Is ultrasonography useful in predicting thyroid cancer in children with thyroid nodules and apparently benign cytopathologic features?

• Published in: Hormone research in paediatrics Vol. 75; no. 4; p. 269
• Main Authors: Saavedra, Jannette, Deladoëy, Johnny, Saint-Vil, Dickens, Boivin, Yvan, Alos, Nathalie, Deal, Cheri, Van Vliet, Guy, Huot, Céline
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2011
• Subjects: Adolescent; Biopsy, Fine-Needle; Child; Diagnosis, Differential; Female; Humans; Male; Medical Records; Retrospective Studies; Sensitivity and Specificity; Thyroid Gland - diagnostic imaging; Thyroid Gland - pathology; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - pathology; Thyroid Nodule - diagnostic imaging; Thyroid Nodule - pathology; Ultrasonography
• ISSN: 1663-2826
• DOI: 10.1159/000322877

To assess whether the presence of certain findings on thyroid ultrasonography (US) correctly diagnoses malignancy even when a fine-needle aspiration biopsy (FNAB) suggests a benign lesion.
We reviewed the charts of 35 children and adolescents with a thyroid nodule who had had an US and a FNAB, and for whom final pathology was available.
The global accuracy of FNAB was 83%, with a sensitivity of 75% and a specificity of 94%. 14 FNABs suggested malignancy (40%), only 1 of which was a false positive (7%). By contrast, 5 of the 21 FNABs suggesting benign lesions were false negatives (24%). These 5 cases had US findings suggestive of malignancy. When FNAB suggested a benign lesion, US had a good sensitivity (80%) but a poor specificity and accuracy (50 and 57%, respectively); its negative predictive value was 90% and its positive predictive value 36%.
US complements FNAB in the evaluation of thyroid nodules in children. A more aggressive approach is warranted in children with a thyroid nodule and a benign FNAB if US findings suggest malignancy.