Informativeness of cytological method of investigation in the morphologic diagnosis of thyroid nodules in children

• Rogova O.S.
• Lyubov’ N. Samsonova

Abstract

Objective. To appreciate the sensitivity and specificity of the cytomorphological method with diagnostic of the nosological variant of children's nodular goiter.

Material and methods. A comparison of the results of cytological and histological studies of thyroid nodules in 76 patients (55 girls, mean age 15.1+1.8 years, and 21 boys, mean age 14.2+3 years), which were operated in a multidisciplinary hospital from 2003 to 2015 because of the nodular goiter (the hospital is not licensed to treat patients with malignant neoplasms). Cytological findings were divided for 4 categories: "non-informative material", "benign education", "follicular neoplasia", "malignant formation".

Results. Analysis of the results of the cytological study showed that in 49% (37/76) of cases the conclusions were "non-informative material", 38% (29/76) - "benign education", 13% (10/76) - "follicular neoplasia", and there was not any conclusion is "malignant education".

The category "non-informative material" was presented with the same frequency as a truly uninformative material (57%, 21/37 cases) and incorrectly formulated conclusions (no signs of atypia, more data for goitre, data for oncopathology No, malignant cells were not found) in 43% (16/37, p>0.05) of the cases.

According to the results of a histological study, 54% (20/37) cases of colloidal proliferative sites were diagnosed in a category of non-informative cytological findings, 38% (14/37) - follicular adenoma, 8% (3/37) - papillary cancer. At the same time, as with the truly uninformative material (9%, 2/21), and in case of incorrectly formulated conclusions (6%, 1/16, p>0.05), papillary cancer was diagnosed by histological examination. Among the conclusions of the category "benign education" in 62% (18/29) of cases, according to the results of the histological examination, colloidal proliferating nodes were diagnosed in various degrees, in 35% (10/29) - follicular adenoma, in 3% (1/29) cases - Papillary cancer. Among the conclusions of the category "follicular neoplasia" in 60% (6/10) cases - follicular adenoma, in 30% (3/10) - colloid proliferating nodes in different degrees, in 10% (1/10) - papillary cancer.

Sensitivity of the cytomorphological method of diagnosis of nodular colloid goiter was 44%, specificity - 69%, follicular neoplasia 20% and 91%.

Conclusion. The results of the study showed a high percentage of the "non-informative material" category and identified malignant tumors in this category, which significantly reduces the sensitivity of the cytomorphological diagnostic method at the children's preoperative stage with nodular goiter and requires unification and optimization of both FNAB and cytological classification.

Keywords:nodular goiter in children, fine needle aspiration biopsy of thyroid nodules in children, sensitivity and specificity of the cytomorphological method, cytological classification of Bethesda Thyroid Classification

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