Wadone Megha M, Masgal Meenakshi M, Anita A M, Rajesh P S
Department of Pathology, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India.
J Cytol. 2023 Apr-Jun;40(2):75-80. doi: 10.4103/joc.joc_93_22. Epub 2023 May 22.
Fine Needle Aspiration Cytology (FNAC) is a well-established early diagnostic technique for evaluating mass lesions in adult patients. Now, FNAC in children is gaining acceptance and is used as a first-line investigation in diagnosis of pediatric lesions.
To analyze the cytomorphologic spectrum of head and neck lesions in pediatric age group with histopathological correlation wherever possible and to study the utility of FNAC in pediatric head and neck lesions.
A prospective study was carried out on all FNACs of head and neck lesions in pediatric age group (0-18 years), detected clinically or under radiological guidance for a period of 3 years from August 2018 to July 2021.
The study included 238 cases. Most of the cases were seen in the age group of 13-18 years and with male to female ratio of 1.35:1. Most common site of FNAC was lymph nodes (70.2%) and the commonest lesion encountered was reactive lymphadenitis (50.8%). Second most common site was thyroid (15.9%). Soft tissue/bone, salivary gland, miscellaneous/skin lesions were also encountered. Among the 43 neoplastic lesions, benign (31 cases) were more common than the malignant (12 cases). The malignant cases included non-Hodgkins lymphoma, Hodgkins lymphoma, metastasis to lymph node, low-grade sarcoma, papillary thyroid carcinoma, and Langerhans cell histiocytosis of bone. Histopathological correlation was done in 32 cases (13.4%). Statistical analysis showed a sensitivity of 85.29% and specificity of 97.74%. Overall diagnostic accuracy was 96.3%.
This study highlighted various cytomorphological patterns in head and neck lesions with high diagnostic accuracy in children. FNAC helps in proper planning of treatment modalities in head and neck masses in pediatric age group.
细针穿刺抽吸细胞学检查（FNAC）是一种成熟的早期诊断技术，用于评估成年患者的肿块病变。如今，FNAC在儿童中越来越被认可，并被用作儿科病变诊断的一线检查方法。
分析儿童年龄组头颈部病变的细胞形态学谱，并尽可能与组织病理学进行相关性分析，同时研究FNAC在儿科头颈部病变中的应用价值。
对2018年8月至2021年7月期间临床发现或在放射学引导下检测到的儿科年龄组（0 - 18岁）头颈部病变的所有FNAC进行了一项前瞻性研究。
该研究包括238例病例。大多数病例见于13 - 18岁年龄组，男女比例为1.35:1。FNAC最常见的部位是淋巴结（70.2%），最常见的病变是反应性淋巴结炎（50.8%）。第二常见的部位是甲状腺（15.9%）。还遇到了软组织/骨、唾液腺、其他/皮肤病变。在43例肿瘤性病变中，良性病变（31例）比恶性病变（12例）更常见。恶性病例包括非霍奇金淋巴瘤、霍奇金淋巴瘤、淋巴结转移、低级别肉瘤、乳头状甲状腺癌和骨朗格汉斯细胞组织细胞增多症。32例（13.4%）进行了组织病理学相关性分析。统计分析显示敏感性为85.29%，特异性为97.74%。总体诊断准确率为96.3%。
本研究突出了儿童头颈部病变的各种细胞形态学模式，诊断准确性高。FNAC有助于为儿科年龄组头颈部肿块的治疗方式进行合理规划。
