Changing role of fine-needle aspiration in the evaluation of pediatric masses

This study examines changes in the use of fine-needle aspiration (FNA) in the pediatric population in the past 14 yr at the University of California, Davis Medical Center. Pediatric FNAs from two 7-yr periods were compared regarding percentage of satisfactory cases and cases with a previous history of cancer, sensitivity, specificity, type of general diagnostic category, ratio of benign to malignant diagnoses, and sources of diagnostic error. Changes in the later 7-yr period included decrease in the percentage of round cell lesions with an increase in spindle cell and epithelial/epithelioid lesions, fewer patients with a prior history of cancer, and a marked increase in benign to malignant ratio. These changes illustrate that FNA is being used more commonly in the general pediatric population, and that the types of lesions seen in this population are not very dissimilar to those seen in adults.