Wilms' tumor. Role of fine needle aspiration and DNA ploidy by image analysis in prognostication

Anal Quant Cytol Histol. 1999 Dec;21(6):505-11.


Objective: To evaluate the utility of cytomorphologic features and DNA ploidy estimation in fine needle aspirates (FNAs), from Wilms' tumors for prognostication.

Study design: Twenty-three cases of Wilms' tumor having FNA and follow-up data were selected. Cytomorphology was analyzed by two observers. DNA ploidy was determined in 19 cases by image cytometry by destaining Papanicolaou-stained slides and restaining with Feulgen stain. Various parameters and patient outcomes were compared, and statistical evaluation was done.

Results: Poor outcome (12/23 cases) was associated with age < 2 years (P = .01), severe pleomorphism of blastemal cells (4/23 cases, P < .05), very large nucleoli (5/23 cases, P = .075), atypical mitosis (6/23 cases, P = .032) and aneuploidy/tetraploidy of tumor cells (6/29 cases, P = .005). Term unfavorable cytology is proposed when a combination of severe pleomorphism, very large nucleoli and atypical mitosis is seen in FNA smears. Four Wilms' tumor FNAs were characterized as showing unfavorable cytology, and all had a poor outcome (P = .0351). Three of the six cases with aneuploid/tetraploid features also showed unfavorable cytology.

Conclusion: Unfavorable cytology and aneuploidy/tetraploidy in FNA smears of Wilms' tumor are associated with a poor prognosis.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aneuploidy
  • Biopsy, Needle / methods
  • Child
  • Child, Preschool
  • DNA / analysis*
  • Female
  • Follow-Up Studies
  • Humans
  • Image Cytometry / methods*
  • Male
  • Mitosis
  • Ploidies*
  • Prognosis
  • Survival Rate
  • Treatment Outcome
  • Wilms Tumor / pathology*
  • Wilms Tumor / therapy


  • DNA