title: Lymphoproliferative disorders of the kidney on fine-needle aspiration: cytomorphology and radiographic correlates in 33 cases.
abstract: BACKGROUND
  Unless renal lesions present in the setting of widespread lymphoma, biopsy can be indicated to differentiate from metastases, hypovascular renal cell carcinoma, urothelial carcinoma or infection. We review our experience with lymphoproliferative disorders in the kidney diagnosed by fine-needle aspiration (FNA), and focus on clinicopathologic and radiographic features.
  
  
  METHODS
  All cases of non-Hodgkin lymphoma diagnosed on renal FNA at 2 academic institutions between 1989 and 2011 were reviewed. Clinical history, radiographic and cytomorphologic features, and follow-up were assessed.
  
  
  RESULTS
  33 cases were identified, with 15 primary tumors and 18 recurrences/secondary tumors including 1 acute lymphoblastic lymphoma. The majority were aggressive/high-grade lesions (25/33). 25 cases were substantiated by positive flow cytometry results. Most were detected at follow-up/incidentally. 22 cases showed multiple renal and/or retroperitoneal masses or a significant component of adenopathy; others showed a solitary renal mass. Salient radiologic features included hypodense, infiltrative and ill-defined masses. Cytomorphology showed a monotonous population of large atypical lymphoid cells, often with lymphoglandular bodies.
  
  
  CONCLUSIONS
  Cytologic diagnosis of renal lymphoma requires analysis of morphological, clinical and immunophenotypic information. Helpful features for diagnosis include: multiple masses on computed tomography, a monotonous population of abnormal cells in a background of lymphoglandular bodies and immunophenotyping demonstrating light chain restriction.
authors.affiliation: Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Andrea P
authors.initials: AP
authors.lastname: Subhawong
authors.forename: Ty K
authors.initials: TK
authors.lastname: Subhawong
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Vandenbussche
authors.forename: Momin T
authors.initials: MT
authors.lastname: Siddiqui
authors.forename: Syed Z
authors.initials: SZ
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002675:Child, Preschool; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008232:Lymphoproliferative Disorders / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies