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- W2170204308 abstract "After viewing this exhibit, attendees will be able to 1) describe the prevalence and risk of malignancy of thyroid nodules in children, 2) understand the diagnostic workup for clinically detected thyroid nodules and indications for fine needle aspiration (FNA), 3) formulate a differential diagnosis for pediatric thyroid nodules, 4) understand how to safely perform an FNA in children, 5) recognize the imaging features and cytologic appearance of ectopic thymus mimicking a thyroid nodule. Thyroid nodules are less common in children than adults, with a prevalence of <1.5%, but are more likely to be malignant (26% vs 5%). Workup of a clinically detected thyroid nodule includes laboratory evaluation, thyroid ultrasound, and FNA. FNA exhibits sensitivity and specificity for malignancy of 94% and 81%. The differential diagnosis for pediatric thyroid nodules is similar to adults, but also includes pediatric specific entities such as acute suppurative thyroiditis, congenital cysts, and ectopic thymus. Thymic tissue may be located anywhere along the thymopharyngeal duct, from the hypopharynx to the superior mediastinum, and demonstrates characteristic features on ultrasound. Sedation is usually required for ultrasound-guided FNA in children to reduce the risk of motion and injury to surrounding structures. A 22- to 27-gauge needle may be used, depending on the preference of the interventionalist and pathologist. Smaller gauge needles may produce less hemorrhagic specimens with lower nondiagnostic rates. Yield may be maximized by obtaining specimens with both aspiration and capillary techniques. On-site review by cytopathology is employed in our institution to ensure sample adequacy and decrease need for repeat procedures. If thymic tissue is suspected, the interventionalist should notify the pathologist, since without the use of special stains the sample may falsely appear inadequate due to lack of follicular cells. The pediatric interventional radiologist plays a key role in the evaluation of pediatric thyroid nodules. Ectopic thymus may mimic thyroid nodules in children, and requires high suspicion to prevent incorrect diagnosis and unnecessary surgery." @default.
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- W2170204308 date "2015-02-01" @default.
- W2170204308 modified "2023-09-26" @default.
- W2170204308 title "Pediatric thyroid nodules: role of the pediatric interventional radiologist and review of a pediatric specific entity" @default.
- W2170204308 doi "https://doi.org/10.1016/j.jvir.2014.12.548" @default.
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