Department of Pathology, IPGME&R, Kolkata, India.
Department of Pathology, MJN Medical College and Hospital, Coochbehar, India.
Diagn Cytopathol. 2021 Mar;49(3):404-411. doi: 10.1002/dc.24670. Epub 2020 Nov 23.
Paediatric abdominal neoplasms are fairly common. Fine needle aspiration cytology (FNAC) is used for the initial evaluation of paediatric abdominal neoplasms. However, sometimes FNA interpretation can be difficult on limited material, owing to tumour heterogeneity and overlapping features. Therefore, we attempted to obtain additional information using cell block (CB) preparation from residual aspiration material along with immunohistochemistry (IHC) to enhance the diagnostic accuracy.
To evaluate the correlation between CB preparation and FNAC in diagnosis of paediatric abdominal tumours with the help of an extended panel of IHC markers and to highlight some of the diagnostic difficulties.
A total of 113 cases of paediatric abdominal masses were studied. In addition to routine FNA smears, CBs were prepared from the residual material for IHC analysis as considered appropriate.
This study included a total of 113 children with abdominal masses. Histopathology following surgical resection was available in 53 cases. Histology was taken as gold standard to measure the diagnostic accuracy with reference to sensitivity (Sn), specificity (Sp), positive predictive value and negative predictive value. The Sn of FNA alone was 87.5% and Sp was 97.78%. The Sn and Sp increased with use of CB alone and were 100% and 97.78% respectively. The highest Sn and Sp were observed when CB was combined with IHC where both the values were 100%.
CB with IHC is a useful adjunct to the routine FNA smears that further contributes to enhance the accuracy of the cytopathological diagnosis and is useful for choosing pre-operative chemotherapeutic regimen.
儿科腹部肿瘤相当常见。细针穿刺细胞学（FNAC）用于儿科腹部肿瘤的初步评估。然而，由于肿瘤异质性和重叠特征，有时在有限的材料上进行 FNA 解释可能很困难。因此，我们试图通过从剩余抽吸材料中获得额外的信息来使用细胞块（CB）制备物并结合免疫组织化学（IHC）来提高诊断准确性。
通过扩展的 IHC 标志物面板评估 CB 制备物与 FNAC 在儿科腹部肿瘤诊断中的相关性，并突出一些诊断困难。
对 113 例儿科腹部肿块进行了研究。除了常规的 FNA 涂片外，还从剩余材料中制备 CB 用于适当的 IHC 分析。
本研究共纳入 113 例腹部肿块儿童。53 例有手术切除后的组织病理学。以组织学作为金标准，参考灵敏度（Sn）、特异性（Sp）、阳性预测值和阴性预测值来衡量诊断准确性。单独进行 FNA 的 Sn 为 87.5%，Sp 为 97.78%。单独使用 CB 时 Sn 和 Sp 增加，分别为 100%和 97.78%。当 CB 与 IHC 结合使用时，观察到最高的 Sn 和 Sp，两者均为 100%。
IHC 联合 CB 是常规 FNA 涂片的有用辅助手段，进一步有助于提高细胞病理学诊断的准确性，并有助于选择术前化疗方案。
