title: Needle core biopsy in the diagnosis of pediatric thyroid neoplasms: a single institution retrospective review.
abstract: OBJECTIVE
  Our institution routinely utilizes needle core biopsy (NCB), instead of fine needle aspiration, in the evaluation of pediatric thyroid nodules. This practice initially arose from limited cytopathology services in our hospital. Given the lack of information regarding the utility of NCB in diagnosing pediatric thyroid neoplasms, we set out to review our institution's experience with this technique.
  
  
  METHODS
  We performed a single institution retrospective chart review of all children who underwent thyroidectomy for primary thyroid pathology.
  
  
  RESULTS
  Seventy-four patients, with a mean age of 12.9 ± 4.5 (SD) years, underwent partial or total thyroidectomy between 2002 and 2010. Seven of these patients had medically refractive hyperthyroidism. The remaining 67 patients had one or more thyroid nodules as identified by ultrasound. 24 (36 %) of these cases were malignant on final pathology. 14 (58 %) of the malignant cases were papillary thyroid carcinoma. 46 of the thyroid nodule cases underwent pre-operative NCB. Biopsy results for these patients were non-diagnostic in 6 (13 %), benign in 11 (24 %), atypical in 17 (37 %), and malignant in 12 (26 %). There were no complications arising from NCB. Sensitivity of NCB for diagnosing papillary carcinoma (PC) and follicular neoplasm was calculated at 0.88 (0.47-1.0, 95 % CI) and 0.84 (0.60-0.97, 95 % CI), respectively. Of the 28 patients not undergoing preoperative NCB, 12 underwent hemithyroidectomy, with one patient (8 %) requiring completion thyroidectomy for PC. Overall, the sensitivity of NCB in diagnosing PC and follicular thyroid neoplasms was 0.85 (0.55-0.99, 95 % CI), while the specificity was 0.63 (0.42-0.82, 95 % CI).
  
  
  CONCLUSIONS
  Needle core biopsy appears to have a low rate of associated complications, and its sensitivity for diagnosing PC and follicular neoplasm is comparable to what has been reported for fine needle aspiration biopsy in a similar patient population.
authors: Bobby R Alford Department of Otolaryngology, Baylor College of Medicine, Houston, TX, USA.
authors: W K
authors: WK
authors: Yunker
authors: S F
authors: SF
authors: Hassan
authors: L B
authors: LB
authors: Ferrell
authors: M J
authors: MJ
authors: Hicks
authors: C M
authors: CM
authors: Giannoni
authors: D E
authors: DE
authors: Wesson
authors: C I
authors: CI
authors: Cassady
authors: J A
authors: JA
authors: Hernandez
authors: M L
authors: ML
authors: Brandt
authors: M E
authors: ME
authors: Lopez
mesh_terms: D000293:Adolescent; D044963:Biopsy, Fine-Needle; D062005:Biopsy, Large-Core Needle; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy