Benign | Comments |
Multinodular (sporadic) goiter ("colloid adenoma") | Colloid adenomas are the most common type of thyroid nodule in certain pediatric populations |
Hashimoto (chronic lymphocytic) thyroiditis | Autoimmune, often multinodular by ultrasonography |
Cysts (colloid, simple, or hemorrhagic) | Pure "simple" cysts are always benign; a cyst may be combined with a solid component in colloid nodules |
Follicular adenomas | |
Macrofollicular adenomas | |
Microfollicular or cellular adenomas | |
Hürthle cell (oxyphil cell) adenomas | Rare in childhood Hürthle cell changes can be seen in degenerating follicular adenomas or with Hashimoto thyroiditis |
Malignant | Comments |
Differentiated thyroid cancer | |
Papillary carcinoma (includes NIFTP) | >85% of pediatric thyroid cancers[1] Bilateral disease is common; primarily lymphatic spread Recurrence rate <1% for NIFTP in adults |
Follicular carcinoma:
| 8 to 9% of pediatric thyroid cancers[1] Typically unifocal; primarily hematogenous spread |
Hürthle cell (oxyphil cell) carcinoma | Uncommon in childhood |
Medullary carcinoma | 4% of pediatric thyroid cancers[1]; most are associated with MEN2 |
Anaplastic carcinoma | Very rare in childhood |
Primary thyroid lymphoma | Rare in childhood |
Metastatic carcinoma (renal cell carcinoma, others) | Rare in childhood |
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