Renal lymphoma. The diagnostic and therapeutic roles of fine-needle aspiration

Am J Clin Pathol. 2001 Jan;115(1):18-31. doi: 10.1309/25PQ-9TWL-1P9U-J31M.


This study focused on 19 patients with renal lymphoma (RL) from whom 20 initial (1 patient with fine-needle aspiration [FNA] specimens of masses in both kidneys) and 1 repeated FNA specimen were obtained. Of the 19 patients, 10 had secondary RL, 8 primary RL, and 1 transplant RL. The FNA samples were studied by smears (all cases), tissues (11), phenotyping by immunostaining (13) or flow cytometry (4), and gene rearrangement (3). The final diagnoses included 1 T-cell lymphoma and 18 B-cell lymphomas. Of the 20 original specimens, 14 were reported as positive for lymphoma, 3 suggestive of lymphoma, 1 positive for transitional cell carcinoma, and 2 unsatisfactory. The follow-up specimen showed reactive changes. Tissue correlation, available in 11 cases, confirmed a positive cytodiagnosis (7), provided a final diagnosis in the cytologically inconclusive cases (3), or revised the misdiagnosis of transitional cell carcinoma from smears (1). The phenotyping elucidated the B vs T lineage of the lymphoma in all tested cases, confirmed the positive cytodiagnosis in 10 cases, confirmed the reactive cytodiagnosis in 1 case, and helped achieve a conclusive diagnosis in 2 cases suggestive of lymphoma. Gene rearrangement studies showed light chain restriction in the 2 tested cases. FNA has an essential role in treatment planning for RL. Although FNA usually is diagnostically conclusive, a high index of suspicion and awareness of atypical or misleading cytomorphologic features are important for a correct interpretation, especially for primary RL. Ancillary testing is essential for the diagnosis in problematic cases and lays the foundation for the differential diagnosis.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Needle*
  • Child
  • Female
  • Gene Rearrangement
  • Humans
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / genetics
  • Kidney Neoplasms / pathology*
  • Lymphoma, B-Cell / diagnostic imaging
  • Lymphoma, B-Cell / genetics
  • Lymphoma, B-Cell / pathology*
  • Lymphoma, T-Cell / diagnostic imaging
  • Lymphoma, T-Cell / genetics
  • Lymphoma, T-Cell / pathology*
  • Male
  • Middle Aged
  • Phenotype
  • Tomography, X-Ray Computed