Fine needle aspiration biopsy of thyroid nodules

BACKGROUND—Fine needle aspirationbiopsy (FNA) is a routine diagnostic technique for evaluating thyroidnodules. Many reports in adults consider that FNA is superior tothyroid ultrasonography (USG) and radionuclide scanning (RS). Only fivestudies have been published on FNA of childhood thyroid nodules.
AIMS—To investigate the reliabilityof FNA in the evaluation and management of thyroid nodules, and comparethe results of FNA, USG, and RS with regard to final histopathological diagnosis.
METHODS—FNA was performed in 46 children with thyroid nodules after USG and RS examination. Weinvestigated the sensitivity, specificity, accuracy, and positive andnegative predictive values of USG, RS, and FNA in their management.
RESULTS—Six patients who hadmalignant or suspicious cells on FNA examination underwent immediatesurgery. The other 40 patients received medical treatment according totheir hormonal status. Fifteen of these nodules either disappeared ordecreased in number and/or size. Surgery was performed in 25 patientswho did not respond to therapy. Statistical analysis revealedsensitivity, specificity, accuracy, and positive and negativepredictive values respectively as follows: 60%, 59%, 59%, 15%, and92% for USG; 30%, 42%, 39%, 12%, and 68% for SC; 100%, 95%,95%, 67%, and 100% for FNAB.
CONCLUSION—FNAB is as reliable inchildren as in adults for definitive diagnosis of thyroid nodules.Using this technique avoids unnecessary thyroid surgery in children.