Cytopathology is the study of cells, obtained by aspiration of a fluid collection or by fine needle aspiration (FNA) biopsy. Although this field is well established in the evaluation of many adult lesions, the use in the pediatric population has been less common, particularly in North America.
The Pediatric Pathology Division of UT Southwestern Medical Center (UTSW) and Children's Health have been forerunners in establishing a pediatric cytopathology service that is one of the few in the nation that provides a fine needle aspiration biopsy service performed by pediatric pathologists. This allows for patient care to be consolidated in the pediatric hospital setting while also having cases reviewed by specialists who are sensitive to the range of benign and malignant lesions seen in the pediatric population.
Mass lesions in the pediatric population show a different spectrum of diagnoses than those seen in adults, which also vary by the age of the child. The most common FNA specimens seen by the pediatric cytopathology service are thyroid nodules, where papillary thyroid carcinoma is more commonly seen than in adults. Also commonly seen are primitive “small round blue cell” lesions such as leukemia/lymphoma, neuroblastoma, Ewing sarcoma, and Wilms tumor. The pediatric cytopathology service frequently coordinates with Interventional Radiology to evaluate these lesions in a minimally invasive fashion.