An analysis of fine-needle aspiration biopsy of the thyroid in children and adolescents.

Fine-needle aspiration biopsy (FNAB) has proven safe and efficacious in the evaluation nodular thyroid disease in adults. Only one study has evaluated FNAB exclusively in children, for whom the prevalence of thyroid nodules and the probability of malignancy are different. In addition, no study has compared the accuracy of FNAB with that of other diagnostic procedures in the evaluation of thyroid nodules in children. The authors report the results of FNAB in 18 children evaluated for thyroid nodules between 1985 and 1994. The overall accuracy of FNAB was similar to that of other diagnostic procedures, including thyroid scintiscan and ultrasonography, but none of these was sufficiently accurate to be used as the sole predictor of malignancy. There were three false-negative biopsy results; this limited the overall accuracy and suggests that children with negative FNAB results should be monitored cautiously.