Malignant risk of indeterminate pediatric thyroid nodules—An institutional experience
dc.contributor.author | Heider, Amer | |
dc.contributor.author | Arnold, Stacy | |
dc.contributor.author | Lew, Madelyn | |
dc.contributor.author | Pang, Judy | |
dc.contributor.author | Rabah, Raja | |
dc.contributor.author | Bruch, Steven | |
dc.contributor.author | Thomas, Inas | |
dc.contributor.author | Menon, Ram | |
dc.contributor.author | Cantley, Richard | |
dc.contributor.author | Davenport, Robertson | |
dc.contributor.author | Jing, Xin | |
dc.date.accessioned | 2019-09-30T15:31:23Z | |
dc.date.available | WITHHELD_14_MONTHS | |
dc.date.available | 2019-09-30T15:31:23Z | |
dc.date.issued | 2019-10 | |
dc.identifier.citation | Heider, Amer; Arnold, Stacy; Lew, Madelyn; Pang, Judy; Rabah, Raja; Bruch, Steven; Thomas, Inas; Menon, Ram; Cantley, Richard; Davenport, Robertson; Jing, Xin (2019). "Malignant risk of indeterminate pediatric thyroid nodules—An institutional experience." Diagnostic Cytopathology 47(10): 993-998. | |
dc.identifier.issn | 8755-1039 | |
dc.identifier.issn | 1097-0339 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/151306 | |
dc.description.abstract | BackgroundFew studies focus on pediatric thyroid nodules categorized under indeterminate diagnostic categories. The current study was conducted to assess the risk of malignancy of indeterminate pediatric thyroid nodules.MethodsA search of the institutional electronic pathology database from 01/2011 to 09/2018 was performed to identify pediatric (<21 years old) thyroid nodules that were interpreted as follicular lesion of undetermined significance (FLUS), suspicious for follicular neoplasm (SFN), or suspicious for malignancy (SFM) and subsequently managed with surgery, repeat fine‐needle aspiration (FNA), or ≥ 6 months of clinical/imaging monitoring. Results of follow‐up (F/U) surgical resections and repeat FNA/Afirma tests, and clinical and radiologic data were collected.ResultsWe identified 46 cases from 42 patients (11‐20 years old, 33 females and 9 males), including 30 FLUS, 10 SFN, and 6 SFM. Twenty‐five FLUS, ten SFN, and six SFM cases underwent surgery. The histology revealed carcinomas in 36% of FLUS, 20% of SFN, and 100% of SFM categories; follicular adenomas in 32% of FLUS and 80% of SFN categories; and benign nodules in 32% of FLUS category. All five nonsurgically treated FLUS cases were considered benign based on the findings of repeat FNA/Afirma tests (n = 3, 3‐22 months F/U) or clinical/radiologic exams (n = 2, 8‐12 months F/U).ConclusionsBased on a limited study cohort, malignancy was identified in 36%, 20%, and 100% of surgically managed pediatric thyroid nodules categorized as FLUS, SFN, and SFM, respectively; suggesting a markedly higher malignant rate than the implied malignant risk for FLUS and SFM categories in adults. | |
dc.publisher | John Wiley & Sons, Inc. | |
dc.subject.other | risks of malignancy | |
dc.subject.other | follicular lesion of undetermined significance | |
dc.subject.other | pediatric thyroid nodule | |
dc.subject.other | follicular neoplasm/suspicious for follicular neoplasm | |
dc.subject.other | suspicious for malignancy | |
dc.title | Malignant risk of indeterminate pediatric thyroid nodules—An institutional experience | |
dc.type | Article | |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Pathology | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/151306/1/dc24266.pdf | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/151306/2/dc24266_am.pdf | |
dc.identifier.doi | 10.1002/dc.24266 | |
dc.identifier.source | Diagnostic Cytopathology | |
dc.identifier.citedreference | Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009; 19 ( 11 ): 1159 ‐ 1165. | |
dc.identifier.citedreference | Rossi ED, Martini M, Cenci T, Capodimonti S, Larocca LM. The role of thyroid FNA cytology in pediatric malignant lesions: an overview of the literature. Cancer Cytopathol. 2017; 125 ( 8 ): 594 ‐ 603. | |
dc.identifier.citedreference | Gupta A, Ly S, Castroneves LA, et al. A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab. 2013; 98 ( 8 ): 3238 ‐ 3245. | |
dc.identifier.citedreference | Rossi ED, Mehrotra S, Kilic AI, et al. Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features in the pediatric age group. Cancer Cytopathol. 2018; 126 ( 1 ): 27 ‐ 35. | |
dc.identifier.citedreference | Cibas ES, Ali SZ. The 2017 Bethesda system for reporting thyroid cytopathology. Thyroid. 2017; 27 ( 11 ): 1341 ‐ 1346. | |
dc.identifier.citedreference | Lai SW, Roberts DJ, Rabi DM, Winston KY. Diagnostic accuracy of fine needle aspiration biopsy for detection of malignancy in pediatric thyroid nodules: protocol for a systematic review and meta‐analysis. Syst Rev. 2015; 4: 120. | |
dc.identifier.citedreference | Nikiforov YE, Seethala RR, Tallini G, et al. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: a paradigm shift to reduce overtreatment of indolent tumors. JAMA Oncol. 2016; 2 ( 8 ): 1023 ‐ 1029. | |
dc.identifier.citedreference | Francis GL, Waguespack SG, Bauer AJ, et al. Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid. 2015; 25 ( 7 ): 716 ‐ 759. | |
dc.identifier.citedreference | Monaco SE, Pantanowitz L, Khalbuss WE, et al. Cytomorphological and molecular genetic findings in pediatric thyroid fine‐needle aspiration. Cancer Cytopathol. 2012; 120 ( 5 ): 342 ‐ 350. | |
dc.identifier.citedreference | Pantola C, Kala S, Khan L, Pantola S, Singh M, Verma S. Cytological diagnosis of pediatric thyroid nodule in perspective of the Bethesda system for reporting thyroid cytopathology. J Cytol. 2016; 33 ( 4 ): 220 ‐ 223. | |
dc.identifier.citedreference | Partyka KL, Huang EC, Cramer HM, Chen S, Wu HH. Histologic and clinical follow‐up of thyroid fine‐needle aspirates in pediatric patients. Cancer Cytopathol. 2016; 124 ( 7 ): 467 ‐ 471. | |
dc.identifier.citedreference | Norlen O, Charlton A, Sarkis LM, et al. Risk of malignancy for each Bethesda class in pediatric thyroid nodules. J Pediatr Surg. 2015; 50 ( 7 ): 1147 ‐ 1149. | |
dc.identifier.citedreference | Lale SA, Morgenstern NN, Chiara S, Wasserman P. Fine needle aspiration of thyroid nodules in the pediatric population: a 12‐year cyto‐histological correlation experience at north shore‐Long Island Jewish health system. Diagn Cytopathol. 2015; 43 ( 8 ): 598 ‐ 604. | |
dc.identifier.citedreference | Rossi ED, Straccia P, Martini M, et al. The role of thyroid fine‐needle aspiration cytology in the pediatric population: an institutional experience. Cancer Cytopathol. 2014; 122 ( 5 ): 359 ‐ 367. | |
dc.identifier.citedreference | Smith M, Pantanowitz L, Khalbuss WE, Benkovich VA, Monaco SE. Indeterminate pediatric thyroid fine needle aspirations: a study of 68 cases. Acta Cytol. 2013; 57 ( 4 ): 341 ‐ 348. | |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.