Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Thyroid fine needle aspiration cytology in children and adolescents

Moslavac, Sandra and Mateša, Neven and Kusić, Zvonko (2010) Thyroid fine needle aspiration cytology in children and adolescents. Collegium Antropologicum, 34 (1). pp. 197-200. ISSN 0350-6134

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    Croatian abstract

    CITOLOŠKA PUNKCIJA ŠTITNJAČE U DJECE I ADOLESCENATA ----- Punkcija štitnjače je najtočnija i najracionalnija metoda u diferencijalnoj dijagnostici čvora štitnjače koja se rutinski izvodi kod odraslih pacijenata. Pojava čvora u štitnjači je rijetka kod mladih osoba i javlja se u 1–2% mladih osoba. Cilj istraživanja je naći relevantne kliničke i citološke pokazatelje u navedenoj demografskoj grupi pacijenata. Učinjena je retrospektivna analiza ultrazvučno navođenih punkcija štitnjače u razdoblju od svibnja 1995. do lipnja 2008. u pacijenata mlađih od 18 godina. Praćeni su klinički parametri: dob, spol, broj i veličina čvorova u štitnjači i citološki parametri (citološka dijagnoza i cito-patohistološka korelacija). Od ukupno učinjenih 11748 punkcija štitnjače, 236 (2%) je zadovoljilo dobni kriterij (aspiracija u 206 pacijenata mlađih od 18 godina). Starost pacijenata bila je 2–18 godina (prosjek 14), od toga 180 (87,4%) djevojčica i 26 (12,6%) dječaka (odnos djevojčice:dječaci =4:1). Za 56 pacijenata bili su poznati podaci o nalazu i broju čvorova u štitnjači, od toga 20 (35,7%) pacijenata nije imalo čvorove, 20 (35,7%) pacijenata je imalo jedan čvor u štitnjači a 16 (28,6%) pacijenata je imalo više od jednog čvora u štitnjači. Veličina čvora varirala je od 0,4 do 5,4 cm (prosjek 1,4 cm). Citološke dijagnoze bile su: nezadovoljavajuće za interpretaciju (9), cistična tekućina (7), benigno (204), celularna folikularna promjena/folikularna neoplazma (9) i papilarni karcinom štitnjače (7). Učestalost maligne promjene u citološkoj dijagnozi bila je 3,4%. Za 21 operiranog pacijenta bila je poznata patohistološka dijagnoza: 5 pacijenata (23,8%) imalo je malignu bolest štitnjače (papilarni karcinom), ostali su imali benigne promjene u štitnjači: folikularni adenom (8), multinodularna struma (5), difuzna struma (2) i Hashimoto tireoiditis (1). Nije bilo lažno pozitivnih niti lažno negativnih citoloških dijagnoza. Prevalencija malignih bolesti štitnjače u postavljenim citološkim dijagnozama slična je prevalenciji u odraslih. Kod pacijenata za koje je postojala patohistološka dijagnoza, dijagnostička točnost citološke metode bila je 100%.

    English abstract

    Thyroid fine needle aspiration cytology (FNAC) is the most accurate and cost effective method in the evaluation of the thyroid nodule and has been commonly used in adults. Thyroid nodules are uncommon in younger patients (1–2%). Our aim was to determine some relevant clinical and cytological parameters in this demographic group. Ultrasound-guided thyroid FNACs performed from May 1995 to June 2008 in patients under 18 years of age were retrospectively reviewed. The following clinical parameters were retrieved: age and gender, number of nodules, and nodule size. Cytological parameters included cytologic diagnosis and cyto-pathohistological correlation. Total of 236 cases, representing 206 patients under 18 years of age, were retrieved from a total of 11748 thyroid FNAC cases (2.0%). The patient’s age ranged from 2 to 18 years (mean 14). There were 180 (87.4%) females and 26 (12.6%) males with a female/male ratio 4:1. For 56 patients data concerning the number of nodules were recorded. 20 (35.7%) patients did not have any nodules, 20 (35.7%) patients had solitary thyroid nodule and 16 (28.6%) patients had multiple nodules. The size of nodules ranged from 0.4–5.4 cm (mean 1.4 cm). The cytologic diagnoses were: unsatisfactory (9), cyst fluid (7), benign (204), cellular follicular lesion/follicular neoplasm (9) and papillary thyroid carcinoma (7). The prevalence of malignancy among cytologic diagnoses was 3.4%. 21 patients had surgical follow up. 5 patients (23.8%) had thyroid malignancies (all papillary carcinomas). The remainder had benign thyroid lesions; follicular adenomas (8), multinodular goiters (5), diffuse goiters (2) and Hashimoto thyreoiditis (1). There were no false negative or false positive cytologic diagnoses. The prevalence of thyroid malignancies among cytologic diagnoses was similar to those reported in adults. In limited number of patients with surgical follow up there were no false negative or false positive cytologic diagnoses.

    Item Type: Article
    MeSH: Adenocarcinoma, Follicular/epidemiology ; Adenocarcinoma, Follicular/pathology ; Adenocarcinoma, Follicular/surgery ; Adolescent ; Biopsy, Fine-Needle/standards ; Biopsy, Fine-Needle/statistics & numerical data ; Carcinoma, Papillary/epidemiology ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery ; Child ; Child, Preschool ; Croatia/epidemiology ; Female ; Goiter, Nodular/epidemiology ; Goiter, Nodular/pathology ; Goiter, Nodular/surgery ; Hashimoto Disease/epidemiology ; Hashimoto Disease/pathology ; Hashimoto Disease/surgery ; Humans ; Male ; Prevalence ; Reproducibility of Results ; Thyroid Diseases/epidemiology ; Thyroid Diseases/pathology ; Thyroid Diseases/surgery ; Thyroid Gland/pathology ; Thyroid Neoplasms/epidemiology ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery
    Divisions: Katedra za radiologiju i opću kliničku onkologiju
    Depositing User: Marijan Šember
    Status: Published
    Creators:
    CreatorsEmail
    Moslavac, Sandra
    Mateša, Neven
    Kusić, Zvonko
    Date: March 2010
    Date Deposited: 27 May 2010
    Last Modified: 23 Sep 2011 18:11
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/798

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