Saleh H, Masood S, Wynn G, Assaf N
Department of Pathology, University of Florida Health Science Center, Jacksonville.
Acta Cytol. 1994 Jul-Aug;38(4):554-61.
Fine needle aspiration biopsy (FNAB) is currently considered a valid procedure in the diagnosis of various primary and metastatic neoplasms. It is also known that computed tomography (CT)-guided percutaneous FNAB of the kidney is very useful in diagnosing primary renal cell carcinoma (RCC) and has a high accuracy rate. Nonetheless, its usage in the detection of unsuspected metastatic RCC has been described rarely. Below we report four unusual cases of metastatic RCC discovered by FNAB. The patients presented with subcutaneous, pulmonary, adrenal and flank masses with no previous history of RCC. Immunocytochemical (ICC) stains, including cytokeratin, epithelial membrane antigen, vimentin and fat stain, were obtained on two cases and were very helpful in establishing the diagnosis. We suggest that cytopathologists consider metastatic RCC a possibility when evaluating patients with tumors of unknown origin and that FNAB can be useful in diagnosing unsuspected metastatic RCC, especially when assisted by ICC and fat stain.
细针穿刺活检（FNAB）目前被认为是诊断各种原发性和转移性肿瘤的有效方法。众所周知，计算机断层扫描（CT）引导下经皮肾穿刺FNAB在诊断原发性肾细胞癌（RCC）方面非常有用，且准确率很高。然而，其在检测未被怀疑的转移性RCC中的应用却鲜有报道。以下我们报告4例通过FNAB发现的不寻常的转移性RCC病例。患者表现为皮下、肺部、肾上腺和侧腹肿块，既往无RCC病史。对其中2例进行了免疫细胞化学（ICC）染色，包括细胞角蛋白、上皮膜抗原、波形蛋白和脂肪染色，这对明确诊断非常有帮助。我们建议细胞病理学家在评估不明来源肿瘤患者时考虑转移性RCC的可能性，并且FNAB在诊断未被怀疑的转移性RCC时可能有用，尤其是在ICC和脂肪染色的辅助下。
