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Paediatric Pathology Online

Diagnosis of Paediatric Tumours

 Dr Sampurna Roy MD

 

                                                                                                                      

 

About 1/650 children will develop cancer before their 15th birth day.

Approximately 2/3 are cured, so that 1/1000 young adults are long term survivors of childhood cancer.

These results are achieved in part by the cooperation of pathologists with multicentre studies and protocols.

Treatment and therefore survival depends on precise diagnosis and accurate staging.

Paediatric solid tumours often prove difficult because even the common types are rare, and because they are often undifferentiated.

Many tumours are not treated by excision in the first instance, and so the definitive diagnosis often has to be made on a small biopsy.

Special diagnostic techniques:

- Their histogenesis is more varied than cancer in adults, so that special stains, immunohistochemistry and electron microscopy are particularly helpful in demonstrating minimal evidence of differentiation (Example: Rhabdomyosarcoma, Neuroblastoma, PNET ).

- Many paediatric tumours have characteristic cytogenetic and molecular markers.

For these reasons tumour biopsies are always received fresh for :

- Touch preparations (cytology and FISH)

- Frozen tissue

- Tissue for cell culture (cytogenetics)

- Tissue for electron microscopy

- Any other special investigations

- Only then is the remaining tissue placed in fixative

For resection specimens a general rule is at least one block per centimeter diameter.

- Paediatric Renal Tumours

- Neuroblastoma

- Ewing's sarcoma/Peripheral Primitive Neuroectodermal Tumour

- Desmoplastic Small Round Cell Tumour

- Rhabdomyosarcoma

 

Further reading:

The expression of WT1 in the differentiation of rhabdomyosarcoma from other pediatric small round blue cell tumors.

Frequency of malignant solid tumors in children.

Childhood cancer

Childhood cancer incidence: geographical and temporal variations. 

The pattern of pediatric solid malignant tumors in western Kenya, east Africa, 1979-1994: an analysis based on histopathologic study.

Frequency of malignant solid tumors in children .

The expression of WT1 in the differentiation of rhabdomyosarcoma from other pediatric small round blue cell tumors.

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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