Syed Furqan Hasan, Rubab Naqvi, Rehana Akhter, Shazia Bhutto.
Fine needle aspiration cytology: a useful diagnostic tool in childhood tumors.
J Surg Pak Jan ;18(1):24-7.

Objective: To find out the diagnostic role and utility of fine needle aspiration cytology (FNAC) in pediatric tumors /swellings. Study design: Descriptive case series. Place & Duration of study: Department of Pathology National Institute of Child Health Karachi, from January 2005 to December 2011. Methodology: Children up to 13 year of age were included in this study. The procedure was explained and consent taken. Material from the tumor / swelling was aspirated with a 10ml syringe having 20G needle for superficial tumors while 22G needle with trocar was used for deeper tumors. Slides were made, air dried, fixed and stained with Leishman and Papanicolaou stains. Clot taken was preserved in 10% formaline and processed for histology. Results: A total of 1337 FNAC procedures were performed. There were 1067 (79.8%) benign and 270 (20.2%) malignant cases. Further breakup of benign cases revealed tuberculosis in 279 (26.1%), chronic inflammation / cold abscess in 421(39.5%), post BCG lymphadenitis in 52 (4.9%), reactive lymphadenitis in 130 (12.2%), acute inflammation in 44 (4.1%), lipoma in 30 (2.8%), hematoma in 34 (3.2%), lymphangioma in 31 (2.9%), thyroid cyst in 08 (0.75%), gynecomastia in 03 (0.28%) and benign inconclusive tumors in 35 (3.3%) cases. The malignant cases diagnosed by FNAC were Hodgkins disease (n=64 - 23.7%), NonHodgkins Non-Burkitts lymphoma (NHNBL) (n=60 - 22.2%), Burkitts lymphoma (n=09 - 3.3%), malignant histiocytosis 41 (15.2%), round blue cell tumour of childhood 13 (4.8%), neuroblastoma (n=17 - 6.3%), rhabdomyosarcoma 12 (4.4%), nephroblastoma 10 (3.7%), retinoblastoma (n=9 - 3.3%), metastatic nasopharyngeal carcinoma (n=3 -1.1%), and malignant teratoma (n=2 - 0.7%). Thirty (11.1%) malignant lesions remained inconclusive as to exact pathology. Conclusions: FNAC is an important diagnostic tool with high yield. It can be used with confidence in making diagnosis specially differentiating benign from malignant conditions.

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