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Pediatric Thyroid FNA Biopsy: Outcomes And Impact On Management Over 24 Years At A Tertiary Care Center.

Elmira Amirazodi, Evan Jon Propst, Catherine T-S Chung, Dimitri A. Parra, Jonathan D Wasserman
Published 2016 · Medicine
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BACKGROUND Thyroid malignancy is rare in young children, although the incidence increases sharply during adolescence. Nodular thyroid disease and thyroid cancer in children differ substantially from those in adults, because the rates of malignancy among children are roughly 5-fold higher, and local and distant metastases as well as recurrences are more common. Even with the recent introduction of pediatric guidelines, there remains a paucity of pediatric data on which to base clinical decision making. The objectives of this study were to characterize the outcomes of fine-needle aspiration biopsy (FNAB) of nodular thyroid disease at a pediatric tertiary-care institution over a 24-year period and to relate cytopathology to histopathology and management decisions in this population. METHODS A retrospective review of patients who underwent preoperative FNAB and thyroid surgery between 1992 and 2015 was conducted. In total, 207 nodules were biopsied among 178 patients. RESULTS Adequate FNAB samples were obtained in 74% of biopsies. Sixty-five patients underwent thyroidectomy after FNAB. In this group, the malignancy rates for lesions deemed benign, atypical, suspicious, and malignant on FNAB cytology were 16%, 67%, 71%, and 100%, respectively. Twenty-seven individuals underwent >1 biopsy; however, no malignancies were identified in these patients. Surprisingly, the rate of malignancy in patients who underwent preoperative FNAB was not significantly different from the rate in those who proceeded directly to surgery (n = 146). CONCLUSIONS FNAB remains a valuable tool for preoperative assessment of pediatric thyroid nodules. When samples are adequate for assessment, cytology other than clearly "benign" merits referral for diagnostic or therapeutic thyroidectomy. In this series, FNAB did not reduce rates of surgery for benign disease. Cancer Cytopathol 2016;124:801-10. © 2016 American Cancer Society.
This paper references
American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules.
H. Gharib (2006)
Type and prevalence of BRAF mutations are closely associated with papillary thyroid carcinoma histotype and patients’ age but not with tumour aggressiveness
Vitor Trovisco (2005)
Multicenter clinical experience with the Afirma gene expression classifier.
Erik K. Alexander (2014)
Changes in pediatric thyroid sonograms in or nearby the Kanto region before and after the accident at the Fukushima Daiichi nuclear power plant.
Kenji Iwaku (2014)
Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules.
Erik K. Alexander (2002)
Is repeated fine-needle aspiration cytology useful in the management of patients with benign nodular thyroid disease?
Shakil H. Merchant (2000)
Is Ultrasonography Useful in Predicting Thyroid Cancer in Children with Thyroid Nodules and Apparently Benign Cytopathologic Features?
Jannette Saavedra (2011)
Natural History of Benign Solid and Cystic Thyroid Nodules
Erik K. Alexander (2003)
Fine needle aspiration of thyroid nodules in the pediatric population: a 12-year cyto-histological correlation experience at North Shore-Long Island Jewish Health System.
Seema Lale (2015)
Pediatric thyroid nodules: disease demographics and clinical management as determined by fine needle aspiration biopsy.
Stephen Spencer Raab (1995)
Nondiagnostic fine-needle aspirations of the thyroid: is the risk of malignancy higher?
Nicholas Coorough (2013)
Follicular variant of papillary carcinoma. Cytologic and histologic correlation.
Zubair W Baloch (1999)
Oncogenic alterations in papillary thyroid cancers of young patients.
Geneviève Sassolas (2012)
Thyroid cancer in children.
Catherine A. Dinauer (2007)
Cytopathologic analysis of thyroid lesions in the pediatric population.
Gregory A Hosler (2006)
Role of operator experience in ultrasound-guided fine-needle aspiration biopsy of the thyroid
Elvio De Fiori (2010)
Low nondiagnostic rate for fine-needle capillary sampling biopsy of thyroid nodules: a singular experience.
Gregory Mahony (2013)
Do repeatedly nondiagnostic fine needle aspirations of thyroid nodules predict malignancy risk?
Dilek Arpaci (2014)
Incidental thyroid abnormalities identified on neck US for non-thyroid disorders
Shivaram Avula (2010)
2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.
B Haugen (2016)
Long-term follow-up of patients with initially benign thyroid fine-needle aspirations.
Yair Liel (2001)
Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer
L FrancisGary (2015)
The biopsy-proven benign thyroid nodule: is long-term follow-up necessary?
