Department of Radiology, Pediatric Radiology Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Department of Pathology, Rambam Health Care Campus, Haifa, Israel.
Diagn Cytopathol. 2021 Jul;49(7):817-821. doi: 10.1002/dc.24746. Epub 2021 Apr 3.
Accurate and swift tissue diagnosis is extremely important for the timely initiation of treatment in pediatric oncology. In our department, ultrasound-guided core needle biopsy (US-guided CNB) is used for tissue diagnosis. In 2016, we added on-site cytology, allowing for an immediate primary diagnosis. We retrospectively reviewed our performance in terms of safety and accuracy for CNBs and on-site cytology.
All pediatric biopsies performed in our hospital between February 2016 and December 2020, were included. Patient clinical, procedural and follow-up data were collected. CNB pathology and cytology results were compared to the final pathologic diagnosis.
We included 71 patients for which 72 biopsies with on-site touch imprint (TI) cytology were performed; the average latency time to biopsy was 1 day. Altogether, we had 61 tumors, (58 malignant, 3 benign) and 11 other lesions. On-site cytology diagnosed 58 malignant tumors, 3 benign tumors and 11 non-tumor tissues. The cytologist correctly differentiated tumor from inflammation in all cases, and diagnosed the precise tumor type in 57 cases, with an accuracy of 94% for final diagnosis. We had no complications related to the procedure or sedation.
US-guided CNB with on-site TI cytology for suspected malignancy in the pediatric population is highly available, safe, and accurate, with real-time diagnosis in most cases. This accelerated diagnostic route has a huge impact on patient care.
准确、快速的组织诊断对于及时启动儿科肿瘤的治疗至关重要。在我们科室，采用超声引导下的核心针活检（US-guided CNB）进行组织诊断。2016 年，我们增加了现场细胞学检查，以便能够立即进行初步诊断。我们回顾性地评估了我们在 CNB 和现场细胞学检查方面的安全性和准确性。
纳入 2016 年 2 月至 2020 年 12 月期间在我院进行的所有儿科活检。收集患者的临床、程序和随访数据。将 CNB 病理学和细胞学结果与最终病理诊断进行比较。
我们纳入了 71 名患者，对其中 72 例进行了现场触诊印片（TI）细胞学检查的活检；活检的平均潜伏期为 1 天。总共，我们有 61 个肿瘤（58 个恶性，3 个良性）和 11 个其他病变。现场细胞学检查诊断出 58 个恶性肿瘤、3 个良性肿瘤和 11 个非肿瘤组织。细胞学专家在所有病例中正确地区分了肿瘤和炎症，并在 57 例中准确诊断了确切的肿瘤类型，最终诊断的准确率为 94%。我们没有与该程序或镇静相关的并发症。
对于儿科人群中疑似恶性肿瘤的超声引导下 CNB 联合现场 TI 细胞学检查具有高度的可行性、安全性和准确性，大多数情况下可实时诊断。这种加速诊断途径对患者的护理有重大影响。
