Thyroid-Nodules in the Elderly - Clinical Management and Incidence of Malignancy as Determined by Fine-Needle Aspiration Biopsy

Ss, Raab; Veronezi-Gurwell, Adelaide

doi:10.3892/or.2.6.1151

Cited by 48 publications

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“…Hence it is difficult to claim that radioactivity played a causative role on nodule development in our study group. On the other hand, in different studies, thyroid nodule prevalence was found to be between 0.055% and 1.8% in school-age children (34,35). These prevalences were much lower compared with our results.…”

Section: Discussioncontrasting

confidence: 55%

Thyroid consequences of the Chernobyl nuclear power station accident on the Turkish population

Emral

Baştemir

Güllü

et al. 2003

European Journal of Endocrinology

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Objective: The Chernobyl accident caused widespread effects across Europe and huge areas were radiocontaminated. The major impact of the accident on human health was a sharp increase in childhood thyroid carcinoma and autoimmune thyroid diseases in exposed populations. The thyroidal effects of the Chernobyl accident have been investigated in most European countries, except Turkey. The aim of the current study was therefore to determine the thyroidal consequences of the Chernobyl nuclear power station accident in a selected Turkish population. Design: This study was designed as a sectional, area study, between October 2000 and March 2001, in two different regions of Turkey. According to the data of the Turkish Atomic Energy Authority, the eastern part of the Black Sea region was the most radiocontaminated area in Turkey at the time of Chernobyl accident, while Middle Anatolia was not seriously affected. Thus, Rize city, which is located in the eastern Black Sea region, served as a study area, and 970 adolescents, living in this region, comprised our study group (group R). On the other hand, Beypazarı, which is located in Middle Anatolia was choosen as the control region, and 710 adolescents living in this location were enrolled into the study as controls (group B). Methods: During the study, thyroid ultrasounds were performed in all subjects and thyroid volumes were calculated. World Health Organization and International Council for Control of Iodine Deficiency Disorders criteria were used for the determination of goiter. Thyroid fine-needle aspiration biopsy with ultrasound guidance was performed when a nodule was detected. Blood samples for thyroid function tests and thyroid autoantibodies, and urine samples for urinary iodine excretion were collected from all subjects. Results: Thyroid function tests were similar in both groups, but thyroid volumes were found to be higher in group B ð13:93^5:04 vs 17:66^5:58 ml; P , 0:001Þ: The prevalence of goiter was found to be 28.25% in group R and 61.95% in group B ðP , 0:001Þ: Thyroid nodules were determined in 6.28% of subjects in group R and 4.22% of subjects in group B ðP ¼ 0:065Þ: No malignant lesions were found in either of the regions. Although the percentage of autoantibody-positive subjects did not differ between groups (21.25% in group R vs 18.72% in group B), the mean antithyroglobulin level was found to be higher in group R ð63:25^378:60 vs 51:97^333:32 IU=ml; P , 0:001Þ and the mean anti-thyroid peroxidase level was higher in group B ð24:14^219:09 vs 48:82^568:50 IU=ml; P , 0:001Þ: The iodine status of the selected regions was found to be significantly different (median urinary iodine excretion was 131 mg/l in Rize and 54 mg/l in Beypazarı). Conclusions: Although there was a slight increase in nodule prevalence and thyroid antibody-positive subjects in the study group, it is hard to conclude that Turkey was affected by the Chernobyl accident. These results, at least the significant differences with regard to the prevalence of goiters between groups, m...

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Section: Discussioncontrasting

confidence: 55%

Thyroid consequences of the Chernobyl nuclear power station accident on the Turkish population

Emral

Baştemir

Güllü

et al. 2003

European Journal of Endocrinology

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“…[1][2][3][4][5][6][7][8][9][10] Of these malignancies, papillary thyroid carcinoma (PTC) is the most common type and comprises the majority of these malignancies.…”

Section: Introductionmentioning

confidence: 99%

Cytomorphological and molecular genetic findings in pediatric thyroid fine‐needle aspiration

Monaco

Pantanowitz

Khalbuss

et al. 2012

Cancer Cytopathology

145

167

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BACKGROUND: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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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;120:342-50. V C 2012 American Cancer Society.

