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An interinstitutional review of the value of FNAB in pediatric oncology in resource‐limited countries
Author(s) -
Razack Rubina,
Michelow Pamela,
Leiman Gladwyn,
Harnekar Anwari,
Poole Janet,
Wessels Glynn,
Hesseling Peter,
Stefan Cristina,
Louw Mercia,
Schubert Pawel T.,
Clarke Herchel,
Wright Colleen A.
Publication year - 2012
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.21624
Subject(s) - medicine , rhabdomyosarcoma , biopsy , cytopathology , fine needle aspiration , population , lymphoma , malignancy , oncology , sarcoma , pathology , cytology , environmental health
Fine‐needle aspiration biopsy (FNAB) has been widely accepted as a reliable diagnostic modality in the general pediatric population, but its role in pediatric oncology still remains elusive. With new treatment protocols subscribing to preoperative chemotherapy, the need for a quick, minimally invasive, and accurate diagnostic procedure has arisen. This study assesses the feasibility of FNAB in childhood malignancies to render a specific diagnosis on which treatment can be initiated. An 11‐year retrospective study was done on FNABs in patients 19 years and under referred for clinically malignant mass lesions. Cases were confirmed with histology, immunocytochemistry, flow cytometry, or clinical follow‐up. Of the 357 patients referred for FNABs, 36 patients were lost to follow‐up and 31 FNABS were inadequate. A total of 290 cases were included in the study, of which 68 (23%) cases were benign and 222 (77%) were malignant. The most frequently occurring tumors were nephroblastoma (68), non‐Hodgkin's lymphoma (39), rhabdomyosarcoma (22), Hodgkin's lymphoma (22), and neuroblastoma (22). The sensitivity of the procedure for neoplasia was 96.6%, the specificity 97.0%, positive predictive value 99.0%, and negative predictive value 90.1%, with a diagnostic accuracy of 96.7%. The ability of FNAB to enable a specific diagnosis to be made, that is correct and accurate subtyping of the tumor on which chemotherapy or radiotherapy could be commenced was 75.7%. This study shows that FNAB can be used with confidence to confirm malignancy in children. With clinicoradiological correlation and the aid of ancillary techniques, FNAB allows a rapid and accurate preoperative diagnosis for definitive therapy commencement in most cases. Diagn. Cytopathol. 2012. © 2011 Wiley Periodicals, Inc.