Online citations, reference lists, and bibliographies.

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, Nora Morgenstern, S. Chiara, Patricia G Wasserman
Published 2015 · Medicine
Cite This
Download PDF
Analyze on Scholarcy
BACKGROUND Diagnostic evaluation of thyroid nodules by FNA is used in the clinical management triage based on the knowledge of the rate of malignancy of each diagnostic category. The Bethesda System for Reporting Thyroid Cytopathology was published in 2007 by the National Cancer Institute (NCI). Using this classification, we studied our institution's experience in the pediatric population calculating the rate of malignancy for each diagnostic category, comparing our findings to our general patient population and that of the literature. METHODS 13,312 thyroid FNAs were performed at our institution between 1998 and 2010. 282 cases were from patients under 19 years of age. We reviewed and reclassified these cases using the new NCI categories, and pursued cytology-surgical follow-up. RESULTS Of the 282 FNA cases, 20.92% (59) were classified as unsatisfactory (U), 48.22, % (136) benign (B), 2.12% (6) Atypia of undetermined significance (AUS), 14.18% (40) suspicious for follicular neoplasm (FN), 2.12% (6) suspicious for malignancy (SM) and 12.41% (35) positive for malignancy (P). The U-category was further classified into nondiagnostic (ND) 12.41% (35) and cysts (C) 8.51% (24). Seventy-four children had surgical follow-up. The rates of histologically confirmed malignancy were 10% in U (1/10), 0% in B (0/17), 50% in AUS (2/4), 39% in FN (7/18), 100% in SM (4/4) and 100% in P (24/24) categories respectively. Among the U category, malignancy rate was 0% for the ND category and 25% for the C category. CONCLUSIONS To our knowledge, this is the first study to apply the NCI categories to the pediatric population. The rate of malignancy in the U category was only seen in the specimens with cystic component. AUS and FN categories had a higher malignancy rate (50 and 39% respectively) as compared with that of the general population (15 and 30% respectively). Given that the rates of malignancy are higher for cysts and AUS, the literature recommendation to "follow-up and repeat" may not apply to the pediatric population. Surgery may be reasonable in these categories instead.
This paper references
Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations Cancer 2007;5:306–315
J Yang (2007)
Preoperative cytology with molecular analysis to help guide surgery for pediatric thyroid nodules.
Melissa A Buryk (2013)
Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference.
Zubair W Baloch (2008)
Thyroid carcinoma in children and adolescents.
Brock Millman (1995)
Pediatric thyroid nodules: management in the era of fine needle aspiration.
Humberto Lugo-Vicente (1998)
Adolescent versus adult thyroid carcinoma.
Yuval Zohar (1986)
Defining the role of fine-needle aspiration of thyroid nodules in male patients: is it necessary?
Richard Berri (2008)
The Indeterminate Thyroid Fine-Needle Aspiration: Experience From an Academic Center Using Terminology Similar to That Proposed in the 2007 National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference
Stephen Spencer Raab (2010)
Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for Reporting Thyroid Cytopathology.
Vickie Y. Jo (2010)
Diagnostic Utility of Fine-Needle Aspiration Cytology in Pediatric Differentiated Thyroid Cancer
Anna E Bargren (2010)
Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation.
Leila Yassa (2007)
Pediatric thyroid nodules: disease demographics and clinical management as determined by fine needle aspiration biopsy.
Stephen Spencer Raab (1995)
AACE / AME Task Force on Thyroid nodules American Association of Clinical Endocrinologists guidelines for the diagnosis and management of thyroid nodules
S Edmund (2006)
Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology
April Chiu (2000)
Adolescents. Arch Otolaryngol Head Neck Surg 1995;121:1261–1264
B Millman (1995)
Cytopathologic analysis of thyroid lesions in the pediatric population.
Gregory A Hosler (2006)
Fine-needle aspiration biopsy in the management of thyroid nodules in children and adolescents.
A Al-Shaikh (2001)
Indeterminate Pediatric Thyroid Fine Needle Aspirations: A Study of 68 Cases
Matthew A. Smith (2013)
Cytomorphological and molecular genetic findings in pediatric thyroid fine-needle aspiration.
Sara E Monaco (2012)
Fine-needle aspiration biopsy in the management of thyroid nodules in children and adolescent
A Al-Shaikh (2001)
Pathogenesis, diagnosis and management of thyroid nodules in children.
Marek Niedziela (2006)
Diseases of thyroid in childhood and adolescence . Vol . 11 . Pediatric and Adolescent medicine
M Smith (1995)
Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations.
Jack Yang (2007)
Thyroid fine-needle aspiration biopsy in children and adolescents: experience with 218 aspirates.
Mojghan Amrikachi (2005)
Fine needle aspiration cytology of pediatric thyroid nodules
Ayper Kaçar (2010)
The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation
Zubair W Baloch (2008)
Indications for thyroid FNA and pre-FNA requirements: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference.
Edmund S Cibas (2008)
Diagnostic Terminology and Morphologic Criteria for Cytologic Diagnosis of Thyroid Lesions: A Synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference
Stephen Spencer Raab (2009)
Implications of Follicular Neoplasms, Atypia, and Lesions Suspicious for Malignancy Diagnosed by Fine-Needle Aspiration of Thyroid Nodules
Richard E Goldstein (2002)

This paper is referenced by
Pediatric thyroid FNA biopsy: Outcomes and impact on management over 24 years at a tertiary care center.
Elmira Amirazodi (2016)
Thyroid Nodules in Children
Siobhan T Pittock (2018)
Diagnosis of Pediatric Foreign Body Ingestion
Jacquelyn R Sink (2016)
Cyto‐morphologic spectrum of thyroid lesions in children
Priya Pathak (2018)
Pediatric Thyroid Cancer
Melanie Goldfarb (2017)
Surgical management of pediatric thyroid disease: Complication rates after thyroidectomy at the Children's Hospital of Philadelphia high-volume Pediatric Thyroid Center.
Heron D. Baumgarten (2019)
Utility of Fine-Needle Aspiration Biopsy in the Evaluation of Pediatric Head and Neck Masses
Phillip Huyett (2016)
Bilateral papillary thyroid cancer in children: Risk factors and frequency of postoperative diagnosis.
Heron D. Baumgarten (2020)
Aspirin Increases the Risk of Nondiagnostic Yield of Fine-Needle Aspiration and Biopsy of Thyroid Nodules
Tayyab S. Khan (2018)
Histologic and clinical follow-up of thyroid fine-needle aspirates in pediatric patients.
Kristen L Partyka (2016)
Management of Childhood Thyroid Nodules: Surgical and Endocrinological Findings in a Large Group of Cases
Emre Divarci (2017)
Malignant risk of indeterminate pediatric thyroid nodules-An institutional experience.
Amer Heider (2019)
XVI International Workshop on Chronic Lymphocytic Leukemia 2015 6–9 September 2015 Sydney, Australia
Sarah Tettamanti (2015)
Incidence and malignancy rates of indeterminate pediatric thyroid nodules
Huiying Wang (2019)
Semantic Scholar Logo Some data provided by SemanticScholar