Fine Needle Aspiration in the Diagnosis of Childhood Malignant Disease in Uganda

One hundred aspirations using a fine needle have been performed on 94 patients with a suspected diagnosis of malignant tumour, 31 of which were in patients with recurrent tumour. In 90 aspirates where histology was also available there was agreement between histological and cytological diagnosis in 81 (90%). This percentage was identical when only previously undiagnosed tumours were considered (60). In 4 aspirates no cells were obtained from tumours in which a diagnosis was made histologically and in 5 there was disagreement with histology, either regarding the presence of malignancy, or tumour type. The technique of fine needle aspiration is simple, rapid, safe and reliable. It is particularly valuable when emergency treatment is required, necessitating a very rapid diagnosis, or when the tumour is entirely intra-abdominal and the patient is unfit for laparotomy. Repeat aspirates may be performed to assess progress following treatment, or multiple suspected tumour sites may be aspirated to assist staging. The technique may be used to confirm the presence of relapsing tumour. Aspiration cytology may prove valuable as a further dimension in the interpretation of histological sections in a variety of childhood tumours, and in some circumstances may be sufficient in itself to establish a diagnosis.