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World J Gastrointest Endosc. Mar 16, 2015; 7(3): 253-257
Published online Mar 16, 2015. doi: 10.4253/wjge.v7.i3.253
Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of kidney lesions: A review
Roberto Iglesias Lopes, Renata Nobre Moura, Everson Artifon
Roberto Iglesias Lopes, Division of Urology, University of São Paulo Medical School, São Paulo - SP 05422-090, Brazil
Renata Nobre Moura, Everson Artifon, Department of Gastroenterology, University of São Paulo Medical School, São Paulo - SP 05422-090, Brazil
Author contributions: Lopes RI and Moura RN wrote the article and performed review of the literature, independently; Artifon EL performed all the EUS-FNA procedures and critically revised the manuscript; final version was approved by all authors.
Conflict-of-interest: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roberto Iglesias Lopes, MD, PhD, Division of Urology, University of São Paulo Medical School, Carvalho Aguiar, 255, 7 andar, São Paulo - SP 05422-090, Brazil. robertoiglesias@terra.com.br
Telephone: +55-11-26618080
Received: September 18, 2014
Peer-review started: September 18, 2014
First decision: December 1, 2014
Revised: November 9, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: March 16, 2015
Processing time: 183 Days and 5.2 Hours
Abstract

Traditionally, treatment of renal lesions is indicated based only on imaging features. Although controversy exists about tissue sampling from small renal masses, renal biopsy is indicated in some cases. In this review, we discuss the rationale for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and summarize the recent advances in this field, providing recommendations for the practicing clinician. The use of EUS-FNA appears to be a safe and feasible means of confirming or excluding malignancy. EUS allows assessment and biopsy of masses or lesions within both kidneys and related complications are rare. The main advantages of EUS-FNA are that it can be done as an outpatient procedure, with good results, minimal morbidity and a short hospital stay. Nevertheless, EUS-FNA of renal masses should be indicated only in selected cases, in which there is potential to decrease unnecessary treatment of small renal masses and to best select tumors for active surveillance and minimally invasive ablative therapies. Additionally, some renal lesions may be ineligible for EUS-guided biopsy because of anatomical limitations. EUS-FNA renal biopsy will probably be best applied to central anterior renal masses, while tumors on the posterior aspect of the kidney, percutaneous access will probably be superior.

Keywords: Kidney; Renal; Endoscopic ultrasound; Cancer; Puncture

Core tip: Although controversy exists on the need of renal biopsy, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) can be used in selected cases. In this review we discuss the rationale for EUS-FNA kidney and summarize the recent advances in this field, providing recommendations for the practicing clinician.