELLS IN CHYLOUS ASCITES, Diagnostic cytopathology, 12(4), 1995, pp. 357-359
Accurate staging as per National Wilms' Tumor Study (NWTS) criteria is
essential for therapy of Wilms' tumor. We report a unique case of a 9
-mo-old white male in whom the diagnosis based upon clinical, radiolog
ical, surgical, and initial histopathologic findings was Stage I Wilms
' tumor without regard to a positive cytologic examination of a small
amount (5 ml) of chylous ascitic fluid obtained intraoperatively. This
problem was clarified later at the NWTS panel review when the deeper
recuts of a renal hilar lymph node revealed a single cluster of Wilms'
tumor cells in capsular sinus, resulting in upstaging of tumor to Sta
ge III. The significance of these findings in relation to staging will
be discussed. (C) 1995 Wiley-Liss, Inc.