Pediatric thyroid nodules: disease demographics and clinical management as determined by fine needle aspiration biopsy.
OBJECTIVE
The prevalence of thyroid nodularity in children has been estimated to be 1.8%. The reported prevalence of specific diseases which comprise these nodules is conflicting as evidenced by a reported range of malignancy of 2 to 50% in solitary nodules. In order to better classify pediatric (< 18 years old) thyroid disease and evaluate the utility of fine needle aspiration biopsy (FNAB) in this patient population, we retrospectively reviewed 66 FNABs from 64 thyroid nodules and 2 perithyroid lymph nodes from 57 patients.


METHODS



METHODS
The study was composed of 8 males and 49 females who ranged in age from 1 to 18 years old (mean = 13.1).


METHODS
Surgical and/or clinical follow-up was obtained in all patients. The 66 FNAB diagnoses were initially classified into specific diseases. However, for the purpose of this review, the cases were classified as: 3 insufficient, 51 benign, 8 suspicious, and 4 malignant.


RESULTS
There were no "false positives" and one "false negative" (a papillary carcinoma was misdiagnosed as a benign nodule). Overall, 10 patients (18%) had malignant thyroid lesions, including 8 papillary carcinomas and 2 follicular carcinomas. Benign diagnoses included benign nodule, cyst, lymphocytic thyroiditis, granulomatous thyroiditis, hyperplasia, and abscess.


CONCLUSIONS
The prevalence of malignancy in pediatric patients with thyroid nodules was 18%. We conclude that, because of its high diagnostic accuracy and minimal invasiveness, FNAB is useful in the management of pediatric thyroid nodules.
Raab
S S
SS
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242-1009, USA.
Silverman
J F
JF
Elsheikh
T M
TM
Thomas
P A
PA
Wakely
P E
PE
D000293:Adolescent; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000145:classification / Q000473:pathology* / Q000601:surgery