Fine-needle aspiration biopsy in pediatric oncology patients: a review of experience with 829 patients (899 biopsies).
The authors review their 20-year (1985-2004) experience with fine-needle aspiration biopsy (FNAB) in 829 children (all but 1 younger than 18 years), from whom 899 samples were obtained. All patients presented with clinical data suggesting malignancy. The procedure followed standard methods (22- to 24-gauge needle; mean of six alcohol-fixed and/or air-dried, H&E- or Giemsa-like-stained smears/procedure; leftover clots processed as a biopsy). Interpretation of cytologic smears was performed taking into consideration the clinical, laboratory, and imaging data. Smears diagnosed as positive for malignant cells were reported in 510 samples (56.7%) (463 patients); 1.89% of the smears were found inadequate for diagnosis. Positive for malignancy cases included 467 primary tumors, 52% of which were localized to the abdomen. NMYC status was determined on neuroblastoma samples by fluorescent in situ hybridization. Overall sensitivity of the procedure was 98% (500/510 FNAB); specificity was 92.6% (463/500 FNAB); positive predictive value was 1 and negative predictive value was 0.99. All FNABs diagnosed as benign tumors or inflammatory lesions correlated with histology and/or clinical outcome. FNAB proved to be highly cost-effective, avoiding a surgical biopsy. The procedure was found to be extremely helpful when deciding on preoperative chemotherapy.
Drut
Ricardo
R
Department of Pathology, Hospital de Niños "Superiora Sor María Ludovica," La Plata, Argentina. patologi@netverk.com.ar
Drut
Rosa Mónica
RM
Pollono
Daniel
D
Tomarchio
Silvia
S
Ibáñez
Osvaldo
O
Urrutia
Azucena
A
Ripoll
María Cecilia
MC
D000008:Abdominal Neoplasms / Q000473:pathology; D000293:Adolescent; D000328:Adult; D044963:Biopsy, Fine-Needle; D002648:Child; D002675:Child, Preschool; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000145:classification / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013899:Thoracic Neoplasms / Q000473:pathology