Evaluation of Role of FNAC in Pediatric Kidney Tumors in a Tertiary Care Hospital
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Abstract
Background: Fine Needle Aspiration Cytology (FNAC) is a very useful technique for morphological diagnosis of any tumors. It is useful in children as the chance of complication is very rare. Moreover, it is rapid, cost effective, and outpatient procedure. No anesthesia is required for this. Diagnosis can be available readily and suitable for giving preoperative chemotherapy. So FNAC plays important role in pediatric kidney tumor where neo adjuvant chemotherapy given before surgery. Guided FNAC is more reliable method than unguided FNAC. Core Needle Biopsy (CNB) is another investigation for preoperative diagnosis. Compared to core needle biopsy, FNAC is more easy to perform and it can be repeated in the same sitting, if necessary. Immunocytochemistry (ICC) can be done on Fine needle aspiration smear or Immunohistochemistry (IHC) can be carried out from the cell block.
Aims and Objectives: To find out the profile of kidney tumor, to help the clinicians to give neoadjuvant chemotherapy to the patients, and to evaluate the role of FNAC in pediatric kidney tumors.
Materials and Methods: The pediatric patients with clinical and radiological diagnosis of kidney tumors were advised for guided FNAC. After examining the patients CT/ USG guided FNAC was performed and Immunostains were applied on the smears and on cell block.
Result: FNAC was done in 96 cases of kidney tumors below 18 year of age over a period of 10 years. The commonest tumor was WILMS’ tumor (86%) with male predominance . Majority patients were below 7 year of age. Mesoblastic Nephroma (5% ), Clear Cell Sarcoma (2% ), Rhabdoid tumor (1% ), Ewing tumor (1%) and one case of Metanephric adenoma were identified. We had 91% accuracy rate. If we use Immunostain the accuracy becomes 96.9%.
Conclusion - Fine needle aspiration cytology is a safe and useful, rapid diagnostic tool in case of Pediatric Renal tumors.
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