Fine needle aspiration cytology diagnosis of renal medullary carcinoma - Acase report

BACKGROUND: Renal medullary carcinoma is a recently described, highly aggre ssive neoplasm that affects predominantly young African American males with a history of sickle cell trait. To thc best of our knowledge, this is the first report of fine needle aspirate cytology (FNAC) findings of renal medu llary carcinoma. CASE: A 14-year-old, African American male with a history of sickle cell tr ait presented with the sudden onset of third cranial nerve palsy. Radiograp hic examination demonstrated possible tumor masses in the brain, thorax and left kidney. Ultrasound-guided fine needle aspiration was performed on thc left kidney, and a cytologic diagnosis of "suspect renal medullary carcino ma" was rendered. The cytologic diagnosis was confirmed by tissue examinati on. CONCLUSION: The cytologic features of renal medullary carcinoma include loo sely cohesive clusters and single epithelioid cells with cytologic atypia, including high nuclear/cytoplasmic ratios, hyperchromasia, prominent nucleo li and cytoplasmic vacuolation. These cytologic findings, coupled with clin ical findings (young black male with sickle cell trait), allow recognition of this rare renal neoplasm.