title: Wilms' tumor. Role of fine needle aspiration and DNA ploidy by image analysis in prognostication.
abstract: OBJECTIVE
  To evaluate the utility of cytomorphologic features and DNA ploidy estimation in fine needle aspirates (FNAs), from Wilms' tumors for prognostication.
  
  
  METHODS
  Twenty-three cases of Wilms' tumor having FNA and follow-up data were selected. Cytomorphology was analyzed by two observers. DNA ploidy was determined in 19 cases by image cytometry by destaining Papanicolaou-stained slides and restaining with Feulgen stain. Various parameters and patient outcomes were compared, and statistical evaluation was done.
  
  
  RESULTS
  Poor outcome (12/23 cases) was associated with age < 2 years (P = .01), severe pleomorphism of blastemal cells (4/23 cases, P < .05), very large nucleoli (5/23 cases, P = .075), atypical mitosis (6/23 cases, P = .032) and aneuploidy/tetraploidy of tumor cells (6/29 cases, P = .005). Term unfavorable cytology is proposed when a combination of severe pleomorphism, very large nucleoli and atypical mitosis is seen in FNA smears. Four Wilms' tumor FNAs were characterized as showing unfavorable cytology, and all had a poor outcome (P = .0351). Three of the six cases with aneuploid/tetraploid features also showed unfavorable cytology.
  
  
  CONCLUSIONS
  Unfavorable cytology and aneuploidy/tetraploidy in FNA smears of Wilms' tumor are associated with a poor prognosis.
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Iyer
authors.forename: K
authors.initials: K
authors.lastname: Kapila
authors.forename: S
authors.initials: S
authors.lastname: Agarwala
authors.forename: A K
authors.initials: AK
authors.lastname: Dinda
authors.forename: K
authors.initials: K
authors.lastname: Verma
mesh_terms: D000367:Age Factors; D000782:Aneuploidy; D001707:Biopsy, Needle / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004247:DNA / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019044:Image Cytometry / Q000379:methods*; D008297:Male; D008938:Mitosis; D011003:Ploidies; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000473:pathology* / Q000628:therapy
chemical_list: D004247:DNA