Renal Lymphoma: The Diagnostic and Therapeutic Roles of Fine-Needle Aspiration

Luan Truong, Nancy Caraway, Thu Huy Ngo, Rodolfo Laucirica, Ruth Katz, Ibrahim Ramzy

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

This study focused on 19 patients with renal lymphoma (RL) from whom 20 initial (1 patient with fine-needle aspiration [FNA] specimens of masses in both kidneys) and 1 repeated FNA specimen were obtained. Of the 19 patients, 10 had secondary RL, 8 primary RL, and 1 transplant RL. The FNA samples were studied by smears (all cases), tissues (11), phenotyping by immunostaining (13) or flow cytometry (4), and gene rearrangement (3). The final diagnoses included 1 T-cell lymphoma and 18 B-cell lymphomas. Of the 20 original specimens, 14 were reported as positive for lymphoma, 3 suggestive of lymphoma, 1 positive for transitional cell carcinoma, and 2 unsatisfactory. The follow-up specimen showed reactive changes. Tissue correlation, available in 11 cases, confirmed a positive cytodiagnosis (7), provided a final diagnosis in the cytologically inconclusive cases (3), or revised the misdiagnosis of transitional cell carcinoma from smears (1). The phenotyping elucidated the B vs T lineage of the lymphoma in all tested cases, confirmed the positive cytodiagnosis in 10 cases, confirmed the reactive cytodiagnosis in 1 case, and helped achieve a conclusive diagnosis in 2 cases suggestive of lymphoma. Gene rearrangement studies showed light chain restriction in the 2 tested cases. FNA has an essential role in treatment planning for RL. Although FNA usually is diagnostically conclusive, a high index of suspicion and awareness of atypical or misleading cytomorphologic features are important for a correct interpretation, especially for primary RL. Ancillary testing is essential for the diagnosis in problematic cases and lays the foundation for the differential diagnosis.

Original languageEnglish (US)
Pages (from-to)18-31
Number of pages14
JournalAmerican Journal of Clinical Pathology
Volume115
Issue number1
DOIs
StatePublished - Jan 1 2001

Keywords

  • Cytology
  • Fine-needle aspiration
  • FNA
  • Immunophenotyping
  • Posttransplant lymphoproliferative disorder
  • Renal lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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