Critical role of fine needle aspiration cytology and immunocytochemistry inpreoperative diagnosis of pediatric renal tumors
OBJECTIVE: To evaluate accuracy and role of immunocytochemistry (ICC) incytologic diagnosis of pediatric renal tumors. STUDY DESIGN: Fine needle aspirates from 75 cases ofpediatric renal tumors were studied. Radiologic-guided aspirations were performed, with 6-7 smearsstained with Papanicolaou and Giemsa stains. Smears were screened without the knowledge of finalhistologic diagnosis. Subsequently, clinical details, final histology and diagnosis rendered by theoriginal cytologist were noted to judge accuracy of diagnosis by a sensitized cytologist. Fiveneuroblastomas that entered close differentials for Wilms tumor were also evaluated. ICC studieswere also performed after staining. RESULTS: Of 58 Wilms tumors, 5 were misdiagnosed; 3 renalrhabdoid tumors and 1 clear cell sarcoma were missed on cytology. Non-Hodgkin’s lymphomas presentingas renal masses were accurately diagnosed on cytology, but primitive neuroectodermal tumors (n = 3)and renal cell carcinomas (n = 2) were not accurately diagnosed. Accuracy rate improved from 65% to92% on review by a cytologist aware of cytologic features of pediatric renal tumors. CONCLUSION: Agood accuracy rate of diagnosis of pediatric renal tumors can be achieved by priming pathologists totypical features of tumors. Immunocytochemistry plays a supportive role in cases with atypicalmorphology or unusual presentations.
Goregaonkar,R　Shet,T　Ramadwar,M　Chinoy,R
Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, India.
Adolescent　 Azure Stains　 Biopsy, Fine-Needle　 Carcinoma, Renal Cell CellNucleus
