Background: Unless renal lesions present in the setting of widespread lymphoma, biopsy can be indicated to differentiate from metastases, hypovascular renal cell carcinoma, urothelial carcinoma or infection. We review our experience with lymphoproliferative disorders in the kidney diagnosed by fine-needle aspiration (FNA), and focus on clinicopathologic and radiographic features. Design: All cases of non-Hodgkin lymphoma diagnosed on renal FNA at 2 academic institutions between 1989 and 2011 were reviewed. Clinical history, radiographic and cytomorphologic features, and follow-up were assessed. Results: 33 cases were identified, with 15 primary tumors and 18 recurrences/secondary tumors including 1 acute lymphoblastic lymphoma. The majority were aggressive/high-grade lesions (25/33). 25 cases were substantiated by positive flow cytometry results. Most were detected at follow-up/incidentally. 22 cases showed multiple renal and/or retroperitoneal masses or a significant component of adenopathy; others showed a solitary renal mass. Salient radiologic features included hypodense, infiltrative and ill-defined masses. Cytomorphology showed a monotonous population of large atypical lymphoid cells, often with lymphoglandular bodies. Conclusion: Cytologic diagnosis of renal lymphoma requires analysis of morphological, clinical and immunophenotypic information. Helpful features for diagnosis include: multiple masses on computed tomography, a monotonous population of abnormal cells in a background of lymphoglandular bodies and immunophenotyping demonstrating light chain restriction.

Morel P, Dupriez B, Herbrecht R, Bastion Y, Tilly H, Delannoy A, Haioun C, Nouvel C, Bouabdallah K, Baumelou E, et al: Aggressive lymphomas with renal involvement: a study of 48 patients treated with the LNH-84 and LNH-87 regimens. Groupe d’Etude des Lymphomes de l’Adulte. Br J Cancer 1994;70:154–159.
Sheth S, Ali S, Fishman E: Imaging of renal lymphoma: patterns of disease with pathologic correlation. Radiographics 2006;26:1151–1168.
Murphy WM, Zambroni BR, Emerson LD, Moinuddin S, Lee LH: Aspiration biopsy of the kidney: simultaneous collection of cytologic and histologic specimens. Cancer 1985;56:200–205.
Truong LD, Todd TD, Dhurandhar B, Ramzy I: Fine-needle aspiration of renal masses in adults: analysis of results and diagnostic problems in 108 cases. Diagn Cytopathol 1999;20:339–349.
Gattuso P, Ramzy I, Truong LD, Lankford KL, Green L, Kluskens L, Spitz DJ, Reddy VB: Utilization of fine-needle aspiration in the diagnosis of metastatic tumors to the kidney. Diagn Cytopathol 1999;21:35–38.
Truong LD, Caraway N, Ngo T, Laucirica R, Katz R, Ramzy I: Renal lymphoma: the diagnostic and therapeutic roles of fine-needle aspiration. Am J Clin Pathol 2001;115:18–31.
Dekmezian RH, Charnsangavej C, Rava P, et al: Fine needle aspiration of kidney tumors in 105 patients: a cytologic and histologic correlation. Acta Cytol 1985;29:931.
Murphy WM, Zambroni BR, Emerson LD, Moinuddin S, Lee LH: Aspiration biopsy of the kidney: simultaneous collection of cytologic and histologic specimens. Cancer 1985;56:200–205.
Kelley CM, Cohen MB, Raab SS: Utility of fine-needle aspiration biopsy in solid renal masses. Diagn Cytopathol 1996;14:14–19.
Ferry JA, Harris NL, Papanicolaou N, Young RH: Lymphoma of the kidney: a report of 11 cases. Am J Surg Pathol 1995;19:134–144.
Osborne BM, Brenner M, Weitzner S, Butler JJ: Malignant lymphoma presenting as a renal mass: four cases. Am J Surg Pathol 1987;11:375–382.
Arranz Arija JA, Carrion JR, Garcia FR, Tejedor A, Pérez-Manga G, Tardio J, Menarguez FJ: Primary renal lymphoma: report of 3 cases and review of the literature. Am J Nephrol 1994;14:148–153.
Kose F, Sakalli H, Mertsoylu H, Sezer A, Kocer E, Tokmak N, Kilinc F, Ozyilkan O: Primary renal lymphoma: report of four cases. Onkologie 2009;32:200–202.
Stallone G, Infante B, Manno C, Campobasso N, Pannarale G, Schena FP: Primary renal lymphoma does exist: case report and review of the literature. J Nephrol 2000;13:367–372.
Karadeniz C, Oguz A, Ataoglu O, Citak C, Buyan N, Pinarli G, Ozkaya O, Kapucu O: Primary renal lymphoma and xanthogranulomatous pyelo-nephritis in childhood. J Nephrol 2002;15:597–600.
Cupisti A, Riccioni R, Carulli G, Paoletti S, Tognetti A, Meola M, Francesca F, Barsotti G, Petrini M: Bilateral primary renal lymphoma treated by surgery and chemotherapy. Nephrol Dial Transplant 2004;19:1629–1633.
Chatzipantelis P, Mastorakis E, Tzortzakakis D, Salla C: Fine needle aspiration cytology diagnosis of primary renal lymphoma involving the pleura: a case report. Acta Cytol 2010;54:71–74.
Balestreri L, Morassut S, Bernardi D, Tavio M, Talamini R, Gloghini A, Carbone A: Efficacy of CT-guided percutaneous needle biopsy in the diagnosis of malignant lymphoma at first presentation. Imaging 2005;29:123–127.
Anderson CM, Pusztai L, Palmer JL, Cabanillas F, Ellerhorst JA: Coincident renal cell carcinoma and non-Hodgkin’s lymphoma: the M.D. Anderson experience and review of the literature. J Urol 1998;159:714–717.
Trpkov K, Marcussen N, Rayner D, Lam G, Solez K: Kidney allograft with a lymphocytic infiltrate: acute rejection, posttransplantation lymphoproliferative disorder, neither, or both entities? Am J Kidney Dis 1997;30:449–454.
Renshaw AA, Granter SR, Cibas ES: Fine needle aspiration of the adult kidney. Cancer 1997;81:71–88.
LeMeur Y, Potelune N, Jaccard A, Petit B, Bordessoule D, Peyronnet P, Ranger S, Labrousse F, Leroux-Robert C: Lymphoproliferative syndromes after renal transplantation (in French). Nephrologie 1998;19:255–261.
Gattuso P, Reddy VB, Kizilbash N, Kluskens L, Selvaggi SM: Role of fine-needle aspiration in the clinical management of solid organ transplant recipients: a review. Cancer 1999;87:286–294.
Siddiqui MT, Reddy VB, Castelli MJ, Gattuso P: Role of fine needle aspiration in clinical management of transplant patients. Diagn Cytopathol 1997;17:429–435.
Gattuso P, Manosca F: Fine-needle aspiration of posttransplant lymphoproliferative disorders: a review. Diagn Cytopathol 2005;33:273–278.
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