Pediatric thyroid nodules: Management in the era of fine needle aspiration

Lugo-Vicente, Humberto; Ortíz, Victor N.; Irizarry, Hilda; Camps, Juan; Pagan, V.

doi:10.1016/s0022-3468(98)90174-9

Cited by 67 publications

(69 citation statements)

References 16 publications

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“…A few studies discuss the role of FNAC in the management of paediatric and adolescent thyroid disease [6][7][8][9][10][11][12][13][14] and its reliability in selecting patients for surgical exploration. The purpose of this Pathology section study is to highlight the cytomorphological spectrum seen in paediatric and adolescent thyroid aspirates and to compare the findings with the other studies.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Pitfalls of FNAC of Thyroid Lesions in Children and Adolescents

Vasudev

2014

JCDR

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Background and Objectives: Fine-needle aspiration has proven safe and efficacious in the evaluation of nodular diseases in the adults. It has been used extensively to select patients for surgical exploration with a high degree of reliability. The purpose of this study was to assess the extent of its applicability in thyroid lesions in children and adolescents, as well as to determine distribution of thyroid lesions in pediatric and adolescent patients in whom the prevalence of thyroid nodules and probability of malignancy are different.Methodology: This is a four-year study undertaken between January 2009 and December 2012, during which, 284 fineneedle aspiration cytology were performed for palpable thyroid lesions in children and adolescents and analysed. Out of these 11, 52, 82 and 116 aspirates belonged to the age group between 7-<12 years, 12 -<16 years, 16 -<19 years, 19-21 years respectively. There were 261 (91.9%) satisfactory aspirates and 23 unsatisfactory aspirates (8.1%). These 261 satisfactory aspirates with adequate cellular material were taken up for interpretation and analysed. Thirty one patients underwent thyroidectomy. There were 4 true positives, 24 true negatives, 2 false positives and one false negative case in this study. Sensitivity, Specificity, Accuracy, Positive predictive value and Negative predictive value were calculated.

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Section: Introductionmentioning

confidence: 99%

Efficacy and Pitfalls of FNAC of Thyroid Lesions in Children and Adolescents

Vasudev

2014

JCDR

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“…Also, the specificity was 100%, which is concordant with reports of specificity ranging from 90-95%. [11][12][13][14] There is interest in refining the diagnostic approach to pediatric thyroid nodules, and this analysis lends support to that growing literature.…”

Section: Discussionmentioning

confidence: 65%

Histologic and Clinical Follow-up of Thyroid Fine Needle Aspirates in Pediatric Patients

Partyka

Cramer

Chen

et al. 2015

Journal of the American Society of Cytopathology

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“…15 Table 4 compares previous series with ours. It shows that benign nodules significantly outnumber those which are malignant.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] To date, only five papers pubished in English have documented series involving the use of FNA for diagnosing thyroid nodules in children. [13][14][15][16][17] We investigated the reliability of FNA in evaluating and managing thyroid nodules, and assessed the overall usefulness of the method. …”

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confidence: 99%

Fine-Needle Aspiration Biopsy of Thyroid Nodules

Dogra¹,

Saad²

2010

Ultrasound-Guided Procedures

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(Arch Dis Child 2001;85:313-317) Keywords: fine needle aspiration; biopsy; thyroid nodule As thyroid nodules have a lower incidence in children than in adults, surgery should be selective to lessen unnecessary operations. Many methods have been used to select patients, but none has eYciently predicted the pathological findings. Ultrasonography (USG) and radionuclide scanning (RS) have been used routinely to screen thyroid nodules, but many reports question their reliability. 1-3 Routine use of FNA has significantly reduced the number of adults undergoing surgery for benign disease. [4][5][6] With experienced physicians performing needle biopsy, and experienced cytopathologists interpreting the results, the accuracy of FNA has been reported as 95-97%. [7][8][9] The technique has been used less extensively in children. [10][11][12] To date, only five papers pubished in English have documented series involving the use of FNA for diagnosing thyroid nodules in children. [13][14][15][16][17] We investigated the reliability of FNA in evaluating and managing thyroid nodules, and assessed the overall usefulness of the method. Patients and methodsOur prospective study included 46 children who presented with nodules in their thyroid glands during a six year period. All nodules were fine needle biopsied after USG imaging and RS examination with 99m-technetium pertechnetate. The same surgeon (ISA) performed aspirations in all cases. Patients were placed in the recumbent position with a pillow under their shoulders, such that their neck was hyperextended, and the skin cleansed with povidone iodine (Betadine scrub). Local anaesthetic was not used routinely, but we have used prilocaine hydrochloride (Citanest) in uncooperative patients or in the case of inadequate material. In children with multiple nodules, we attempted to biopsy the largest one. The nodule was fixed in position manually, and a 23 gauge needle attached to a 20 ml disposable syringe inserted perpendicular to the anterior surface of the neck. Once the needle was in place, constant suction was applied and maintained while the needle was withdrawn to the level of the nodule capsule. The content was then discharged onto glass slides and smears were made. If no sample was drawn into the syringe on the first attempt, the needle was inserted in a diVerent direction to obtain adequate material without withholding it outside the skin. We have prepared at least five smears similar to the technique for preparation of bone marrow aspirates. All smears were dried in air and Giemsa stained (Merck Laboratories, Germany). One cytopathologist evaluated the smears. The presence of more than seven groups of cells per stained smear was considered suYcient aspirate volume. FNA examination results were classified according to cell type-benign, malignant, or follicular pattern. Biopsy specimens were labelled suspicious when cell types could not be determined.After obtaining the results of FNA examination, we administered thyroid hormone or antithyroid drugs to patients as appropr...

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Pediatric thyroid nodules: Management in the era of fine needle aspiration

Cited by 67 publications

References 16 publications

Efficacy and Pitfalls of FNAC of Thyroid Lesions in Children and Adolescents

Efficacy and Pitfalls of FNAC of Thyroid Lesions in Children and Adolescents

Histologic and Clinical Follow-up of Thyroid Fine Needle Aspirates in Pediatric Patients

Fine-Needle Aspiration Biopsy of Thyroid Nodules

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