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Indeterminate Pediatric Thyroid Fine Needle Aspirations: A Study Of 68 Cases

Matthew A. Smith, Liron Pantanowitz, Walid E. Khalbuss, Vanessa A Benkovich, Sara E Monaco
Published 2013 · Medicine
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Objective: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) provides a reporting scheme for thyroid fine needle aspiration (FNA) and includes three indeterminate categories with different management strategies. This study analyzes indeterminate thyroid FNAs in children, and correlates these findings with the histological features. Methods: A total of 179 thyroid FNA specimens were retrieved from children. Cases were categorized by TBSRTC. Only cases diagnosed as atypia (AUS)/follicular lesion of undetermined significance (FLUS), suspicious for follicular or oncocytic neoplasm (SFON), or suspicious for malignancy (SM) were selected and correlated with the nodule size and histological follow-up. Results: Sixty-eight cases were identified, including 43 (63%) AUS/FLUS diagnoses, 19 (28%) SFON, and 6 (9%) SM. On follow-up, 48% were malignant, including 28% AUS/FLUS cases, 58% SFON, and 100% SM. The average size of the malignant lesions diagnosed preoperatively as AUS/FLUS was 1.5 cm (range 0.7-4.5), compared to 3.3 cm (range 1.2-6.6) in SFON and 2.8 cm (range 0.7-3.8) in SM. Malignancies included 92% papillary thyroid carcinoma (PTC), 77% of which were the follicular variant of PTC (FVPTC) and 8% follicular carcinomas. The AUS/FLUS cases were largely due to compromised specimens (49%) and the highest malignancy rate occurred in those with cytological atypia (50%). Conclusions: This study shows an incremental risk of malignancy within the indeterminate categories using TBSRTC in children. Malignant nodules with a preoperative AUS/FLUS diagnosis tended to be smaller than those with a SFON or SM diagnosis, and the vast majority of malignancies were PTC, with a high proportion being FVPTC.
This paper references
10.1002/lary.23861
False negatives in thyroid cytology: impact of large nodule size and follicular variant of papillary carcinoma.
Rania Mehanna (2013)
Solitary thyroid nodules in childhood: is the incidence of thyroid carcinoma declining?
Mary Dawson Scott (1976)
10.1309/AJCPO0BQ2YSKPXXP
Usefulness of diagnostic qualifiers for thyroid fine-needle aspirations with atypia of undetermined significance.
Paul A VanderLaan (2011)
10.1677/erc.1.00882
Pathogenesis, diagnosis and management of thyroid nodules in children.
Marek Niedziela (2006)
10.1016/S1077-9108(09)79290-4
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)
10.1530/acta.0.1210197
High frequency of cancer in cold thyroid nodules occurring at young age.
Annamaria Belfiore (1989)
10.1210/jc.2011-1469
Impact of mutational testing on the diagnosis and management of patients with cytologically indeterminate thyroid nodules: a prospective analysis of 1056 FNA samples.
Yuri E Nikiforov (2011)
10.1002/cncy.20063
Contribution of molecular testing to thyroid fine-needle aspiration cytology of "follicular lesion of undetermined significance/atypia of undetermined significance".
N Paul Ohori (2010)
10.1210/jcem.86.10.7950
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)
10.1002/dc.20388
Cytopathologic analysis of thyroid lesions in the pediatric population.
Gregory A Hosler (2006)
10.1002/dc.21292
Fine-needle aspiration of follicular patterned lesions of the thyroid: Diagnosis, management, and follow-up according to National Cancer Institute (NCI) recommendations.
William C Faquin (2010)
10.1016/J.YEND.2011.12.001
Sensitivity of Fine-Needle Biopsy in Detecting Pediatric Differentiated Thyroid Carcinoma
Erica Eugster (2012)
10.1002/cncy.20178
The atypical thyroid fine-needle aspiration: past, present, and future.
Massimo Bongiovanni (2012)
10.1016/S0084-3741(10)79463-4
Molecular Testing for Mutations in Improving the Fine-Needle Aspiration Diagnosis of Thyroid Nodules
Matthias Schott (2010)
10.1016/B978-141604208-2.10006-5
The Bethesda System for Reporting Cervical Cytology
Ritu Nayar (2004)
10.1089/thy.2012.0265
The impact of thyroid nodule size on the risk of malignancy and accuracy of fine-needle aspiration: a 10-year study from a single institution.
Merica Shrestha (2012)
10.1016/j.jpedsurg.2007.12.019
The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices.
Chris Stevens (2008)
Cytopathology
YE Nikiforov (2009)
10.1002/cncy.20091
Should "atypical follicular cells" in thyroid fine-needle aspirates be subclassified?
Andrew A Renshaw (2010)
The indeterminate thyroid fineneedle aspiration : experience from an academic center using terminology similar to that proposed in the
R Nayar (2007)
10.1002/cncy.20029
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.
Ritu Nayar (2009)
10.1016/s1077-9108(08)79032-7
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)
10.1089/thy.2009.0274
The Bethesda System for Reporting Thyroid Cytopathology.
Edmund S Cibas (2009)
10.1002/cncy.21199
Cytomorphological and molecular genetic findings in pediatric thyroid fine-needle aspiration.
