Solid renal masses in adults: image-guided fine-needle aspiration cytology and imaging techniques--"two heads better than one?".

We have compared the diagnostic accuracy of image-guided 25G-FNA (fine-needle aspiration) and imaging modalities in a group of 31 patients with solid space-occupying renal lesions. All patients had undergone total nephrectomy and histologic sections were available for review. By FNA there were 24 malignant diagnoses, I benign diagnosis, and 6 cases with yield inadequate for diagnosis. The FNA accuracy for malignancy was 100% with no false positive cases; cancer typing by FNA matched the final histologic diagnoses in 91.6% of cases. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 14%, 80%, and 14%, respectively. Radiologically there were 26 diagnoses of malignancy, I of benignity, and 4 indeterminate lesions (IL). Accuracy for malignancy was 100%, with one false positive case; cancer typing matched the final histologic diagnoses in 84%. Sensitivity of imaging modalities was 86%, specificity 17%, positive predictive value 83%, and negative predictive value 20%. Four IL corresponded to renal cell carcinoma in the final histologic report: two IL had a previous diagnosis of malignancy by FNA, and the yield of two was inadequate for cytologic diagnosis. Both techniques have 100% accuracy for the diagnosis of malignancy. The sensitivity, specificity, positive predictive value, and negative predictive value of imaging techniques are slightly higher than those obtained by FNA. Imaging techniques and FNA of solid renal masses complement each other in IL and in nondiagnostic FNAs.

[Influence of recipient age on renal transplantation performed with organs coming from child donors]. / Influencia de la edad del receptor en el trasplante renal realizado con órganos procedentes de donantes infantiles.

OBJECTIVES: To evaluate the influence of receptor's age on the outcomes of kidney transplants with organs from donors below the age of three years and/or weighting less than 15 Kg. METHODS: We retrospectively studied the renal transplants with organs from donors below the age of three years and/or weighting less than 15 Kg performed at the Hospital Clínico San Carlos between 1991 and 1999. Receptors were divided into two groups depending on the age at the time of transplantation; group I included patients younger than 50 years and group II patients older than 50. RESULTS: We study 49 kidney transplants with pediatric donors (8.6%); 22 of them were included in group I and 27 in group II. There were no deaths among receptors younger than 50 years. Five-year survival for group II was 75.99%. Five-year graft survival what's 81.82% for group I, and 88.89% for group II (p 0.45). CONCLUSIONS: Receptor's age does not seem to influence graft survival when this kind of organs are used; we consider that the lower incidence of acute rejection in patients older than 50 years may explain the excellent response.