Lymphoproliferative Disorders of the Kidney on Fine-Needle Aspiration: Cytomorphology and Radiographic Correlates in 33 CasesSubhawong A.P. · Subhawong T.K. · VandenBussche C.J. · Siddiqui M.T. · Ali S.Z.
Departments of aPathology and bRadiology, The Johns Hopkins School of Medicine, Baltimore, Md., and cDepartment of Pathology, Emory School of Medicine, Atlanta, Ga., USA
Background: Unless renal lesions present in the setting of widespread lymphoma, biopsy can be indicated to differentiate from metastases, hypovascular renal cell carcinoma, urothelial carcinoma or infection. We review our experience with lymphoproliferative disorders in the kidney diagnosed by fine-needle aspiration (FNA), and focus on clinicopathologic and radiographic features. Design: All cases of non-Hodgkin lymphoma diagnosed on renal FNA at 2 academic institutions between 1989 and 2011 were reviewed. Clinical history, radiographic and cytomorphologic features, and follow-up were assessed. Results: 33 cases were identified, with 15 primary tumors and 18 recurrences/secondary tumors including 1 acute lymphoblastic lymphoma. The majority were aggressive/high-grade lesions (25/33). 25 cases were substantiated by positive flow cytometry results. Most were detected at follow-up/incidentally. 22 cases showed multiple renal and/or retroperitoneal masses or a significant component of adenopathy; others showed a solitary renal mass. Salient radiologic features included hypodense, infiltrative and ill-defined masses. Cytomorphology showed a monotonous population of large atypical lymphoid cells, often with lymphoglandular bodies. Conclusion: Cytologic diagnosis of renal lymphoma requires analysis of morphological, clinical and immunophenotypic information. Helpful features for diagnosis include: multiple masses on computed tomography, a monotonous population of abnormal cells in a background of lymphoglandular bodies and immunophenotyping demonstrating light chain restriction.
Correspondence to: Dr. Syed Ali
Department of Cytopathology, The Johns Hopkins Hospital
Pathology Building, Room 406, 600 North Wolfe Street
Baltimore, MD 21287 (USA)
This work was presented as a poster at the United States and Canadian Academy of Pathologists meeting in March of 2012.
Received: June 20, 2012
Accepted after revision: August 9, 2012
Published online: December 6, 2012
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 1, Number of References : 25
Acta Cytologica (The Journal of Clinical Cytology and Cytopathology)
Vol. 57, No. 1, Year 2013 (Cover Date: January-February)
Journal Editor: Bibbo M. (Philadelphia, Pa.)
ISSN: 0001-5547 (Print), eISSN: 1938-2650 (Online)
For additional information: http://www.karger.com/ACY