THE CLINICAL USE OF FINE-NEEDLE ASPIRATION CYTOLOGY FOR DIAGNOSIS ANDMANAGEMENT OF CHILDREN WITH NEUROBLASTIC TUMORS

This study presents the results of fine needle aspiration cytology in a series of 26 consecutive children with neuroblastic tumours. The cyt ological spectrum varied from undifferentiated small tumour cells to m ature ganglion cells in a fibrillar background. In 24 children with ne uroblastic tumours at onset the cytological diagnosis was correct in 2 1 cases, whereas two aspirates yielded nondiagnostic necrotic material and a fibrillar material without tumour cells, respectively. One necr otic lymph node aspirate was initially incorrectly diagnosed as lympho ma, but the diagnosis was later revised to neuroblastoma. Suspected si gns of disease progression or relapses were confirmed (n = 9) or ruled out (n = 1) using aspiration cytolology. The diagnostic accuracy in t he complete series was 97% (31/32) in cases with adequate smears. Immu nocytochemistry confirmed the cytological diagnosis in 14 of 15 cases and was decisive in one. Elevated catecholamine metabolites in urine w as detected in all children with a cytological diagnosis of neuroblast oma. General anaesthesia was only performed when coincidental invasive investigations (n = 13) were to be carried out or if the aspiration w as intrathoracic (n = 6). It is concluded that aspiration cytology in conjunction with immunocytochemistry offers a safe, rapid and accurate diagnostic method which may be useful, together with analyses of cate cholamine metabolites in urine, in the clinical management of children with neuroblastic tumours. (C) 1998 Elsevier Science Ltd. All rights reserved.