The Role of Radiologically Guided Fine Needle Aspiration Cytology in The Diagnosis of Renal Masses

Abstract

background: Renal masses represent 3% of all visceral tumors with high morbidity and mortality rates both in the developed and developing countries. The aim of the study is to evaluate the role of imaging guided fine needle aspiration cytology in diagnosis of renal masses. Methods: A retrospective study done between 2007-2010 , at Police Hospital , on 52 Sudanese patients with renal masses, diagnosed radiologically. Clinical data and cytological slides were collected from the records. Fine needle aspiration of the renal lesions was done guided by ultrasound in 16 cases and by CT scan in 36 cases. The cytological slides were examined by the candidate and experienced cytopathologist. Histopathological slides were available for only ten cases, examined and correlated by the candidate and experienced histopathologist. Results: The study included 52 patients. The mean age ± SD was 54.44 ± 15.6 years, the age ranged from 24-88 years with a majority of patients above the age of 40 years (80.8%). Females to male ratio was 1.2:1. Thirty three patients (63.5 %) were from the central regions including Khartoum state. Renal cell carcinoma was most cancer in the central region 23 patients (69.7%). Cytological examination revealed 37 patients with malignant lesions and 15 patients with benign lesions. The ratio between the benign (28.9 %) and malignant (71.1 %) lesions was 1.0:2.5. Five cytological types of renal cell carcinoma were identified. Those were conventional renal cell carcinoma (77.1%), chromophobe renal cell carcinoma (5.7%), metastatic renal cell carcinoma (8.6%), suprarenal carcinoma (5.7%) and squamous cell carcinoma (2.9%). Ten Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. vii out of the 52 patients had a histologically confirmed carcinoma, two of which were cytologically diagnosed as benign lesions. For the remaining 42 cases; 15 cases diagnosed as benign lesions and no histopathological examination was done. The next 15 cases cytologically diagnosed as malignant lesions with radiological evidence of metastasis and there for no histopathological examination was done. For the last 12 cases histopathological slides and blocks were not available. Conclusion: FNAC is a useful technique in evaluating renal masses. It is simple, safe and what made it more useful is the better coordination between radiologist, pathologist and clinicians.