穿刺活检在儿童及青少年颌面部肿瘤中的诊断价值

目的:探讨穿刺活检诊断儿童及青少年颌面部肿瘤的准确性和安全性。方法:收集2017年1月—2018年7月上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科门诊收治的18岁以下颌面部肿瘤病例共10例,其中男6例,女4例,平均年龄12岁（8~18岁）,所有患者均采用穿刺活检进行诊断。粗针穿刺：使用16G穿刺针取3~5条组织;细针穿刺：用10 mL针筒吸取细胞。对比穿刺病理及术后病理诊断,并记录穿刺后并发症情况。结果:粗针穿刺共4例,3例接受手术治疗。1例穿刺病理为纤维母细胞/肌纤维细胞性肿瘤。2例为横纹肌肉瘤,1例诊断为非肿瘤性病变。细针穿刺共6例,5例接受手术治疗。1例穿刺病理为朗格汉斯细胞组织细胞增生症或巨细胞肉芽肿待排;1例穿刺见大量血液;1例为小圆细胞肿瘤;1例为左下颌下淋巴结穿刺见大量炎症细胞;1例为上皮性恶性肿瘤;1例为横纹肌肉瘤。粗针及细针穿刺后进行手术的患者,大体标本病理诊断与穿刺病理诊断结果均一致。穿刺后均未发生大出血、伤口感染、肿瘤穿刺通道种植转移等并发症。结论:穿刺活检诊断儿童及青少年颌面部肿瘤安全、准确。

Reliability and safety of puncture biopsy in the diagnosis of maxillofacial tumors in children and adolescents

PURPOSE:To evaluate the accuracy and safety of puncture biopsy in the diagnosis of maxillofacial tumors in children and adolescents.METHODS:From January 2017 to July 2018,10 cases of maxillofacial tumors under 18 years old were collected from the outpatient Department of Oromaxillofacial Head and Neck Oncology,Shanghai Ninth People's Hospital,College of Stomatology,Shanghai Jiao Tong University,including 6 males and 4 females,with an average age of 12 years old(8-18 years old).In core needle biopsy,three to five pieces of tissues were taken with 16G needle.In fine needle aspiration,a 10 mL syringe was used to extract tissue.Puncture pathology and postoperative pathological diagnosis was compared.Complications were recorded.RESULTS:Core needle biopsy was performed in 4 cases and 3 cases received surgical treatment.One case was fibroblast/myofibroblast tumor.Two cases were rhabdomyosarcoma and one was diagnosed as non-neoplastic lesion.There were 6 cases of fine needle aspiration,and 5 cases received surgical treatment.One patient showed Langerhan's cell istiocytosis or giant cell granuloma.Large amount of blood was observed in 1 case.One case was small round cell tumor.One case showed a large number of inflammatory cells in the left submandibular lymph node.One case was epithelial malignant tumor.One case was rhabdomyosarcoma.The pathological diagnosis of resection specimens of the patients undergoing surgery after core needle biopsy and fine needle aspiration was consistent with the pathological diagnosis of puncture.No complications such as bleeding,wound infection,needle tract recurrence occurred after puncture.CONCLUSIONS:Core needle biopsy and fine needle aspiration are both safe and reliable in the diagnosis of suspected maxillofacial tumors in children and adolescents.