Sukhyung Lee (2013)
The Bethesda System for Reporting Thyroid Cytopathology.
Edmund S Cibas (2009)
False negatives in thyroid cytology: impact of large nodule size and follicular variant of papillary carcinoma.
Rania Mehanna (2013)
Fine-needle aspiration biopsy of thyroid nodules: comparison of diagnostic performance of experienced and inexperienced physicians.
Alptekin Gursoy (2010)
Predictive factors of malignancy in thyroid nodules with repeatedly nondiagnostic cytology (Bethesda category I): value of ultrasonography.
Pedro Weslley Rosario (2014)
Pediatric thyroid nodules: management in the era of fine needle aspiration.
Humberto Lugo-Vicente (1998)
Fine needle aspiration biopsy of thyroid nodules
I S Arda (2001)
Sonographically guided fine-needle biopsy of thyroid nodules: the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material.
Bumin Değirmenci (2007)
Repeat thyroid nodule fine-needle aspiration in patients with initial benign cytologic results.
Melina B. Flanagan (2006)
Fine-needle aspiration cytology of benign nodular thyroid disease. Value of re-aspiration.
Alan Lucas (1995)
Accuracy of fine needle aspiration biopsy of thyroid nodules in detecting malignancy in childhood: comparison with conventional clinical, laboratory, and imaging approaches.
Andrea Corrias (2001)
Genetic markers differentiating follicular thyroid carcinoma from benign lesions
Beatriz Cistina Freitas (2010)
Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer.
Gary L. Francis (2015)
New Strategies in Diagnosing Cancer in Thyroid Nodules: Impact of Molecular Markers
Yuri E Nikiforov (2013)
Role of repeated fine-needle aspiration of thyroid nodules with benign cytologic features.
Joe M. Chehade (2001)
Increase in the incidence of differentiated thyroid carcinoma in children, adolescents, and young adults: a population-based study.
Lucas Bonachi Vergamini (2014)
Fine-needle aspiration biopsy in the management of thyroid nodules in children and adolescents.
A Al-Shaikh (2001)
Clinical and economic outcomes of thyroid and parathyroid surgery in children.
Julie Ann Sosa (2008)
Pediatric thyroid fine-needle aspiration cytology: a meta-analysis.
Christopher J Stevens (2009)
Diagnostic features of thyroid nodules in pediatrics.
Andrea Corrias (2010)
Cytomorphological and molecular genetic findings in pediatric thyroid fine-needle aspiration.
Sara E Monaco (2012)
The role of fine-needle aspiration biopsy in the management of thyroid nodules in children, adolescents, and young adults: a multi-institutional study.
Kamal K Khurana (1999)
Thyroid fine-needle aspiration biopsy in children and adolescents: experience with 218 aspirates.
Mojghan Amrikachi (2005)
Can malignant thyroid nodules be distinguished from benign thyroid nodules in children and adolescents by clinical characteristics? A review of 89 pediatric patients with thyroid nodules.
Melissa A Buryk (2015)
Malignancy risk stratification in thyroid nodules with nondiagnostic results at cytologic examination: combination of thyroid imaging reporting and data system and the Bethesda System.
Hee Jung Moon (2015)
Thyroid Fine Needle Aspirate: A Post-Bethesda Update
Shikha Bose (2012)
A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults.
Anjuli Gupta (2013)
Variability in the Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Diagnosis in the Bethesda System for Reporting Thyroid Cytopathology: Sources and Recommendations
N Paul Ohori (2011)
Risk of malignancy for each Bethesda class in pediatric thyroid nodules.
Olov Norlén (2015)
Rapid on-site evaluation of fine needle aspiration specimens by cytology scientists: a review of 3032 specimens.
Phyllis W. Shield (2014)
Pathogenesis, diagnosis and management of thyroid nodules in children.
Marek Niedziela (2006)
Thyroid carcinoma, version 2.2014.
Robert Michael Tuttle (2014)
Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
David S. Cooper (2009)
Follicular thyroid carcinoma: From diagnosis to treatment.
Jen-Der Lin (2006)
Fine-needle aspiration biopsy of thyroid nodules. Impact on thyroid practice and cost of care.
Bertil Hamberger (1982)
A Prospective Assessment Defining the Limitations of Thyroid Nodule Pathologic Evaluation
Edmund S Cibas (2013)
Management of nodules with initially nondiagnostic results of thyroid fine-needle aspiration: can we avoid repeat biopsy?
Thomas J T Anderson (2014)
Integrated Genomic Characterization of Papillary Thyroid Carcinoma
Nishant Agrawal (2014)

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