Assessment of percutaneous fine needle aspiration cytology as a technique to provide diagnostic and prognostic information in neuroblastoma

The International Neuroblastoma Staging System (INSS) criteria for diagnosi s requires an unequivocal pathological diagnosis and favours the identifica tion of prognostic markers in the samples. Surgical biopsies of the primary tumour and bone marrow (BM) sampling in metastatic disease constitute the major sources of tumour material for the laboratory. We analysed the possib ility of percutaneous fine needle aspiration cytology (FNAC) constituting a n alternative procedure to the conventional technique of sampling of the pr imary tumour in children with advanced neuroblastoma. From July 1987 throug h July 1998, 64 consecutive children suspected of having advanced neuroblas toma and referred to our institution underwent percutaneous FNAC of deeply located tumours. FNAC was performed using 22-gauge needles under ultrasound guidance, before any chemotherapy and within the first days following admi ssion. No complication occurred after FNAC. The median number of the extrac ted tumour cells was 2.3x10(6) (range: 0-40.6x10(6)). Cytology analysis was possible in 59/64 cases (92%) and immunocytochemistry in 56/64 (88%) allow ing confirmation of the diagnosis. N-Myc analysis was available in 46/64 (7 2%). In addition, the presence of a partial deletion of chromosome Ip (del Ip) was assessed, since 1992, in 24/47 cases (51%), where enough cells were available. FNAC of deeply located advanced neuroblastoma is safe and infor mation is available in a few hours after admission. The provided material i s reliable for confirmation of diagnosis and analysis of biological prognos tic markers in the majority of cases. More invasive tumour sampling procedu res are required only in selected cases. (C) 2000 Elsevier Science Ltd. All rights reserved.