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      The role of thyroid fine-needle aspiration cytology in the pediatric population: An institutional experience : Pediatric FNA Cytology

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          Abstract

          The current study was conducted to investigate the role of thyroid fine-needle aspiration cytology (FNAC) in the authors' pediatric series. Thyroid pediatric FNAC has been reported to have conflicting sensitivity and specificity in different series. The authors evaluated their thyroid cytological series mainly for the categories of 1) follicular/indeterminate neoplasms with atypical cells of indeterminate significance (FN/AUS) and 2) suspicious for malignancy (SM). In this setting, the application of immunocytochemistry (ICC) is likely to allow a correct diagnosis.

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          Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients.

          Anthony R. Hogan, Ying Zhuge, Eduardo A Perez … (2009)
          To examine outcomes and predictors of survival for pediatric patients with thyroid carcinoma. The Surveillance, Epidemiology, and End Results (SEER) registry from 1973 to 2004 was queried for all patients with thyroid carcinoma less than 20 y of age. A total of 1753 patients with malignant thyroid neoplasms were identified with an age-adjusted annual incidence of 0.54 cases per 100,000 persons. There has been a significant increase in the annual incidence by 1.1% per y. Female patients outnumbered males 4 to 1. Tumors were classified as papillary (n=1044, 60%), follicular variant of papillary (n=389, 23%), follicular (n=165, 10%), and medullary (n=87, 5%). The majority of patients presented with localized and regional disease. Overall mean survival time (MST) was 30.5 y. The MST for females was 40 y, whereas males survived an average of 20.4 y (P=0.0001). Patients with medullary cancer had significantly shorter mean survival than those with papillary cancer (P=0.006). Surgical treatment significantly improved outcome. Multivariate analysis demonstrated that male gender, nonpapillary histology, distant disease, and no surgery were all independent prognostic factors of worse outcome. For patients with medullary thyroid carcinoma, radiation therapy was also identified as an independent predictor of lower survival. The incidence of pediatric thyroid cancer is increasing. Females have a higher incidence than males, but enjoy longer survival. Papillary thyroid cancer has overall excellent survival. Male gender, nonpapillary tumor, distant metastases, and nonsurgical treatment all predict worse outcome.
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            American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules.

            Hossein Gharib, Enrico Papini, Ralf Paschke … (2015)
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              Pathogenesis, diagnosis and management of thyroid nodules in children.

              M Niedziela (2006)
              According to the literature thyroid nodules are quite rare in the first two decades of life. However, there are some exceptions, relating to areas with an iodine deficiency or affected by radioactive fallout, where the risk of nodules and carcinomas is increased. Therefore, it is a great challenge for the physician to distinguish between benign and malignant lesions preoperatively, and not only in these areas of greater risk. A careful work-up, comprising the patient's history, clinical examination, laboratory tests, thyroid ultrasound, scintigraphy, fine-needle aspiration biopsy (FNAB) and molecular studies, is mandatory to improve the preoperative diagnosis. The differential diagnosis should also include benign thyroid conditions such as: (i) congenital hypothyroidism due to dyshormonogenesis or ectopy, (ii) thyroid hemiagenesis, (iii) thyroglossal duct cyst, (iv) simple goiter, (v) cystic lesion, (vi) nodular hyperplasia, (vii) follicular adenoma, (viii) Graves' disease and (ix) Hashimoto thyroiditis, all of which can predispose to the development of thyroid nodules. The majority of thyroid carcinomas derive from the follicular cell (papillary, follicular, insular and undifferentiated (or anaplastic) thyroid carcinoma), whereas medullary thyroid carcinoma derives from calcitonin-producing cells. Inherited forms of thyroid cancer may occur, especially in relation to medullary thyroid carcinoma. FNAB is a critical factor in establishing the preoperative diagnosis. However, we should keep in mind the fact that a conventional cytological evaluation can miss the neoplastic nature of a lesion and the employment of immunocytochemical and molecular studies of aspirates from FNAB can give us a more precise diagnosis of neoplasia in thyroid nodules once they are detected.
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                Author and article information

                Journal
                Title: Cancer Cytopathology
                Abbreviated Title: Cancer Cytopathology
                Publisher: Wiley
                ISSN: 1934662X
                Publication date Created: May 2014
                Publication date (Print): May 2014
                Publication date (Electronic): January 28 2014
                Volume: 122
                Issue: 5
                Pages: 359-367
                Affiliations
                [1 ]Division of Anatomic Pathology and Histology; Catholic University of the Sacred Heart, Agostino Gemelli School of Medicine; Rome Italy
                [2 ]Division of Endocrine Surgery; Catholic University of the Sacred Heart, Agostino Gemelli School of Medicine; Rome Italy
                [3 ]Division of Endocrinology; Catholic University of the Sacred Heart, Agostino Gemelli School of Medicine; Rome Italy
                Article
                DOI: 10.1002/cncy.21400
                PubMed ID: 24474727
                SO-VID: 29b14285-c637-4325-88c9-1a4701095358
                Copyright © © 2014
                License:

                http://doi.wiley.com/10.1002/tdm_license_1.1

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