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“…Devido à grande freqüência de carcinoma em crianças e adolescentes com nódulo tireoidiano, a biópsia excisional é preferida à punção aspirativa com agulha fina (PAAF), em contraste com adultos. No entanto, estudos recentes têm mostrado que em mãos experientes, a PAAF pode ser útil no manejo de nódulos tireoidianos em crianças 7 . Das seis pacientes, duas foram submetidas a punção aspirativa do nódulo, com laudo citológico compatível com o anátomo-patológico pós-operatório de carcinoma papilífero.…”

Section: Discussionunclassified

“…As outras foram submetidas a biópsia excisional. A histologia mostrou um total de quatro carcinomas papilíferos e dois carcinomas foliculares; esta maior incidência de carcinoma papilífero também é registrada por outros autores [1][2][3][4][7][8][9] .…”

Section: Discussionunclassified

Carcinoma de tireóide em crianças e adolescentes - revisão de seis casos

Szeliga¹,

Setian²,

Passos³

et al. 2001

J. Pediatr. (Rio J.)

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ResumoObjetivo: O carcinoma de tireóide é raro em crianças, e existem aspectos controversos sobre seu manejo. Este estudo foi realizado para avaliar aspectos diagnósticos e de seguimento destes pacientes.Métodos: Foi revisada retrospectivamente a evolução clínica de seis pacientes com carcinoma de tireóide, seguidos em Unidade de Endocrinologia Pediátrica nos últimos 17 anos.Resultados: Foram encontrados seis pacientes com carcinoma de tireóide, todos do sexo feminino, com idade de 4,5 a 12 anos. Nódulo tireoidiano esteve presente na avaliação inicial em todos os casos. A ultra-sonografia e cintilografia com 131 I mostraram nódulo sólido e hipocaptante em quatro pacientes. Histologicamente, quatro eram carcinomas papilíferos, e dois foliculares. Todos foram submetidos à tireoidectomia total, sendo que quatro necessitaram também dose terapêutica de 131 I devido a metástases e/ou resíduo tireoidiano.Conclusão: Nossos achados confirmaram a impressão clínica de que crianças e adolescentes com carcinoma tireoidiano têm um bom prognóstico, sem haver registro de óbito neste seguimento de até 17 anos. Estes dados estão de acordo com a literatura, que mostra baixa mortalidade nestes casos.J Pediatr (Rio J) 2001; 77(1):45-48: tireóide, carcinoma de tireóide, nódulo tireoidiano, crianças e adolescentes. AbstractObjective: Thyroid carcinoma occurs rarely in children, and there are controversial aspects about its management. This study was carried out to evaluate diagnostic and follow-up aspects of these patients.Methods: The clinical courses of six patients with thyroid cancer followed in a Pediatric Endocrinology Unit for 17 years were retrospectively reviewed.Results: There were six females ranging in age from 4.5 to 12 years. At initial examination thyroid nodules were present in all cases. The ultrasonography and 131 I scan showed solid and cold nodules in four patients. Histologically, four were papillary and two were follicular carcinomas. All of them underwent total thyroidectomy, four also had to do radioiodine therapy because of the presence of metastasis and/or thyroid remnants.Conclusions: Our findings support the clinical impression that children and adolescents with thyroid carcinoma have a good prognosis: there were no deaths in this follow-up of 17 years. These data are similar to those in the literature, that reveals low mortality in these cases.J Pediatr (Rio J) 2001; 77(1):45-48 Introdução O carcinoma de tiróide é uma entidade rara nas primeiras duas décadas de vida. Estima-se que apenas 10% do total destes carcinomas ocorra nesta faixa etária 1 . Na população geral, sua ocorrência é de um caso novo por milhão de pessoas por ano 2 , com pico de incidência entre os 10 e os 20 anos 3 , correspondendo a 0,5-3% das doenças malignas em crianças e adolescentes 1 . Afeta mais meninas que meninos, numa proporção de 2-2,5:1 1,4 . Em áreas com fatores de risco, como na República de Belarus, devido ao acidente atômico de Chernobyl, a ocorrência pode alcançar até 80-100 por milhão por ano 2 .O tipo histológico mais co...

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Thyroid-Nodules in the Elderly - Clinical Management and Incidence of Malignancy as Determined by Fine-Needle Aspiration Biopsy

Cited by 48 publications

References 0 publications

Thyroid consequences of the Chernobyl nuclear power station accident on the Turkish population

Thyroid consequences of the Chernobyl nuclear power station accident on the Turkish population

Cytomorphological and molecular genetic findings in pediatric thyroid fine‐needle aspiration

Carcinoma de tireóide em crianças e adolescentes - revisão de seis casos

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