Raab S S, Silverman J F, Elsheikh T M, Thomas P A, Wakely P E
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242-1009, USA.
Pediatrics. 1995 Jan;95(1):46-9.
The prevalence of thyroid nodularity in children has been estimated to be 1.8%. The reported prevalence of specific diseases which comprise these nodules is conflicting as evidenced by a reported range of malignancy of 2 to 50% in solitary nodules. In order to better classify pediatric (< 18 years old) thyroid disease and evaluate the utility of fine needle aspiration biopsy (FNAB) in this patient population, we retrospectively reviewed 66 FNABs from 64 thyroid nodules and 2 perithyroid lymph nodes from 57 patients.
The study was composed of 8 males and 49 females who ranged in age from 1 to 18 years old (mean = 13.1).
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 review, the cases were classified as: 3 insufficient, 51 benign, 8 suspicious, and 4 malignant.
There were no "false positives" and one "false negative" (a papillary carcinoma was misdiagnosed as a benign nodule). Overall, 10 patients (18%) had malignant thyroid lesions, including 8 papillary carcinomas and 2 follicular carcinomas. Benign diagnoses included benign nodule, cyst, lymphocytic thyroiditis, granulomatous thyroiditis, hyperplasia, and abscess.
The prevalence of malignancy in pediatric patients with thyroid nodules was 18%. We conclude that, because of its high diagnostic accuracy and minimal invasiveness, FNAB is useful in the management of pediatric thyroid nodules.
据估计儿童甲状腺结节的患病率为1.8%。构成这些结节的特定疾病的报告患病率相互矛盾，如孤立性结节的恶性肿瘤报告范围为2%至50%所示。为了更好地对儿科（<18岁）甲状腺疾病进行分类并评估细针穿刺活检（FNAB）在该患者群体中的效用，我们回顾性分析了57例患者64个甲状腺结节和2个甲状腺周围淋巴结的66次FNAB结果。
该研究包括8名男性和49名女性，年龄范围为1至18岁（平均 = 13.1岁）。
所有患者均获得手术和/或临床随访。66次FNAB诊断最初被分类为特定疾病。然而，为了本次综述的目的，病例被分类为：3例结果不足，51例良性，8例可疑，4例恶性。
无“假阳性”，有1例假阴性（1例乳头状癌被误诊为良性结节）。总体而言，10例患者（18%）有甲状腺恶性病变，包括8例乳头状癌和2例滤泡状癌。良性诊断包括良性结节、囊肿、淋巴细胞性甲状腺炎、肉芽肿性甲状腺炎、增生和脓肿。
儿科甲状腺结节患者的恶性肿瘤患病率为18%。我们得出结论，由于其高诊断准确性和最小侵入性，FNAB在儿科甲状腺结节的管理中很有用。
