John Clyde Childress MD, Presenter: Nothing to Disclose

Ethan Andrew Smith MD, Abstract Co-Author: Nothing to Disclose

Jonathan Russell Dillman MD, Abstract Co-Author: Research support, Bracco Group Research support, General Electric Company Research support, Siemens AG

Thyroid nodules are less common in the pediatric population compared to adults, although they are more likely to represent malignancy. In contrast to adults, ultrasound-guided fine needle aspiration biopsy (US-FNAB) is not standard of care in the evaluation of pediatric thyroid nodules. In this study, we assessed the utility of US-FNAB in the management of thyroid nodules in children and adolescents.

US-FNAB results of 42 thyroid nodules in 36 pediatric patients (mean age = 13.9 years, range = 7–18 years) were retrospectively reviewed. Medical records were evaluated to document use of sedation/general anesthesia, presence of onsite cytopathology analysis, pertinent grey-scale ultrasound findings, number of needle passes performed, and final cytopathologic diagnosis. Final cytopathology was then correlated with surgical pathology, when available. Descriptive statistical analyses were performed.

US-FNAB was diagnostic in 34/36 patients (94%) and 40/42 thyroid nodules (95%). A total of 6/36 patients (14%) had results positive for malignancy, all of which were confirmed papillary thyroid cancer after total thyroidectomy (mean age= 14.7 years, range = 10–18 years). Sedation or general anesthesia was required in 22/36 patients (61%). Onsite cytopathologic analysis was present for 32/36 cases (89%). The average number of needle passes per nodule was 5.9. Benign nodules included: nodular hyperplasia (n=19), lymphocytic thyroiditis (n=8), benign cyst (n=3), colloid nodule (n=2), lymph node (n=1), and follicular adenoma (n=1).

Ultrasound-guided FNAB in pediatric patients is feasible, has a high diagnostic rate, and reliably distinguishes between benign and malignant thyroid nodules.

Ultrasound-guided FNAB is useful in the evaluation of pediatric thyroid nodules, as it reliably distinguishes between benign and malignant nodules.

Childress, J, Smith, E, Dillman, J, Utility of Ultrasound-guided Fine Needle Aspiration Biopsy in Management of Pediatric Thyroid Nodules.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12029020.html