Sara E Monaco (2012)
10.1159/000333231
The Frequency of ‘Atypia of Undetermined Significance’ Interpretations for Thyroid Fine-Needle Aspirations Is Negatively Correlated with Histologically Proven Malignant Outcomes
Paul A VanderLaan (2011)
10.1016/j.surg.2007.08.012
The incidence of cancer and rate of false-negative cytology in thyroid nodules greater than or equal to 4 cm in size.
Kelly L. Mccoy (2007)
10.1002/dc.20830
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)
10.1002/cncy.20154
Subclassification of atypical cells of undetermined significance in direct smears of fine-needle aspirations of the thyroid: distinct patterns and associated risk of malignancy.
Andrew A Renshaw (2011)



This paper is referenced by
10.1210/jc.2012-1230
Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1).
Rajesh V. Thakker (2012)
10.1002/cncy.22104
Incidence and malignancy rates of indeterminate pediatric thyroid nodules
Huiying Wang (2019)
10.1002/dc.24266
Malignant risk of indeterminate pediatric thyroid nodules-An institutional experience.
Amer Heider (2019)
10.1016/j.yapd.2017.03.007
Pediatric Thyroid Cancer.
Christine M. Chan (2017)
10.1016/j.ecl.2017.01.014
Molecular Genetics of Thyroid Cancer in Children and Adolescents.
Andrew J Bauer (2017)
10.2217/IJE.15.20
Evaluation and management of thyroid nodules with atypia/follicular lesion of undetermined significance on fine-needle aspiration
Iuliana Dit Bobanga (2015)
10.1016/j.jpedsurg.2014.10.046
Risk of malignancy for each Bethesda class in pediatric thyroid nodules.
Olov Norlén (2015)
10.1002/cncy.21713
Histologic and clinical follow-up of thyroid fine-needle aspirates in pediatric patients.
Kristen L Partyka (2016)
10.5795/JJSCC.53.251
甲状腺細胞診「鑑別困難」のベセスダシステムによる検討
竹沢 奈緒子 (2014)
10.1159/000371752
Review of the Bethesda System for Reporting Thyroid Cytopathology: A Local Study in Bohol Island, Philippines
Annette L. Salillas (2015)
10.1002/cncy.21605
A meta-analytic review of the Bethesda System for Reporting Thyroid Cytopathology: Has the rate of malignancy in indeterminate lesions been underestimated?
Patrizia Straccia (2015)
10.1634/theoncologist.2014-0115
Evaluation and management of the pediatric thyroid nodule.
Jeremy T Guille (2015)
10.1007/978-3-319-54493-9_10
Pediatric Thyroid Cancer
Melanie Goldfarb (2017)
10.1515/jpem-2014-0427
Reclassification of cytologically atypical thyroid nodules based on radiologic features in pediatric patients
Nicoleta C Arva (2015)
10.1186/s13633-015-0019-x
Pediatric thyroid surgery and management of thyroid nodules – an institutional experience over a 10-year period
Wen Jiang (2016)
10.1053/j.semnuclmed.2015.10.006
Management of Differentiated Thyroid Cancer in Children: Focus on the American Thyroid Association Pediatric Guidelines.
Marguerite T. Parisi (2016)
10.1002/cncy.21933
Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features in the pediatric age group
Esther Diana Rossi (2018)
10.1089/thy.2014.0312
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)
10.1002/dc.23265
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)
10.1089/thy.2014.0460
Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer.
Gary L. Francis (2015)
10.14341/KET2015440-50
Comments to part of the American thyroid association guidelines for the management of thyroid nodules in children
Alexey Vasil'evich Kiyaev (2016)
10.1159/000366498
Thyroid Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance: An Indispensable Bethesda 2010 Diagnostic Category or Waste Garbage?
Ivana Kholová (2014)
10.1016/j.ecl.2016.02.002
Thyroid Cancer in Pediatrics.
Josef Machac (2016)
10.1002/cncy.21884
The role of thyroid FNA cytology in pediatric malignant lesions: An overview of the literature.
Esther Diana Rossi (2017)
10.5005/jp-journals-10001-1266
Surgery of the Thyroid in Children: Current Trends in Practice
Alanna M. Windsor (2016)
10.1007/978-3-319-43618-0_10
Surgical Intervention for Indeterminate Thyroid Nodules
Snehal G. Patel (2017)
10.1155/2016/1256189
The Clinical and Pathological Presentation of Thyroid Nodules in Children and the Comparison with Adult Population: Experience of a Single Institution
Tamás Solymosi (2016)
10.5603/EP.a2019.0033
Surgical approach to differentiated thyroid cancers (DTC) in children [Specyfika leczenia chirurgicznego zróżnicowanych raków tarczycy (ZRT) u dzieci].
Agnieszka Czarniecka (2019)
Turkish Journal of Clinics and Laboratory Türk Klinik ve Laboratuvar Dergisi
Kübra Hacıeminoğlu (2017)
10.1542/peds.2018-3063
Management Guidelines for Children With Thyroid Nodules and Differentiated Thyroid Cancer
Gary L. Francis (2018)
10.1007/s40137-013-0035-9
Use of Molecular Markers for Cytologically Indeterminate Thyroid Nodules to Optimize Surgical Management
Linwah Yip (2013)
10.4103/JOC.JOC_160_18
Thyroid Bethesda Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance (AUS/FLUS): A Heterogenous Group
Priyanka Maity (2019)
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