Paediatric Pathology Online
Diagnosis of Paediatric Tumours
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.
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