Cytomorphology - quick and safe diagnostic method in children with malignant diseases /our experiences/

Malignant diseases represent one of the most serious problems that modern medicine is faced with. They are the most frequent cause of mortality in children up to 14 years of age and after accidents take the second place. Malignant diseases in children occur as hemoblastoses (leukemias and lymphomas) and solid tumors in roughly the same 50:50 ratio. There are many differences between malignant diseases in children and those in the adults. Today some types of malignant diseases in children (leukemias and solid tumors) are curable, but it is extremely important to identify, diagnose and classify them early enough, which is a prerequisite for choosing efficient therapeutic protocols and thereby for the success in therapy. Cytology is based on the assumption that any pathological process, including the tumor process, has its characteristic cells, so an opinion, and often a diagnosis, is formed by studying the appearance of individual cells in clusters and the mutual relationship between individual cell elements by inspecting the whole smear. Cytodiagnostics is a method of trying to arrive at a diagnosis by studying the morphology of individual cells in colored smears. Cytodiagnostics has major advantages in early detection and diagnosing of hemoblastoses and solid tumors in children.

Smears obtained by one of the cytodiagnostic methods can be used in analyzing new technical possibilities in the area of molecular diagnostics. In the period 1974-2008, at the Clinic for Children’s Diseases Zagreb 1428 children have been diagnosed with malignant diseases, of whom 480 with leukemia and 948 with solid malignant tumors. With a cytodiagnostic method it is possible to diagnose malignant diseases in children. The method is quick, simple, relatively harmless and painless and can be applied in most laboratories. Furthermore, the method helps in following the progression of a tumor process and the success of therapeutic protocols, and in the early detection of tumor relapse or distant metastases. Correlation with a pathohistologic diagnosis is high.

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