Fine-needle aspiration in the evaluation of thyroid lesions in children.
Kaur J, Srinivasan R, Arora SK, Rajwanshi A, Saikia UN, Dutta P, Gupta N, Nijhawan R, Dey P.Source
Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Introduction
You don’t see this very often…articles on thyroid evaluations of nodules in children. This is of interest for those of you who may typically see more children in your practice. A good reference for a review of the subject. I think this is another nice article to file in your desktop library for reference. - The Populist Cytologist
Abstract
The role of fine-needle aspiration (FNA) cytology in the evaluation of thyroid lesions in not as well established in children when compared with adults. Hence we aimed to ascertain the utility and limitations of FNA in childhood thyroid lesions. This was a retrospective analysis of all thyroid FNA performed in children less than 14 years of age over a 4-year period (2005-2009). Histopathological follow-up was available in six cases. A total of 77 cases were included in the analysis. The most common cytological diagnosis was lymphocytic thyroiditis (49.3%), followed by colloid goiter (18.2%), hyperplasia (10.4%), and benign aspirate (7.8%); malignancy was identified in six cases (7.8%). Of these six cases, three were papillary thyroid carcinoma. There was one false-positive case reported as a Hurthle-cell neoplasm, which on histology showed Hashimoto’s thyroiditis. One case each of rhabdomyosarcoma and spindle epithelial tumor with thymus like differentiation was wrongly diagnosed as thyroid neoplasm, NOS, and medullary carcinoma (spindle variant), respectively. The overall diagnostic accuracy was 98.6% with 100% sensitivity, 98.6% specificity, 80% positive predictive value, and 100% negative predictive value. FNA is extremely valuable in the initial evaluation of thyroid swelling in children. Rare neoplasms masquerading as thyroid nodules in children can pose difficulties in diagnosis; however, papillary carcinoma is easily recognized. In lymphocytic thyroiditis, it provides a tissue diagnosis, thereby avoiding more invasive procedure for merely diagnostic purposes.
(via Fine-needle aspiration in the evaluation of… [Diagn Cytopathol. 2012] – PubMed – NCBI in Diagn Cytopathol. 2012 May;40 Suppl 1:E33-7. doi: 10.1002/dc.21568. Epub 2010 Oct 26.)
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