Fine needle aspiration cytology in the diagnosis of solid renal and adrenal masses.

In the eight-year period 1977-1984, 83 renal and adrenal mass lesions which were not clearly simple cysts by ultrasonographic examination (US) were investigated by percutaneous fine needle aspiration (FNA) biopsy. Initially, biopsy was often guided by fluoroscopy, later US was by far the most commonly used modality. There were 77 renal and 6 adrenal masses; 69 lesions were malignant and 14 were benign. A positive cytological diagnosis of malignancy was given in 62 cases, a diagnostic sensitivity of 90%. One false positive diagnosis occurred, an angiomyolipoma was misinterpreted as a low grade renal cell tumour. One significant complication was recorded, post biopsy haemorrhage into a large, extensively necrotic renal adenocarcinoma causing severe pain. The place of FNA in the preoperative investigation of solid renal tumours is discussed on the basis of this experience and results reported in the literature.