Gurley A M, Silverman J F, Lassaletta M M, Wiley J E, Holbrook C T, Joshi V V
Department of Pathology, East Carolina University School of Medicine, Greenville, NC 27858-4354.
Diagn Cytopathol. 1992;8(2):137-46. doi: 10.1002/dc.2840080210.
We evaluated the diagnostic contribution of adjunct studies performed on aspirated material in the work-up of pediatric fine-needle aspiration (FNA) biopsies. Ancillary studies were performed on 54 of 136 (39.7%) pediatric FNA biopsies during a 5-year period. In 23 (16.9%) cases, immunocytochemical (ICC) studies, consisting of immunoperoxidase staining of direct smears and/or cell blocks or flow cytometric immunophenotyping, were performed. The studies were adequate in 14 cases (60.9%), suboptimal in five cases (21.7%), and inadequate in four cases (17.4%). Of the adequate and suboptimal cases, the ICC data helped to narrow the differential diagnosis or classify the disease process in eight cases (42.1%), confirmed cytologic impression in nine cases (47.4%), and gave contradictory results in two cases (10.5%). Adequate material for electron microscopy (EM) was obtained in 14/19 cases (73.7%). Ultrastructural studies were diagnostic, or helped classify the disease process in five cases (35.7%), confirmed the cytologic impression in four cases (28.6%), helped exclude diagnostic considerations in three cases (21.4%), and were judged to be non-contributory in two cases (14.3%). Cytogenetic studies revealed six of seven cases (all neoplasms) to have abnormal karyotypes. Special stains for organisms performed on smears from 25 cases including Ziehl-Neelsen, Gomori methenamine silver (GMS), Gram, and Warthin-Starry (WS) were negative except for 1/16 GMS and 4/9 Gram stains. In summary, we found that with appropriate case selection, ancillary studies performed on aspirated material can provide useful information in pediatric FNA cytology.
我们评估了在儿科细针穿刺（FNA）活检检查过程中，对穿刺获取的材料进行辅助检查的诊断价值。在5年期间，对136例儿科FNA活检中的54例（39.7%）进行了辅助检查。其中23例（16.9%）进行了免疫细胞化学（ICC）检查，包括对直接涂片和/或细胞块进行免疫过氧化物酶染色，或流式细胞术免疫表型分析。检查结果充分的有14例（60.9%），次优的有5例（21.7%），不充分的有4例（17.4%）。在结果充分和次优的病例中，ICC数据有助于缩小鉴别诊断范围或对疾病进程进行分类的有8例（42.1%），证实细胞学诊断印象的有9例（47.4%），结果矛盾的有2例（10.5%）。19例中有14例（73.7%）获得了适合电子显微镜（EM）检查的材料。超微结构研究具有诊断价值或有助于对疾病进程进行分类的有5例（35.7%），证实细胞学诊断印象的有4例（28.6%），有助于排除诊断考虑因素的有3例（21.4%），被判定无贡献的有2例（14.3%）。细胞遗传学研究显示，7例中的6例（均为肿瘤）核型异常。对25例涂片进行的包括萋-尼氏染色、高碘酸-美蓝银染色（GMS）、革兰氏染色和沃-星氏染色（WS）在内的病原体特殊染色，除1/16的GMS染色和4/9的革兰氏染色外均为阴性。总之，我们发现通过适当的病例选择，对穿刺获取的材料进行辅助检查可为儿科FNA细胞学提供有用信息。
