title: Indications for renal fine needle aspiration biopsy in the era of modern imaging modalities.
abstract: BACKGROUND
  Renal fine needle aspiration biopsy (FNAB) has become an uncommon procedure in the era of renal helical computed tomography (CT), which has high diagnostic accuracy in the characterization of renal cortical lesions. This study investigates the current indications for renal FNAB. Having knowledge of the specific clinico-radiologic scenario that led to the FNAB, cytopathologists are better equipped to expand or narrow down their differential diagnosis.
  
  
  METHODS
  All renal FNABs performed during a 6 year interval were retrieved. Indication for the procedure was determined from the clinical notes and radiology reports.
  
  
  RESULTS
  Forty six renal FNABs were retrieved from 43 patients (14 females and 29 males with a mean age of 52 years [range, 4-81 years]). Twenty one cases (45.6%) were performed under CT-guidance and 25 cases (54.4%) under US-guidance. There were four distinct indications for renal FNAB: (1) solid renal masses with atypical radiological features or poorly characterized on imaging studies due to lack of intravenous contrast or body habitus (30.2%); (2) confirmation of radiologically suspected renal cell carcinoma in inoperable patients (advanced stage disease or poor surgical candidate status) (27.9%); (3) kidney mass in a patient with a prior history of other malignancy (27.9%); and (4) miscellaneous (drainage of abscess, indeterminate cystic lesion, urothelial carcinoma) (14.0%). 36 patients (83.7%) received a specific diagnosis based on renal FNAB cytology.
  
  
  CONCLUSIONS
  Currently, renal fine needle aspiration remains a useful diagnostic tool in selected clinico-radiologic scenarios.
authors: Department of Pathology, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
authors: Ema A
authors: EA
authors: Dragoescu
authors: Lina
authors: L
authors: Liu
keywords: Fine needle aspiration biopsy; imaging modalities; indications; radiology; renal
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