Fine Needle Aspiration Cytology for Neck Masses in Childhood. An Illustrative Approach

Abstract

The primary indication of fine-needle aspiration cytology of the head and neck region is a thyroid nodule or a mass located in the cervical area or the head. Although a thyroid nodule may raise the suspicion of malignancy, less than one in 20 cases results in a carcinoma. In addition, the list of differential diagnoses is quite different according to the age of the patient. A number of benign lesions, such as branchial cysts, sialadenosis, and sialoadenitis are often seen in childhood and youth. The malignant lesions that are on the top of the list of a pediatric mass of the head and neck (H&N) region include rhabdomyosarcoma, neuroblastoma, and papillary carcinoma of the thyroid gland. This critical review of the diagnostic features of a pediatric mass of the H&N region is accompanied by panels of several cytology features that may be of help to the cytopathologist and clinician.

Diagnosis of solid tumors in infants by fine‐needle aspiration cytology: 5 years retrospective study from a tertiary care oncology center in South India

“…The practice guidelines in RRS dictate that US guided FNA of a deep lesion in an infant should be performed with either general anesthesia or IV sedation with monitoring by an anesthetist; but the feasibility of the same is questionable in RLS where anesthetist doctors, ICU beds and other resources are restricted and not readily available for diagnostic workup, especially when minimal invasive procedure like FNA is to be performed 10 . Few studies suggest that pediatric FNA does not usually need heavy sedation or general anesthesia; however, it should be institutional protocol rather than a rule for optimal patient care 5,14,15 . In the present study, mild oral sedation was given to selected infants at the request of parents of infants after discretion with the pediatrician; however, anesthesia was not used for the FNA procedure.…”

“…10 Few studies suggest that pediatric FNA does not usually need heavy sedation or general anesthesia; however, it should be institutional protocol rather than a rule for optimal patient care. 5,14,15 In the present study, mild oral sedation was given to selected infants at the request of parents of infants after discretion with the pediatrician; however, anesthesia was not used for the FNA procedure. In the present study, FNAC of infant solid tumors encompassed a wide range of diagnoses commonly encountered in clinical practice.…”

Pediatric Sarcoidosis: A Review with Emphasis on Early Onset and High-Risk Sarcoidosis and Diagnostic Challenges

“…The diagnostic approach to pulmonary sarcoidosis has been revolutionized in the past decade by the use of endobronchial ultrasound (EBUS) real-time guided transbronchial sampling of intrathoracic lymph nodes and lung biopsies [6]. Cytopathological assessments by fine needle aspiration provide fair diagnostic yield and excellent patient safety profile in children [37,38]. Combining EBUS and transbronchial needle aspiration (TBNA) lung biopsy and cytopathologic study may increase the diagnostic sensitivity to close to 100% [39,40].…”

Pattern of pediatric fine needle aspiration cytology and its utility in management of head and neck swellings in a tertiary hospital in northwestern Nigeria

“…22 In the management of pediatric head and neck Swellings, several studies that compared FNAC preliminary diagnosis with the final definitive histological diagnoses have shown the usefulness of FNAC in terms of its high sensitivity and specificity and in avoidance of unnecessary surgical biopsies for benign lesions. 16,17,[22][23][24] This study aims to review the pattern of all pediatric FNAC cases in our hospital over a 10-year period (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) and to assess the utility of FNAC in terms of its accuracy in the management of head and neck swellings in our setting.…”