Abstract | BACKGROUND: Tissue sampling of renal lesions is traditionally performed with percutaneous US or CT guidance. To date, only 3 known cases of EUS-guided FNA (EUS-FNA) of a renal mass have been reported. OBJECTIVE: To describe a multicenter experience with the indications, yield, and complications from attempted EUS-FNA of a kidney mass. DESIGN: Retrospective case series. SETTING: Six tertiary referral hospitals in the United States. PATIENTS: Consecutive subjects undergoing attempted EUS-FNA of a kidney mass. Endosonographers at 15 other teaching hospitals were contacted regarding EUS findings and follow-up of any EUS-guided renal biopsies previously attempted or considered at that institution. INTERVENTIONS: EUS-FNA of a kidney mass. MAIN OUTCOME MEASUREMENTS: Biopsy indications, yield, diagnosis, and complications. RESULTS: Fifteen procedures in 15 patients (9 men; median age 67 years) were performed at 6 (37%) of 16 hospitals (Indiana University plus 15 other hospitals). Kidney masses (median diameter 32 mm; range 11-60 mm) were located in the upper (n = 12) and lower (n = 3) poles of the left (n = 10) and right (n = 5) kidneys, respectively. Initial mass detection was by previous imaging in 13 (87%) patients or by EUS in 2 (13%) patients. Results of EUS-FNA (median 3 passes; range 2-4 passes) in 13 (87%) procedures were diagnostic of (n = 7) or highly suspicious for (n = 1) renal cell carcinoma (RCC), atypical cells (n = 2), oncocytoma (n = 1), benign cyst (n = 1), and nondiagnostic (n = 1). No complications were encountered. Surgical resection confirmed RCC in 7 patients in whom preoperative EUS-FNA demonstrated RCC (n = 5) or oncocytoma (n = 1) or was not performed (n = 1). LIMITATIONS: Retrospective series, small number of patients. CONCLUSIONS: EUS-FNA of renal masses is rarely performed at the U.S. teaching hospitals surveyed. This technique appears safe and feasible and should be considered when results would affect patient management.
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Authors | John DeWitt, Frank G Gress, Michael J Levy, Lyndon V Hernandez, Mohamad A Eloubeidi, Girish Mishra, Stuart Sherman, Mohammad A Al-Haddad, Julia K LeBlanc |
Journal | Gastrointestinal endoscopy
(Gastrointest Endosc)
Vol. 70
Issue 3
Pg. 573-8
(Sep 2009)
ISSN: 1097-6779 [Electronic] United States |
PMID | 19560139
(Publication Type: Journal Article, Multicenter Study)
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Topics |
- Adenoma, Oxyphilic
(diagnostic imaging, pathology)
- Aged
- Aged, 80 and over
- Biopsy, Fine-Needle
(adverse effects, methods)
- Carcinoma, Renal Cell
(diagnostic imaging, pathology)
- Cohort Studies
- Confidence Intervals
- Endosonography
(adverse effects, methods)
- Female
- Follow-Up Studies
- Hospitals, Teaching
- Humans
- Immunohistochemistry
- Kidney Neoplasms
(diagnostic imaging, pathology, surgery)
- Male
- Middle Aged
- Neoplasm Staging
- Probability
- Retrospective Studies
- Risk Assessment
- Sensitivity and Specificity
- United States
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