Multidisciplinary and multimodal diagnostic approach in paediatric tumours combining fine needle aspiration, core needle biopsy and ancillary techniques

Fassina, Ambrogio; Klijanienko, Jerzy

doi:10.1111/cyt.12130

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…FNA, which is less invasive than CNB, is a well‐established cytological procedure 7,8 . Researchers have shown that with the correct training, FNA may be used to achieve a final diagnosis 9 . Indeed, FNA is widely used as a primary tool for tissue diagnosis in a variety of tumors (eg, thyroid, breast, lung, pancreas), and on‐site cytological evaluation offers an improved diagnostic rate 7,8 .…”

Section: Discussionmentioning

confidence: 99%

Ultrasound‐guided core biopsy with on‐site cytology‐immediate diagnosis in pediatric oncology

Sokolovski

Scolnik

Malkin

et al. 2021

Diagnostic Cytopathology

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Background Accurate and swift tissue diagnosis is extremely important for the timely initiation of treatment in pediatric oncology. In our department, ultrasound‐guided core needle biopsy (US‐guided CNB) is used for tissue diagnosis. In 2016, we added on‐site cytology, allowing for an immediate primary diagnosis. We retrospectively reviewed our performance in terms of safety and accuracy for CNBs and on‐site cytology. Methods All pediatric biopsies performed in our hospital between February 2016 and December 2020, were included. Patient clinical, procedural and follow‐up data were collected. CNB pathology and cytology results were compared to the final pathologic diagnosis. Results We included 71 patients for which 72 biopsies with on‐site touch imprint (TI) cytology were performed; the average latency time to biopsy was 1 day. Altogether, we had 61 tumors, (58 malignant, 3 benign) and 11 other lesions. On‐site cytology diagnosed 58 malignant tumors, 3 benign tumors and 11 non‐tumor tissues. The cytologist correctly differentiated tumor from inflammation in all cases, and diagnosed the precise tumor type in 57 cases, with an accuracy of 94% for final diagnosis. We had no complications related to the procedure or sedation. Conclusion US‐guided CNB with on‐site TI cytology for suspected malignancy in the pediatric population is highly available, safe, and accurate, with real‐time diagnosis in most cases. This accelerated diagnostic route has a huge impact on patient care.

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Section: Discussionmentioning

confidence: 99%

Ultrasound‐guided core biopsy with on‐site cytology‐immediate diagnosis in pediatric oncology

Sokolovski

Scolnik

Malkin

et al. 2021

Diagnostic Cytopathology

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“…In contrast to core needle and excision biopsy specimens, there has been a tendency to utilise direct FNAB smears and cell blocks less frequently for these ancillary techniques, leading to a lower percentage (reported as 25% to 47%) of tumours being precisely subtyped 1–4,6 . It is reported that FNAB cytopathology provides an optimal, safe and a relatively more representative sample, given the possibility of multiple passes, in contrast to a core needle biopsy (CNB) 11 . Another challenge in the primary diagnosis of soft tissue tumours by FNAB is the relatively small number of these often complex tumours that present to cytopathologists, especially at peripheral laboratories, leading to limited experience for cytopathologists and a significant number of diagnostic errors 12 …”

Section: Pattern Immunohistochemistry Molecular/genetic Testmentioning

confidence: 99%

“…[1][2][3][4]6 It is reported that FNAB cytopathology provides an optimal, safe and a relatively more representative sample, given the possibility of multiple passes, in contrast to a core needle biopsy (CNB). 11 Another challenge in the primary diagnosis of soft tissue tumours by FNAB is the relatively small number of these often complex tumours that present to cytopathologists, especially at peripheral laboratories, leading to limited experience for cytopathologists and a significant number of diagnostic errors. 12 While in histopathology, soft tissue tumours are classified based on lineage, in FNAB cytopathology they are initially classified based on their cytomorphological patterns, which include round cell, predominant spindle cell, adipocytic, epithelioid, pleomorphic and myxoid.…”

mentioning

confidence: 99%

Pitfalls in soft tissue cytopathology

Rekhi,

Qian,

Domanski

et al. 2023

Cytopathology

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Fine needle aspiration biopsy (FNAB) is a diagnostic modality for the evaluation of suspicious soft tissue masses. Despite its reasonable sensitivity, specificity and positive predictive value in differentiating benign from malignant neoplasms, the exact subtyping of the primary soft tissue tumours can be challenging. Certain tumours constitute “pitfalls” and add to the diagnostic challenge. This review provides a detailed account of the diagnostic challenges in soft tissue cytopathology, including pitfalls and, more importantly, the ways to overcome these challenges by integrating clinical details, key cytomorphological features and judicious application of ancillary techniques.

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