Fine-needle aspiration biopsy in the diagnosis and follow-up of thyroid nodules in childhood

Abstract

Objective: To assess the role of fine−needle aspiration biopsy (FNAB) in the management of pediatric thyroid nodules.Methods: Results of 30 FNABs performed in our clinic were retrospectively reviewed. Clinical and surgical follow−up data were obtained from the patient files, and clinical correlation and accuracy of FNAB were evaluated.Results: The results of 30 FNABs were reported as benign in 24 (80%), insufficient in 4 (13.3%) patients, malignant in 1 (3.3%), and suspicious in 1 (3.3%) patient. One patient with a FNAB result of malignancy underwent surgery and the histological diagnosis was papillary carcinoma. FNAB was repeated in two of the insufficient biopsies, and reported as benign; in one of these patients, the thyroid nodule disappeared and in one, remained stable at clinical follow−up. Four of the patients with benign FNAB results underwent surgery at clinical follow−up because of an increase in the size of the nodules and one patient was found to have papillary carcinoma. The remaining patients were clinically followed. In this study, the malignancy prevalence was 6.6% in patients with thyroid nodules. There was only one falsenegativecase.Conclusion: FNAB is a reliable diagnostic tool in the management of pediatric thyroid nodules.Conflict of interest:None declared.

Evolution of pediatric thyroid surgery at a tertiary medical center

“…Fine needle aspiration has been recommended by the American Thyroid Association (ATA) as a first-line diagnostic tool in adults (7), but it has been less uniformly encouraged in children, even though the risk of malignancy in children who present with nodules is higher than in adults (17,18). A recent meta-analysis demonstrates a 98.2% negative predictive value of FNA in children, while a retrospective study of 110 patients shows a positive predictive value of 95% in FNAs that are read as malignant.…”

Guidelines for the management of thyroid cancer

“…Fine needle aspiration cytology (FNAC) is a valuable and cost‐effective pre‐operative investigation for thyroid nodules in adults . The results can reassure that a nodule is benign, triage patients for diagnostic surgery, or provide a definite diagnosis of some thyroid malignancies enabling one‐stage therapeutic surgery.…”

Cytomorphological and molecular genetic findings in pediatric thyroid fine‐needle aspiration

“…[2][3][4][5][6][7][8][9][10] Studies have shown that thyroid FNA is an effective screening tool in these young patients, [11][12][13][14][15][16][17] but no prior studies have applied the new Bethesda System for Reporting Thyroid Cytopathology to pediatric thyroid FNAs and investigated the utility of reflex molecular genetic studies in children. This study shows that the 6-tier system of the Bethesda System for Reporting Thyroid Cytopathology can be applied to children with a rate of malignancy that increases in an incremental fashion from nondiagnostic or negative to positive, including a lower rate of malignancy in the AUS/FLUS cases than in the suspicious categories.…”

“…[1][2][3][4][5][6][7][8][9][10] Of these malignancies, papillary thyroid carcinoma (PTC) is the most common type and comprises the majority of these malignancies.…”