Lymph node fine needle aspiration cytology (FNAC) in paediatric patients: Why not? Diagnostic accuracy of FNAC in a series of heterogeneous paediatric lymphadenopathies

Pathol Res Pract. 2021 Jan:217:153294. doi: 10.1016/j.prp.2020.153294. Epub 2020 Nov 22.

Abstract

Fine needle aspiration cytology (FNAC) can be a precious tool for the evaluation of lymphadenopathies in children and adolescents. The purpose of this study was to analyse the diagnostic accuracy of FNAC in a paediatric lymph node series. We report a series of 76 patients, aged up to 19 years, who underwent lymph node FNAC. In our series, 57 cases were diagnosed as non-neoplastic, including benign reactive hyperplasia and other inflammatory lesions, 18 cases were diagnosed as malignant and 1 case was diagnosed as suspicious for lymphoproliferative process, not otherwise specified. Sensitivity, specificity, positive predictive value and negative predictive value were 93 %, 100 %, 100 % and 98 %, respectively. Diagnostic accuracy resulted 98.6 %. FNAC is an accurate, minimally invasive method with minimal complications that allows evaluation of paediatric lymphadenopathies and a correct triage of reactive/inflammatory and neoplastic lymphadenopathies. The application of rapid on-site evaluation, the realization of a cell block and the application of ancillary diagnostic tests, including at least immunocytochemistry and flow cytometry, allows to achieve an excellent diagnostic performance.

Keywords: Fine needle aspiration cytology; Hodgkin lymphoma; Lymph node; Non-hodgkin lymphoma; Paediatric patients.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Age Factors
  • Biopsy, Fine-Needle
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Italy
  • Lymph Nodes / pathology*
  • Lymphadenopathy / pathology*
  • Male
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Young Adult