application and acceptance as a methodology for evaluating mass lesions (whether palpable or deep-seated) in adults. This is especially true in large, academic institutions where the appropriate imaging technology and professional expertise are often found. As an indication of FNB's increased utilization, many smaller health care facilities and some privately owned laboratory settings now offer this diagnostic approach to their patient clientele.While this wider utilization of FNB has been observed for evaluating masses in the adult population, physicians have been more reluctant to expand its use to the pediatric population. '-I6 This may in part be due to the lack of familiarity by clinicians with the role FNB plays in triaging their pediatric patients. Recent attempts have been made to reform health care delivery in the United States and increasing emphasis has been placed on the role of the primary care physician in patient management. This has focused attention on the use of FNB in pediatric as well as adult populations since, in experienced hands, it is an extremely cost-effective and reliable diagnostic technique. Furthermore, it allows physicians in smaller community practices to triage their patients to appropriate outcomes without having to interface with large, expensive tertiary care facilities. Likewise, many pathologists lack experience in evaluating the morphologic characteristics of FNB specimens obtained from this age group (1 month to 19 years).
I2-l4This study presents the largest series of pediatric FNBs to date in the scientific literature: 288 FNBs from 276 pediatric patients. The purpose of this paper is to present our experience with these cases at Diagnostic Cytology Laboratory's Outpatient Fine Needle Biopsy Clinic, and to discuss the utility of FNB in the management of these young patients.
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