title: Thyroid nodules in children and adolescents: a single institution's experience.
abstract: OBJECTIVE
  The aims of this study were to analyze the role of fine-needle aspiration biopsy (FNAB) in the management of pediatric thyroid nodules and to analyze the malignancy risk of thyroid nodules by studying the association between autoimmune thyroiditis and thyroid cancer.
  
  
  METHODS
  We conducted a retrospective study on 111 patients with thyroid nodules diagnosed in childhood or adolescence. FNAB was performed in 46 participants with thyroid nodules after ultrasonography (US). Cytology diagnoses were categorized as insufficient, benign, suspicious, and malignant. Clinical and surgical follow-up data were obtained from medical records. The clinical correlation and accuracy of FNABs were evaluated.
  
  
  RESULTS
  The family history was positive in four patients. Forty-six patients had positive antithyroid antibodies and an inhomogeneous hypoechogenic US pattern. One patient had previous neck irradiation history. Eighty-six patients (%77.5) were euthyroid. All patients underwent US examination. The FNAB results of the 46 patients were 29 (63%) benign cases, 7 (15%) insufficient, and 10 (22%) suspicious patients. Malignancy was not reported at all. A repetition of FNAB in two benign cases, which were diagnosed with papillary carcinoma during followup, reported these cases as suspicious. Ten patients with suspicious FNAB results underwent surgery because of increases in the size of the nodules; two patients were diagnosed with papillary carcinoma. In this study, the prevalence of malignancy was 4.5% in patients with thyroid nodules.
  
  
  CONCLUSIONS
  In this study, the importance of FNAB in the diagnosis and follow-up of thyroid nodules in childhood has been observed, and risk factors, such as history of familial thyroid carcinoma, radiotherapy to the neck at younger ages, suspicious cytological findings, and increased nodular sizes during follow-up in cases with Hashimoto thyroiditis have been correlated with increased thyroid carcinoma malignancy risk.
authors.affiliation: Clinics of Pediatric Endocrinology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey. veyselbas@yahoo.com
authors.forename: Veysel Nijat
authors.initials: VN
authors.lastname: Baş
authors.forename: Zehra
authors.initials: Z
authors.lastname: Aycan
authors.forename: Semra
authors.initials: S
authors.lastname: Cetinkaya
authors.forename: Ciğdem
authors.initials: C
authors.lastname: Uner
authors.forename: Yusuf Hakan
authors.initials: YH
authors.lastname: Cavuşoğlu
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Arda
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D044963:Biopsy, Fine-Needle; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000706:statistics & numerical data; D055815:Young Adult