No abstract

BACKGROUND:The most common malignant thyroid neoplasm in children is papillary thyroid carcinoma (PTC). In 2015, the Endocrine Pathology Society introduced the terminology "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) to replace the noninvasive follicular variant of PTC. The objective of the current study was to evaluate previously diagnosed PTC in the pediatric population, reappraise it for NIFTP, and discuss the impact of NIFTP on the risk of malignancy (ROM) for each The Bethesda System for Reporting Thyroid Cytopathology category in the pediatric population. METHODS: The electronic databases of both study institutions were searched for all thyroidectomy specimens in patients aged <19 years from June 1, 2001 through June 1, 2016. The patient's age, sex, diagnosis, previous fine-needle aspiration cytology diagnosis, and follow-up were tabulated. Slides for available cases were reviewed and cases qualifying as NIFTP were separated. RESULTS: The cohort included 101 resected nodules; cytological diagnoses were available for 95 cases. These cases included diagnoses of nondiagnostic (5 cases; 5.2%), benign (21 cases; 22.1%), atypia/follicular lesion of undetermined significance (9 cases; 9.5%), follicular neoplasm/suspicious for follicular neoplasm (FN/SFN) (25 cases; 26.3%), suspicious for malignancy (7 cases; 7.4%), and malignant (28 cases; 29.5%). On the histological follow-up, 50 cases (49.5%) were benign, 49 cases (48.5%) were malignant, and 2 cases (1.9%) were NIFTP. These NIFTP cases originally were diagnosed as FNs on fine-needle aspiration cytology. The average ROM for FNs with and without NIFTPs was 28% and 25%, respectively CONCLUSIONS: According to our rate of 1.9% for NIFTPs on reappraisal for resected nodules, this entity is likely to be less frequent in the pediatric population due to the higher prevalence of PTCs and/or more aggressive variants. NIFTPs do not appear to affect the ROM for The Bethesda System for Reporting Thyroid Cytopathology categories in the pediatric population. However, large-scale studies are necessary to determine whether NIFTPs could affect the pediatric population.

The composite, US-based risk stratification criteria from the 2015 ATA Guidelines may provide an appropriate and reproducible method for estimating risk of malignancy for pediatric thyroid nodules.

The PAIR technique was found to be an effective and safe approach in order to treat Gharbi type 1 and type 2 cysts percutaneously for outpatients. It has a very low complication rate in comparison with the catheterization technique. So every effort should be made to finish the treatment with PAIR technique.

Obese patients have a higher mean IOP and lower flow velocity than non-obese patients. Increased IOP together with decreased retrobulbar blood flow, particularly in obese individuals, may increase the risk of glaucoma development.