Spectrum of pediatric tumors diagnosed by fine-needle aspiration cytology

Abstract

Pediatric tumors differ markedly from adult tumors in their nature, distribution, and prognosis. In this 10-year retrospective study, we present our experience with fine-needle aspiration (FNA) in pediatric patients 18 years of age and younger and correlate relationship between gender with organ, diagnosis, malignancy, and age. In our study, FNA material of pediatric tumors or masses with 18 years aged and younger were analyzed retrospectively.All FNAs in pediatric patients during this time period were identified and analyzed for age, gender, cytologic diagnosis, and site of aspiration. A total 1000 FNAs were performed from January 2007 to October 2015 in 499 children. Regardless the gender, the most frequently aspirated organ was lymph node, comprising 129 of the 499 cases followed by thyroid (112), neck cyst (79), and parotid (35) cases. The majority of the cases were diagnosed as benign lesions (436 of 499 cases). Other 63 cases comprising 40 female and 23 male cases had malignant lesions. There was significant age difference between people with or without malignancy. In malignant cases, there was a significant difference between the age on males and females. In regard to gender and diagnosis, cytologic diagnosis was stratified into 9 broad diagnostic categories: lymphadenitis, benign and malignant thyroid, cyst contents, benign breast, benign and malignant salivary, and negative for malignancy.In conclusion, our study supports the use of FNA cytology (FNAC) in lesions of various anatomic sites in the children less than 18 years old. As a simple, minimally invasive, and rapid procedure, cytopathologists can reliably utilize FNAC in children. The mean age of children receiving a malignant diagnosis was significantly higher than that of benign lesions. The mean age of malignancy in boys is significantly lower than that of girls with malignancy.

To evaluate efficacy of FNAC in diagnosis of cystic lesions in paediatric age group patients- A retrospective study in a tertiary care teaching hospital

“…There was a female predominance with 60.95% of patients as females the male: female ratio being 0.64:1. This was in accordance with other studies where there was female preponderance (53.7%), and in contrast to some studies with male predominance (males 60.46%) [19,20].…”

Ultrasonography and the American Thyroid Association Ultrasound-Based Risk Stratification Tool: Utility in Pediatric and Adolescent Thyroid Nodules

“…Specific US variables and clinical factors significantly associated with malignant cytology included presence of a TSH > 1.4 mIU/L, hypoechogenicity, microcalcifications, and lymphadenopathy. While the diagnostic accuracy of the McGill Criteria is excellent, a significant limitation is that the score requires an FNA, which independently predicts thyroid cancer in children [32-34]. …”

Pediatric fine-needle aspiration cytology: An audit of 266 cases of pediatric tumors with cytologic-histologic correlation

“…[ 2 - 4 ] There have been only occasional studies including both benign and malignant lesions in pediatric FNAC. [ 5 , 6 , 8 ] However, the literature on studies encompassing the gamut of pediatric tumors in various sites, including non-palpable lesions in deep anatomical locations is scarce. [ 5 , 8 ] The present study, conducted at a cancer research institute and a pediatric tertiary care hospital, included both superficial/ easily accessible lumps as well as intra-abdominal or mediastinal lesions for evaluation of the diagnostic utility and test characteristics of FNAC in pediatric tumors.…”

“…[ 2 - 4 ] Only occasional studies on pediatric FNAC have included both benign and malignant lesions encompassing various body sites. [ 5 , 6 ] The reported sensitivity and specificity of FNAC in diagnosis of pediatric lesions has varied depending on the body site included in the study. [ 4 , 7 ]…”