Pathology and Cytology of Thyroid Diseases in Pediatric Population
Thyroid diseases are rarely seen in childhood and are similar to thyroid diseases seen in adults.
The major diseases encountered during childhood are Hashimoto thyroiditis, Graves’ disease, and multinodular or adenomatous goiter. Palpable thyroid nodules are present in 1.5% of child population. Palpable or nonpalpable thyroid nodules may be either of benign or malignant nature. The benign nodules may be solitary nodule or follicular adenoma, multinodular goiter (MNG), toxic MNG, nodules on Graves’ disease background, and dyshormonogenetic goiter. Malignant nodules may be follicular cell origin, such as papillary, follicular, poorly differentiated, and undifferentiated carcinoma, but may also be medullary thyroid carcinoma of C cell origin. Dyshormonogenetic goiter is another disease presenting with thyroid nodules caused by autosomal recessive inherited defects of thyroid hormone synthesis. Fine needle aspiration (FNA) of dyshormonogenetic goiter demonstrates similar characteristics to follicular neoplasia and follicular variant papillary thyroid carcinoma or noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and should be included in the differential diagnosis of fine needle aspiration examination of thyroid nodules in the pediatric population.
Since thyroid disease has the same cytological findings in adults and pediatric population, cytological and histopathological features and differential diagnosis of dyshormonogenetic goiter which is more common to childhood are discussed at length.
KeywordsPediatric Thyroid Goiter Dyshormonogenetic goiter FNA Cytology Thyroid carcinoma Toxic adenoma Immunohistochemistry
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