title: Utility of fine-needle aspiration and core biopsy with touch preparation in the diagnosis of renal lesions.
abstract: BACKGROUND
  Cytologic evaluation by fine-needle aspiration (FNA) and core biopsy (CB) with touch preparation (TP) is used in the diagnosis of renal lesions.
  
  
  METHODS
  Consecutive image-guided FNA and CB, with or without TP, of renal lesions were reviewed. The cytology diagnoses were correlated with the radiology, surgical specimens, and clinical course.
  
  
  RESULTS
  A total of 154 procedures (76 FNA, 17 FNA+CB, 46 CB+TP, 15 FNA+CB+TP) were performed for lesions with benign (21), malignant (123), or indeterminate (10) radiology. Specimen adequacy was satisfactory in 86% of FNAs (93 of 108), 95% of TPs (58 of 61), and 94% of CBs (73 of 78), and is statistically significant for CB with or without TP versus FNA (P = .045). In the subset with concerning radiology (n = 133), specimen adequacy was satisfactory in 83% of FNAs (72 of 87), 95% of TPs (58 of 61), and 94% of CBs (73 of 78) (P = .006 for CB ± TP versus FNA), and procedures were diagnostic in 79% of FNAs (69 of 87), 90% of 61 TPs (55 of 61) and 90% of CBs (70 of 78) (P = .02 for CB ± TP versus FNA). Renal cell carcinoma subtype was reported in 63% of FNA (19 of 30) versus 88% of CB ± TP (43 of 49) (P = .01), and Fuhrman nuclear grade was reported only on CB. The cytology diagnoses correlated with surgical specimens in 94% (33 of 35). The most common treatment was ablation of small (3.0 ± 1.3 cm) masses (n = 47).
  
  
  CONCLUSIONS
  Compared with FNA, CB and TP have higher adequacy and diagnostic yield and provide more diagnostic information. Cytology diagnoses are highly accurate when correlated to surgical specimens.
authors.affiliation: Department of Pathology and Laboratory Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Lori R
authors.initials: LR
authors.lastname: Scanga
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Maygarden
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000473:pathology; D003584:Cytological Techniques; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: core biopsy; diagnostic utility; fine needle aspiration; renal masses; touch preparation