Sc. Campbell et al., PROSPECTIVE EVALUATION OF FINE-NEEDLE ASPIRATION OF SMALL, SOLID RENAL MASSES - ACCURACY AND MORBIDITY, Urology, 50(1), 1997, pp. 25-29
Objectives. To determine the accuracy and clinical utility of fine nee
dle aspiration (FNA) of small, solid renal masses. Methods, A total of
25 patients with small (less than 5.0 cm), solid, clinically localize
d renal masses were prospectively identified and evaluated with comput
ed tomography guided FNA with analysis for presence of malignant cells
and determination of nuclear grade. The final pathologic findings wer
e used for comparison in each case. All patients had renal cell carcin
oma and were managed with radical or partial nephrectomy; 3 had low-gr
ade lesions (Fuhrman's grade 1/4), 2 had high-grade lesions (Fuhrman's
grade 4/4),. and all other patients had intermediate-grade lesions (F
uhrman's grade 2/4 or 3/4) on final histopathologic assessment. Result
s. Overall, 10 aspirations yielded diagnostic malignant cells, and 9 w
ere read as rare atypical cells suspicious for malignancy. The remaind
er were negative (n = 6). Correlation with final nuclear grade was obs
erved in eight instances and discordance in two instances. Subcapsular
hematomas were observed at the time of surgery in 10 patients, but in
no instance was the operation adversely affected. Conclusions. The di
agnostic yield of FNA of small, solid renal masses appears to be too l
ow to justify the potential morbidity of the procedure. (C) 1997, Else
vier Science Inc. All rights reserved.