Cytopathologic analysis of thyroid lesions in the pediatric population Journal Article


Authors: Hosler, G. A.; Clark, I.; Zakowski, M. F.; Westra, W. H.; Ali, S. Z.
Article Title: Cytopathologic analysis of thyroid lesions in the pediatric population
Abstract: Fine-needle aspiration (FNA) of the thyroid is seldom performed in the pediatric population. Therefore, the clinical utility of thyroid FNA in this patient group has not been adequately addressed. A 15 yr retrospective review of the cytopathology archives at the participating institutions was performed to identify cases of thyroid FNA performed in pediatric patients. The medical records of these cases were reviewed, including the surgical pathology reports of those patients who had subsequently undergone surgical resection. One hundred one specimens from 82 patients were identified. Of these, 40 had a cytopathologic diagnosis of carcinoma, "suspicious" for carcinoma, neoplasm, or atypia, 48 were benign, and 13 were unsatisfactory. Of the 82 patients, 45 underwent partial or total thyroidectomy. Twenty-two (49%) of these were found to harbor a malignant neoplasm (18 papillary carcinomas). The diagnostic sensitivity for identifying a lesion was 87% (26/30) and the diagnostic specificity was 92% (47/51). There were four false-positives and four false-negatives in the review, yielding a positive predictive value of 87% and a negative predictive value of 92%. We conclude that FNA is a useful adjunct to the management of thyroid lesions in the pediatric population, with good diagnostic accuracy. Although thyroid neoplasms are relatively rare in children, our experience demonstrated that 40% of thyroid masses referred for FNA had an interpretation that caused concern, ranging from "atypical" to carcinoma. Additionally, a benign diagnosis by FNA may avoid unnecessary surgery with its potential complications, a significant consideration for this age group. © 2006 Wiley-Liss, Inc.
Keywords: adolescent; child; human tissue; school child; retrospective studies; major clinical study; review; diagnostic accuracy; sensitivity and specificity; retrospective study; oncocytoma; sex ratio; pediatric; sarcoma; false negative result; cancer center; diagnostic value; medical record; thyroidectomy; adenosquamous carcinoma; age distribution; benign tumor; thyroid diseases; papillary carcinoma; aspiration biopsy; thyroid nodule; false positive result; thyroid papillary carcinoma; thyroid; cytopathology; thyroid follicular carcinoma; thyrotoxicosis; fine needle aspiration; thyroid adenoma
Journal Title: Diagnostic Cytopathology
Volume: 34
Issue: 2
ISSN: 8755-1039
Publisher: Wiley Liss  
Date Published: 2006-02-01
Start Page: 101
End Page: 105
Language: English
DOI: 10.1002/dc.20388
PUBMED: 16514673
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 12" - "Export Date: 4 June 2012" - "CODEN: DICYE" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Ian Clark
    3 Clark
  2. Maureen F Zakowski
    289 Zakowski