title: Fine-needle aspiration in the evaluation of thyroid lesions in children.
abstract: The role of fine-needle aspiration (FNA) cytology in the evaluation of thyroid lesions in not as well established in children when compared with adults. Hence we aimed to ascertain the utility and limitations of FNA in childhood thyroid lesions. This was a retrospective analysis of all thyroid FNA performed in children less than 14 years of age over a 4-year period (2005-2009). Histopathological follow-up was available in six cases. A total of 77 cases were included in the analysis. The most common cytological diagnosis was lymphocytic thyroiditis (49.3%), followed by colloid goiter (18.2%), hyperplasia (10.4%), and benign aspirate (7.8%); malignancy was identified in six cases (7.8%). Of these six cases, three were papillary thyroid carcinoma. There was one false-positive case reported as a Hurthle-cell neoplasm, which on histology showed Hashimoto's thyroiditis. One case each of rhabdomyosarcoma and spindle epithelial tumor with thymus like differentiation was wrongly diagnosed as thyroid neoplasm, NOS, and medullary carcinoma (spindle variant), respectively. The overall diagnostic accuracy was 98.6% with 100% sensitivity, 98.6% specificity, 80% positive predictive value, and 100% negative predictive value. FNA is extremely valuable in the initial evaluation of thyroid swelling in children. Rare neoplasms masquerading as thyroid nodules in children can pose difficulties in diagnosis; however, papillary carcinoma is easily recognized. In lymphocytic thyroiditis, it provides a tissue diagnosis, thereby avoiding more invasive procedure for merely diagnostic purposes.
authors.affiliation: Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Jasleen
authors.initials: J
authors.lastname: Kaur
authors.forename: Radhika
authors.initials: R
authors.lastname: Srinivasan
authors.forename: Sandeep Kumar
authors.initials: SK
authors.lastname: Arora
authors.forename: Arvind
authors.initials: A
authors.lastname: Rajwanshi
authors.forename: Uma Nahar
authors.initials: UN
authors.lastname: Saikia
authors.forename: Pinaki
authors.initials: P
authors.lastname: Dutta
authors.forename: Nalini
authors.initials: N
authors.lastname: Gupta
authors.forename: Raje
authors.initials: R
authors.lastname: Nijhawan
authors.forename: Pranab
authors.initials: P
authors.lastname: Dey
mesh_terms: D000293:Adolescent; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006042:Goiter / Q000473:pathology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013952:Thymus Hyperplasia / Q000175:diagnosis / Q000473:pathology; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis / Q000473:pathology