Utility of Fine-Needle Aspiration Biopsy in the Evaluation of Pediatric Head and Neck Masses

被引:14
作者
Huyett, Phillip [1 ]
Monaco, Sara E. [2 ]
Choi, Sukgi S. [3 ]
Simons, Jeffrey P. [3 ]
机构
[1] Univ Pittsburgh, Dept Otolaryngol Head & Neck Surg, Med Ctr, 203 Lothrop St,Suite 500, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Dept Pathol, Med Ctr, Pittsburgh, PA USA
[3] Univ Pittsburgh, Dept Otolaryngol, Childrens Hosp Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA
基金
美国国家卫生研究院;
关键词
fine-needle aspiration biopsy; head and neck mass; thyroid nodule; pediatrics; sensitivity and specificity; THYROID-NODULES; MANAGEMENT; CYTOLOGY; CHILDREN; POPULATION; GUIDELINES; DIAGNOSIS; CANCER;
D O I
10.1177/0194599816631728
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objectives Fine-needle aspiration biopsy (FNAB) has a well-established role in the evaluation of an adult head and neck mass (HNM) but remains underused in children. The objectives of this study were to assess the diagnostic accuracy, safety profile, use of anesthesia, and influence on surgical decision making of FNAB of HNM in the pediatric population. Study Design Case series with chart review. Setting Tertiary care children's hospital. Subjects and Methods In total, 257 consecutive patients with HNM who underwent 338 FNABs from July 2007 to July 2014 were reviewed. Patients ranged in age from 0 to 21 years (mean, 9.3 years); lesions ranged in size from 0.3 to 12.5 cm (mean, 2.4cm). Fine-needle aspiration biopsies were performed in the interventional radiology suite, operating room, clinic, or ward. Results The most common patient final diagnoses included reactive lymphadenopathy (n = 99, 38.5%), benign thyroid colloid nodule (n = 31, 12.1%), malignancies (n = 21, 8.2%), and atypical mycobacterial infection (n = 15, 5.8%). On surgical histopathologic and clinical follow-up, overall sensitivity of FNAB was 94.6% and specificity was 97.7%. The complication rate was 2.1%, and general anesthesia or sedation was used for 73% of FNAB. Surgery occurred only 9 times following the 191 patients with negative FNAB results, indicating that 95.3% of unnecessary surgeries were avoided with the assistance of the FNAB result. Conclusions Fine-needle aspiration biopsy is an accurate and safe diagnostic tool for guiding management of persistent lymphadenopathy, thyroid nodules, and other HNM in pediatric patients. Negative FNABs can often obviate the need for surgical intervention.
引用
收藏
页码:928 / 935
页数:8
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