title: EUS-guided FNA aspiration of kidney masses: a multicenter U.S. experience.
abstract: BACKGROUND
  Tissue sampling of renal lesions is traditionally performed with percutaneous US or CT guidance. To date, only 3 known cases of EUS-guided FNA (EUS-FNA) of a renal mass have been reported.
  
  
  OBJECTIVE
  To describe a multicenter experience with the indications, yield, and complications from attempted EUS-FNA of a kidney mass.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Six tertiary referral hospitals in the United States.
  
  
  METHODS
  Consecutive subjects undergoing attempted EUS-FNA of a kidney mass. Endosonographers at 15 other teaching hospitals were contacted regarding EUS findings and follow-up of any EUS-guided renal biopsies previously attempted or considered at that institution.
  
  
  METHODS
  EUS-FNA of a kidney mass.
  
  
  METHODS
  Biopsy indications, yield, diagnosis, and complications.
  
  
  RESULTS
  Fifteen procedures in 15 patients (9 men; median age 67 years) were performed at 6 (37%) of 16 hospitals (Indiana University plus 15 other hospitals). Kidney masses (median diameter 32 mm; range 11-60 mm) were located in the upper (n = 12) and lower (n = 3) poles of the left (n = 10) and right (n = 5) kidneys, respectively. Initial mass detection was by previous imaging in 13 (87%) patients or by EUS in 2 (13%) patients. Results of EUS-FNA (median 3 passes; range 2-4 passes) in 13 (87%) procedures were diagnostic of (n = 7) or highly suspicious for (n = 1) renal cell carcinoma (RCC), atypical cells (n = 2), oncocytoma (n = 1), benign cyst (n = 1), and nondiagnostic (n = 1). No complications were encountered. Surgical resection confirmed RCC in 7 patients in whom preoperative EUS-FNA demonstrated RCC (n = 5) or oncocytoma (n = 1) or was not performed (n = 1).
  
  
  CONCLUSIONS
  Retrospective series, small number of patients.
  
  
  CONCLUSIONS
  EUS-FNA of renal masses is rarely performed at the U.S. teaching hospitals surveyed. This technique appears safe and feasible and should be considered when results would affect patient management.
authors: Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana 43202, USA.
authors: John
authors: J
authors: DeWitt
authors: Frank G
authors: FG
authors: Gress
authors: Michael J
authors: MJ
authors: Levy
authors: Lyndon V
authors: LV
authors: Hernandez
authors: Mohamad A
authors: MA
authors: Eloubeidi
authors: Girish
authors: G
authors: Mishra
authors: Stuart
authors: S
authors: Sherman
authors: Mohammad A
authors: MA
authors: Al-Haddad
authors: Julia K
authors: JK
authors: LeBlanc
mesh_terms: D018249:Adenoma, Oxyphilic / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology; D015331:Cohort Studies; D016001:Confidence Intervals; D019160:Endosonography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014481:United States