Utilidad de la citología en el diagnóstico y manejo de tumores renales y perirrenales del adulto

USEFULNESS OF CYTOLOGY IN DIAGNOSIS AND MANAGEMENT OF RENAL AND PERIRENAL TUMORS IN ADULTS Introduction: The use more and more extended of tumorectomy, partial nephrectomy and nonsurgical treatments of renal tumors has supposed a renewed interest in the diagnosis use of cytology. Whether during preoperative period, through the puncture aspiration with fine needle (PAAF), or during the intraoperative analysis, the cytology offers the possibility of a specific morphologic diagnosis. In this revision the information concerning the diagnostic value of the cyto- logy in renal tumors is updated. Material and methods: The references related to renal masses cytological descriptions has been reviewed. For this purpose we have searched both with computer in Medline data base and also manually. In the same way we include aut- hors experience as much in the PAAF of these lesions as in the intraoperative use of the cytology. Results: Between neoplasias with more cytological typical presentation are the clear cell renal and papillary carcino- mas. The chromophobe and oncocytoma can show similarities, although the accumulated experience in the last years reflects that its differentiation is possible in most of the cases. For the diagnosis of angiomyolipoma, urothelial carcino- ma and kidney metastasis, the clinical and image information are of great interest for the pathologist. The integration of these data usually allows a specific diagnosis. Conclusion: Generally, cytology reflects with accuracy the histological characteristics of renal neoplasias, allowing in many cases a specific diagnosis. We consider much appropriated the use of cytology, due to the more and more frequent situation of "incidentaloma". The PAAF minimum invasive nature and the possibility of performing a fast cytological analysis during intraoperative studies offer important information for the therapeutic management of these patients.