Cytogenetics as an Adjunct to Fine Needle Aspiration in the Diagnosis and Classification of Renal Neoplasms
MH Roh, P dal Cin, SG Silverman, ES Cibas. Brigham and Women's Hospital and Harvard Medical School, Boston, MA
Background: Fine needle aspiration (FNA) is an important diagnostic modality for the evaluation and management of selected renal masses. Cytogenetic analysis can serve as a useful adjunct for precise classification because certain kidney tumors are associated with specific chromosomal aberrations; the clear cell, papillary, and chromophobe subtypes of renal cell carcinoma (RCC) are associated with 3p deletions, trisomies of chromosomes 7 and 17, and multiple monosomies, respectively. This study summarizes our experience with the application of cytogenetics as an adjunct to FNA of renal neoplasms.
Design: All renal FNAs from January, 2005 through August, 2008 were identified from the electronic pathology database. The diagnoses were reviewed and correlated with the results of concurrent cytogenetics specimens derived from portions of the FNAs.
Results: 260 FNAs of the kidney were performed during the above time period. Based on an on-site assessment, a portion of the FNA was allocated for cytogenetic analysis in 64 (25%) cases (excluding unsatisfactory and atypical cases). Cultures were successful in 39 of these 64 (61%) cases. The cytogenetic profiles aided in the classification of the tumor in 23 of 39 (59%) cases. Eighteen showed trisomy 7 and 17, twelve via karyotypic analysis of metaphase chromosomes and six via fluorescence in-situ hybridization using probes for chromosomes 7 and 17, and thus were consistent with papillary RCC. Four showed deletions in 3p consistent with RCC, clear cell type. Trisomy 3, seen in a subset of clear cell RCCs, was observed in one case. In the remaining 16 cases, a normal karyotype or non-specific chromosomal aberrations were observed.
Conclusions: FNA of renal specimens is amenable for cytogenetic analysis. Cytogenetics can be useful in the diagnosis and classification of RCCs, especially the papillary and clear cell subtypes.
Wednesday, March 11, 2009 1:00 PM
Poster Session VI # 50, Wednesday Afternoon