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Cytomorphological and molecular genetic findings in pediatric thyroid fine-needle aspiration†
Article first published online: 17 MAY 2012
Copyright © 2012 American Cancer Society
Volume 120, Issue 5, pages 342–350, 25 October 2012
How to Cite
Monaco, S. E., Pantanowitz, L., Khalbuss, W. E., Benkovich, V. A., Ozolek, J., Nikiforova, M. N., Simons, J. P. and Nikiforov, Y. E. (2012), Cytomorphological and molecular genetic findings in pediatric thyroid fine-needle aspiration. Cancer Cytopathology, 120: 342–350. doi: 10.1002/cncy.21199
Presented in part at the United States and Canadian Academy of Pathology (USCAP) Annual Meeting; March 17-23, 2012; Vancouver, BC, Canada.
- Issue published online: 12 OCT 2012
- Article first published online: 17 MAY 2012
- Manuscript Accepted: 6 MAR 2012
- Manuscript Revised: 20 FEB 2012
- Manuscript Received: 24 JAN 2012
- fine-needle aspiration;
The Bethesda System for Reporting Thyroid Cytopathology is largely based on data from adult studies. Although thyroid nodules in children are rare, the rate of malignancy is high. The authors' aim was to analyze the cytomorphology and mutational profiles in pediatric thyroid fine-needle aspirations (FNAs).
Thyroid FNAs from patients 21 years old or younger were identified from the authors' pathology archive, categorized using the Bethesda System for Reporting Thyroid Cytopathology, and correlated with histological and molecular follow-up.
A total of 179 samples from 142 patients were identified, including 96 cases (54%) with histological follow-up and 66 cases (37%) with molecular data. The diagnoses included 21 (12%) unsatisfactory, 82 (46%) negative, 43 (24%) atypia or follicular lesion of undetermined significance, 19 (11%) suspicious for follicular neoplasm, 6 (3%) suspicious for malignancy, and 8 (4%) positive for malignancy. The rate of malignancy in each category was 0%, 7%, 28%, 58%, 100%, and 100%, respectively. Of the 66 FNAs with molecular data, there were 11 (17%) positive for mutations. All mutation-positive FNAs were papillary thyroid carcinomas (PTCs) on resection. The overall sensitivity and specificity in this population were 80% and 100%, respectively.
This study demonstrates that thyroid FNA in children is a sensitive and highly specific tool. There was a 17% positivity rate for a genetic mutation, which correlated with malignancy in all cases. In comparison to adults, there was a higher prevalence of RET/PTC mutations and lower prevalence of BRAF mutations, which may in part explain the less aggressive nature of PTCs reported in children. Cancer (Cancer Cytopathol) 2012. © 2012 American Cancer Society.