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Accuracy of Subclassification and Grading of Renal Tumors on Fine Needle Aspiration Cytology Alone.
- Source :
-
Acta cytologica [Acta Cytol] 2021; Vol. 65 (2), pp. 140-149. Date of Electronic Publication: 2021 Feb 03. - Publication Year :
- 2021
-
Abstract
- Background: Fine needle aspiration (FNA) of renal masses can distinguish between benign and malignant neoplasms in 73-94% of cases. Previous studies suggested the correct subclassification of renal cell carcinomas (RCCs) by cytomorphology can be achieved in up to 80% of cases. However, as RCCs become increasingly subclassified by molecular signatures, correct subclassification based on cytology alone is increasingly difficult.<br />Design: Two FNA passes (2 stained with Diff-Quik® and 2 with the Papanicolaou method) were performed on all fresh nephrectomy specimens for a 1-year period. There were 30 cases in this study, with 29 primary renal tumors and 1 case of metastatic lung adenocarcinoma. Each case was assigned a random number and came with 2 slides (1 from each staining method). Eight cytopathologists were asked to provide a diagnosis and the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grading if applicable. Fleiss' Kappa and Cohen's Kappa equations were used to look at inter-rater variability.<br />Results: When compared to the surgical pathology diagnosis, the average percent correct diagnosis for all cytopathologist was 35%. Chromophobe RCCs had the best average percent accuracy at 72% followed by clearcell RCC at 48%. Average accuracy for grading RCCs was 40%. Inter-rater variability among the cytopathologists for all RCC diagnoses was fair with a Fleiss' Kappa coefficient of 0.28. For the WHO/ISUP grade, the weighted coefficient for each pathologist ranged from 0.11 to 0.45, ranging from fair to moderate, respectively.<br />Conclusions: Renal tumors are difficult to classify on cytopathology alone. Core needle biopsy and ancillary studies are necessary if diagnosis will change management.<br /> (© 2021 S. Karger AG, Basel.)
- Subjects :
- Azure Stains
Biopsy, Fine-Needle
Carcinoma, Renal Cell classification
Carcinoma, Renal Cell surgery
Humans
Kidney Neoplasms classification
Kidney Neoplasms surgery
Methylene Blue
Neoplasm Grading
Observer Variation
Papanicolaou Test
Predictive Value of Tests
Reproducibility of Results
Xanthenes
Carcinoma, Renal Cell pathology
Kidney Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1938-2650
- Volume :
- 65
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Acta cytologica
- Publication Type :
- Academic Journal
- Accession number :
- 33535202
- Full Text :
- https://doi.org/10.1159/000513065