Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Division of Hematology/Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Acta Cytol. 2022;66(3):179-186. doi: 10.1159/000522208. Epub 2022 Feb 28.
Fine-needle aspiration (FNA) biopsy is the standard diagnostic tool recommended by consensus management guidelines for preoperative evaluation of salivary gland tumors in adults. However, its utility in the pediatric population remains debated due to a paucity of data and inherited challenges of pediatric management (patient cooperation, the need for sedation, and procedural complications).
Consecutive series of 92 FNA biopsies of pediatric salivary gland lesions with available procedural data were included for retrospective analysis. Patient demographics, procedural characteristics, and complications were assessed.
Sixty-three patients (68%) tolerated FNA without sedation. Sedation need was significantly associated with younger age, concurrent non-FNA procedure requiring sedation, ultrasound guidance, interventional radiologist as the proceduralist, and radiology suite as the facility setting. The sedation rates for children, and early, middle, and late adolescents were 69%, 32%, 12%, and 10%, respectively, with an optimal cutoff point of ≤12 years for age derived from receiver operating characteristic curve analysis. No significant procedural complications were observed. Sedation did not provide significantly better diagnostic yield.
FNA biopsy of salivary gland tumors is safe, well tolerated by the pediatric population, and can be effectively performed in an outpatient setting without sedation in most cases. FNA biopsy is a useful tool in the preoperative management of pediatric patients with salivary gland tumors.
细针抽吸活检（FNA）是成人唾液腺肿瘤术前评估的共识管理指南推荐的标准诊断工具。然而，由于数据匮乏和儿科管理的固有挑战（患者配合、镇静需求和程序并发症），其在儿科人群中的应用仍存在争议。
对 92 例具有可获得程序数据的儿科唾液腺病变的连续 FNA 活检进行回顾性分析。评估患者的人口统计学特征、程序特征和并发症。
63 例（68%）患者无需镇静即可耐受 FNA。需要镇静与年龄较小、同期需要镇静的非 FNA 程序、超声引导、介入放射医师作为操作医师以及放射科套房作为设施设置显著相关。儿童、早期青少年、中期青少年和晚期青少年的镇静率分别为 69%、32%、12%和 10%，来自受试者工作特征曲线分析的最佳年龄截断点为≤12 岁。未观察到明显的程序并发症。镇静并未显著提高诊断率。
FNA 活检对唾液腺肿瘤是安全的，大多数情况下儿科人群可耐受，且无需镇静即可在门诊环境中有效进行。FNA 活检是儿科唾液腺肿瘤患者术前管理的有用工具。
