Aspiration and cytology in the evaluation of renal mass lesions

Author and Disclosure Information


Differentiation between a renal cyst and solid tumor has long been a vexing problem to the urologist. The intravenous urogram, if of good quality, can readily demonstrate a mass lesion within the kidney, but cannot accurately differentiate between cyst and tumor. Laminography or retrograde pyelography or both may be useful if the intravenous pyelogram is of poor quality. A renal scan is of little diagnostic value, since both cyst and neoplasm fail to concentrate the radioactive material to a significant degree.1 Nephrotomography has been of additional value in some cases, and selective renal angiography, even with the addition of epinephrine intra-arterially, continues to be only 95 % effective in making a definitive diagnosis.2, 3 Open exploration of renal mass lesions is not without complications; a mortality rate of 1% to 2% and morbidity of 20% to 30% can be expected following this type of surgery.4

In an effort to develop a reliable and nontoxic diagnostic protocol and therefore eliminate the need for unnecessary surgery in patients with a presumptive diagnosis of renal cyst, we have evaluated the results of aspiration and cytology of cyst fluid in 84 consecutive operated cases.


Eighty-four patients were operated on for renal cysts at the Cleveland Clinic Hospital from January 1966 through December 1969. All patients were evaluated with respect to age, complaint on primary examination, color, and cytology of cyst aspirate, type of surgery, and morbidity following operation. All but four patients underwent selective renal angiography, and the angiogram in every case. . .



Next Article: