Objective: The objectives were to evaluate fine needle aspiration cytology results of 39 pediatric patients, and the pathologies that cause childhood thyroid nodules, and to review the literature on the subject.

Material and Method: Thyroid fine needle aspiration cytology results of 39 pediatric patients were retrospectively reviewed. Associated diseases, thyroid functions, anti-thyroid antibody levels, ultrasonographic findings and number of nodules were also evaluated.

Results: The vast majority of patients with thyroid nodules were cytopathologically diagnosed as benign (97.3%). Of these patients, 64.8% (24 patients) were diagnosed as nodular goiter and 35.2% (13 patients) as lymphocytic thyroiditis. Thyroid malignancy was found in two patients; one was diagnosed as follicular neoplasm/ minimal invasive follicular carcinoma on surgical evaluation while the other was a secondary tumor (Burkitt's lymphoma). The majority of our subjects were females (66.6%): the female/male ratio was 2:1 for nodular goiter and 3.3:1 for thyroiditis. Surgical resection was performed in 5 patients (4 cases of nodular goiter, 1 suspicious for malignancy) and cytological diagnoses were confirmed by histology.

Conclusion: Our study confirmed the utility of fine needle aspiration cytology in childhood thyroid disorders along with a possible higher incidence of nodular thyroiditis in childhood. Nodular autoimmune thyroiditis, focal thyroiditis and thyroid cancer in children are discussed and attention is drawn to some special subtypes of thyroid cancer and some benign lesions that can cause difficulty in interpreting fine needle aspiration cytology and frozen sections at this age.