PEDIATRIC THYROID-NODULES - DISEASE DEMOGRAPHICS AND CLINICAL MANAGEMENT AS DETERMINED BY FINE-NEEDLE ASPIRATION BIOPSY

Objective. The prevalence of thyroid nodularity in children has been e stimated to be 1.8%. The reported prevalence of specific diseases whic h comprise these nodules is conflicting as evidenced by a reported ran ge of malignancy of 2 to 50% in solitary nodules. In order to better c lassify pediatric (<18 yeats old) thyroid disease and evaluate the uti lity of fine needle aspiration biopsy (FNAB) in this patient populatio n, we retrospectively reviewed 66 FNABs from 64 thyroid nodules and 2 perithyroid lymph nodes from 57 patients. Methodology. Patients: The s tudy was composed of 8 males and 49 females who ranged in age from 1 t o 18 years old (mean = 13.1). Design: Surgical and/or clinical follow- up was obtained in all patients. The 66 FNAB diagnoses were initially classified into specific diseases. However, for the purpose of this re view, the cases were classified as: 3 insufficient, 51 benign, 8 suspi cious, and 4 malignant. Results. There were no ''false positives'' and one ''false negative'' (a papillary carcinoma was misdiagnosed as a b enign nodule). Overall, 10 patients (18%) had malignant thyroid lesion s, including 8 papillary carcinomas and 2 follicular carcinomas. Benig n diagnoses included benign nodule, cyst, lymphocytic thyroiditis, gra nulomatous thyroiditis, hyperplasia, and abscess. Conclusions. The pre valence of malignancy in pediatric patients with thyroid nodules was 1 8%. We conclude that, because of its high diagnostic accuracy and mini mal invasiveness, FNAB is useful in the management of pediatric thyroi d nodules.