Summary of the cytological diagnosis of childhood thyroid diseases around Chernobyl

摘要

A combination of ultrasonography and fine-needle aspiration biopsy was performed in the screening project on children around Chernobyl. The aspirated materials from 446 cases were analyzed cytologically. The ultrasonographical screening revealed a 2,9% prevalence of thyroid abnormalities, Fine-needle aspiration biopsy (FNA), conducted in 446 cases, revealed the following diseases: papillary carcinoma, 7.2%; follicular neoplasm, 10.3%; adenomatous goiter, 22.4%; chronic thyroiditis, 26.2%; and cyst, 22.9%. We evaluated the detail of findings of papillary carcinoma. Intranuclear inclusion and nuclear grooving were encountered in 7.5% and 85%, respectively. Psammoma body was encountered in about .50% of the cases. Nuclear atypism as defined by pleomorphism and the ratio of nucleus to cytoplasm were relatively conspicuous. The cytological characteristics of pediatric papillary carcinoma revealed diagnostic findings almost the same as those in adult cases, with the noteworthy exception of high prevalence ofpsammoma body, which seems to be specific to the Chernobyl cases. We also analyzed 47 cases of chronic thyroiditis diagnosed by fine-needle aspiration biopsy. Prominent epithelial hyperplasia was encountered in 23.4%, and Askinazy cell metaplasia was present in 55.3%. The presence of epithelial changes suggests that thyroiditis has existed for a long time or that thyroid follicles are destructed heavily in children. In this viewpoint, the Chernobyl cases are classified into auto-immune thyroiditis or Hashimato thyroiditis. This study suggests that childhood thyroid diseases, including both neoplasms and immunological disorders, are considered to be an ideal follow-up disease for monitoring the late effect of radioactive fallout.