The utility of ancillary studies in pediatric FNA cytology.
We evaluated the diagnostic contribution of adjunct studies performed on aspirated material in the work-up of pediatric fine-needle aspiration (FNA) biopsies. Ancillary studies were performed on 54 of 136 (39.7%) pediatric FNA biopsies during a 5-year period. In 23 (16.9%) cases, immunocytochemical (ICC) studies, consisting of immunoperoxidase staining of direct smears and/or cell blocks or flow cytometric immunophenotyping, were performed. The studies were adequate in 14 cases (60.9%), suboptimal in five cases (21.7%), and inadequate in four cases (17.4%). Of the adequate and suboptimal cases, the ICC data helped to narrow the differential diagnosis or classify the disease process in eight cases (42.1%), confirmed cytologic impression in nine cases (47.4%), and gave contradictory results in two cases (10.5%). Adequate material for electron microscopy (EM) was obtained in 14/19 cases (73.7%). Ultrastructural studies were diagnostic, or helped classify the disease process in five cases (35.7%), confirmed the cytologic impression in four cases (28.6%), helped exclude diagnostic considerations in three cases (21.4%), and were judged to be non-contributory in two cases (14.3%). Cytogenetic studies revealed six of seven cases (all neoplasms) to have abnormal karyotypes. Special stains for organisms performed on smears from 25 cases including Ziehl-Neelsen, Gomori methenamine silver (GMS), Gram, and Warthin-Starry (WS) were negative except for 1/16 GMS and 4/9 Gram stains. In summary, we found that with appropriate case selection, ancillary studies performed on aspirated material can provide useful information in pediatric FNA cytology.
Gurley
A M
AM
Department of Pathology, East Carolina University School of Medicine, Greenville, NC 27858-4354.
Silverman
J F
JF
Lassaletta
M M
MM
Wiley
J E
JE
Holbrook
C T
CT
Joshi
V V
VV
D000008:Abdominal Neoplasms / Q000473:pathology; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D003582:Cytogenetics; D003584:Cytological Techniques; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D009369:Neoplasms / Q000473:pathology*; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology; D010673:Pheochromocytoma / Q000473:pathology; D013899:Thoracic Neoplasms / Q000473:pathology