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Pulmonary Cytopathology in Neonatal and Pediatric Age Groups

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Color Atlas of Pulmonary Cytopathology

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Abstract

Cytologic evaluation of several types of specimens from the lower respiratory tract is routinely performed in adult pulmonary medicine. It is primarily used for working up patients with respiratory symptoms, especially those suspected of harboring cancer. Because of the excellent diagnostic yield and high accuracy rate, pulmonary cytopathology has become an indispensable diagnostic tool. In the pediatric population, however, the use of cytopathology is very limited. The possible reasons are:

  1. 1.

    Most pulmonary diseases in the general pediatric population are infectious. The majority are either bacterial or viral in origin, self-limiting, or transient, and are empirically treated based on clinical judgment. In more severe cases, the offending organisms are isolated, cultured, and have specific therapy instituted. Invasive diagnostic procedures (e.g., bronchoscopy or fine needle biopsy for cytopathologic study) are generally not sought. Sputum samples are difficult to obtain from children because of their inability to expectorate.

  2. 2.

    Several pulmonary diseases are diffuse and interstitial in nature, where cytopathology may not be diagnostically useful.

  3. 3.

    Solitary lung lesions (neoplasms or localized inflammatory processes), where a fine needle aspiration biopsy would be most diagnostic, are uncommon in the pediatric age group compared with adults. In the pediatric population, thoracotomy and open biopsy are still preferred to fine needle biopsies by many clinicians and surgeons.

  4. 4.

    Until recently bronchoscopy was not a popular procedure in pediatric practice because of the large size of bronchoscopes. Relative inexperience on the part of pulmonologists to perform the procedure in this age group also contributed to the underutilization of cytopathology laboratory services.

  5. 5.

    Lack of interest in the descipline of cytopathology by some pathologists to aggressively recommend and offer cytopathology services.

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Authors and Affiliations

  1. Division Head Cytopathology, Department of Pathology, Henry Ford Hospital, 48202, Detroit, Michigan, USA

    Sudha R. Kini MD

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Kini, S.R. (2002). Pulmonary Cytopathology in Neonatal and Pediatric Age Groups. In: Color Atlas of Pulmonary Cytopathology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-21641-6_14

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  • DOI: https://doi.org/10.1007/978-0-387-21641-6_14

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