Endoscopic ultrasound-guided fine-needle aspiration for thediagnosis of kidney lesions： A review

Traditionally, treatment of renal lesions is indicatedbased only on imaging features. Although controversyexists about tissue sampling from small renalmasses, renal biopsy is indicated in some cases. Inthis review, we discuss the rationale for endoscopicultrasound-guided fine needle aspiration （EUS-FNA） andsummarize the recent advances in this field, providingrecommendations for the practicing clinician. The useof EUS-FNA appears to be a safe and feasible meansof confirming or excluding malignancy. EUS allowsassessment and biopsy of masses or lesions withinboth kidneys and related complications are rare. Themain advantages of EUS-FNA are that it can be doneas an outpatient procedure, with good results, minimalmorbidity and a short hospital stay. Nevertheless,EUS-FNA of renal masses should be indicated only inselected cases, in which there is potential to decreaseunnecessary treatment of small renal masses and tobest select tumors for active surveillance and minimallyinvasive ablative therapies. Additionally, some renallesions may be ineligible for EUS-guided biopsy becauseof anatomical limitations. EUS-FNA renal biopsy willprobably be best applied to central anterior renalmasses, while tumors on the posterior aspect of thekidney, percutaneous access will probably be superior.