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Cytological evaluation of thyroid nodules in children and young adults: a multi-institutional experience

Chanchal Rana1, Neha Nigam2, Shipra Agarwal3

  • 1Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Endocrine
|January 5, 2023
PubMed

Insights

Thyroid nodules in children have a higher risk of malignancy compared to adults. Young adults also showed increased risk of neoplasia and higher surgical resection rates, similar to pediatric patients.

Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • The Bethesda System for Reporting Thyroid Cytopathology's utility in pediatric patients is uncertain.
  • Defining the pediatric age group varies across studies.
  • This study addresses these limitations by comparing malignancy risk across age groups.

Purpose of the Study:

  • To compare the risk of malignancy (ROM) and risk of neoplasia (RON) across Bethesda categories.
  • To analyze these risks in pediatric, young adult, and adult patients.

Main Methods:

  • Retrospective multi-institutional study in three Indian hospitals.
  • Compared ROM and RON across Bethesda categories for adults (>18 years) and pediatric (≤18 years) patients.
  • Subgroup analysis included young adults (19-21 years).

Main Results:

  • Thyroid nodules from 5958 patients (199 pediatric) were analyzed; histology available for 2276.
  • Pediatric patients had significantly higher overall ROM and RON than adults.
  • Higher ROM in 'suspicious for malignancy' and 'malignant' categories was observed in children. Pediatric patients also had higher surgical resection rates (45.2% vs. 35.7%).

Conclusions:

  • Thyroid nodules in children are more likely to be malignant than in adults.
  • Young adults exhibited similar trends in ROM, RON, and resection rates as pediatric patients.
  • These findings suggest a need for age-specific considerations in thyroid nodule management.
Abstract

Keywords:
FNAPediatricRisk of malignancyThyroidThyroid nodulesYoung adults

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