Characteristic Sonographic and Follow Up Features of Thyroid Nodules According to Childhood Age Groups

• Main Authors: Bo Da Nam, Yun-Woo Chang, Seong Sook Hong, Ji-Young Hwang, Hyun Kyung Lim, Jeong Ho Lee, Dong Hwan Lee
• Format: Article
• Language: English
• Published: The Korean Society of Radiology 2016-08-01
• Series: 대한영상의학회지
• Subjects: thyroid nodule; ultrasonography; pediatrics
• Online Access: https://doi.org/10.3348/jksr.2016.75.2.126

Purpose We analyzed the spectrum and the significance of pediatric thyroid nodules depicted on sonography and evaluated the follow-up change according to the age group. Materials and Methods We retrospectively reviewed the sonographic features of 82 nodules in 69 patients (6.6%) among 1282 children less than 13 years of age without a palpable lesion, from January 2006 to January 2013. Patients were divided into three age groups; infants, preschoolers, and schoolers. Thyroid nodules were evaluated according to their sonographic characteristics (simple cyst, colloid cyst, solid mass, or intrathyroid thymus) and the changes detected at follow-up (disappearance, decrease in size, no change or increase in size) were reported. Results There was a significant difference in the nodule patterns among the age groups (p < 0.001). The nodules in infants included a simple cyst (n = 12), a solid mass (n = 12), or an intra-thyroid thymus (n = 9). The preschoolers had a simple cyst (n = 11), a colloid cyst (n = 5), a solid mass (n = 3) or an intra-thyroid thymus (n = 5). However, the schoolers had a simple cyst (n = 2), a colloid cyst (n = 18), and a solid mass (n = 5), but there was no case of intra-thyroid thymus. Follow-up of 38 cases revealed significant differences among the age groups (p = 0.018). The nodules in infants showed findings such as disappearance of nodules (n = 9) and no change (n = 10) on follow-up sonography. In preschoolers, the nodules had disappeared (n = 2), decreased in size (n = 1), and showed no change (n = 11). However, the nodules in schoolers were found to be decreased in size (n = 1), show no change (n = 2), and increased in size (n = 2). The proven pathologic finding was benign in four patients. Conclusion There were significant differences in the prevalence and the interval change of thyroid nodules among infants, preschoolers, and schoolers. A large series of intrathyroid thymus was seen in infants and preschoolers, and masses did not increase in size in these age groups. The frequency of a colloid cyst could be increased in schoolers, and masses were increased in size in this age group, but none of the patients showed a malignant finding on pathology.