Sunday, January 13, 2008

How to Diagnose Neuroblastoma


A neuroblastoma is a malignant tumor of immature nerve cells. It is a poorly differentiated tumor that is most common in young children and infants. A neuroblastoma is the most common abdominal cancer in infants and the most common extracranial tumor of solid tissue in children. It is one of the few tumors that can spontaneously resolve. The following steps will show how to diagnose a neuroblastoma.


Difficulty: Challenging



Step One

Expect the symptoms of a neuroblastoma to be highly variable depending on its location, degree of metastasis and by-products produced. Most neuroblastomas are in the abdomen, especially the adrenal gland so the most common complaint is fullness or distension of the abdomen.

Step Two

Conduct a complete physical exam. This is important in diagnosing neuroblastomas because of its ability to imitate other diseases. The most common findings may include an enlarged liver, subcutaneous nodules and a large firm abdominal mass.

Step Three

Perform general laboratory studies. Widely disseminated neuroblastoma can cause anemia. Abnormal coagulation results can be expected if the liver becomes affected and a low platelet count may be caused by massive involvement of bone marrow.

Step Four

Order an extensive battery of more specific tests if neuroblastoma is being considered.

Step Five

Diagnose neuroblastoma with a biopsy. The suspect tissue must be histologically determined to be of neural origin. Small uniform cells are characteristic of neuroblastomas. The nuclei are dense and hyperchromatic with little cytoplasm. Clusters of neuroblasts surrounding eosinophilic neuropil occur in 15 to 50 percent of patients and will confirm the diagnosis.

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