The Role of Fine Needle Aspiration Biopsy and Rapid Onsite Evaluation in the Diagnosis of Kidney Lesions.

Authors

Zehra Şahin, Şenay Erdoğan Durmuş, Deniz Ünlüer Kapışkay, Ahmet Baş, Nesrin Uygun

Published in

Diagnostic cytopathology. Sep 21, 2025. Epub Sep 21, 2025.

Abstract

Although core needle biopsy is widely preferred for evaluating renal lesions, fine needle aspiration (FNA) combined with rapid on-site evaluation (ROSE) remains a valuable diagnostic method in selected cases. This study aims to assess the diagnostic efficacy of renal FNA and highlight the impact of ROSE on achieving definitive diagnoses.
This retrospective study included 273 patients who underwent ultrasound- or CT-guided FNA for renal lesions between 2010 and 2018 at Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine. Lesions were evaluated based on size, radiologic features, localization, ROSE status, and number of smears. Cytopathological results were categorized as nondiagnostic, limited, non-neoplastic, or neoplastic. Histopathological correlation was assessed in available cases. Statistical analyses were performed using SPSS v25.0, with p < 0.05 considered significant.
Of the 273 cases, 218 (79.8%) yielded diagnostic results. Definitive diagnosis rates increased with lesion size and were significantly higher in solid (86.3%) and mixed (91.4%) lesions compared to cystic lesions (60%) (p = 0.001). ROSE was performed in 177 cases, significantly improving diagnostic yield compared to cases without ROSE (85.8% vs. 68.7%, p = 0.001). Histopathological follow-up was available in 119 cases, with an overall cytological-histological concordance of 84%, reaching 98% in cases with adequate material.
Renal FNA remains a reliable and accurate diagnostic method when combined with ROSE, especially in well-sampled cases. It aids in identifying both primary and metastatic tumors and can guide clinical decision-making, particularly when surgery is not feasible.

PMID:
40975883
Bibliographic data and abstract were imported from PubMed on 22 Sep 2025.

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