Fine-needle aspiration of thyroid nodules

✍ Scribed by Sidawy, Mary K. ;Vecchio, David M. Del ;Knoll, Stanley M.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 355 KB
• Volume: 81
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19970825)81:4<253::aid-cncr7>3.0.co;2-q

✦ Synopsis

Background:

The purpose of this study was to evaluate the results of thyroid fine-needle aspiration (fna) and to determine the reasons for the discrepancies between the cytologic and histologic diagnoses.

Methods:

The authors evaluated the cytologic and histologic results of 133 fnas obtained from 92 patients who underwent subsequent thyroidectomies.

Results:

The initial cytologic results were indeterminate in 39 of 133 cases (29%) because a neoplasm could not be ruled out. these cases corresponded histologically to 9 adenomatoid nodules (ans), 14 follicular adenomas (fas), and 16 malignant thyroid neoplasms. the reported fna diagnoses of the remaining 94 cases (71%) were 48 ans, 19 follicular neoplasms (fns), 21 papillary carcinomas (pcs), and 6 cases of hashimoto's thyroiditis (ht). correlation of cytology and histology showed that 69 of 94 fna results (73%) correlated with the histologic diagnoses, whereas 25 (27%) were discrepant. the discrepancies resulted from cytodiagnostic errors in 13 cases (52%), suboptimal smears in 11 (44%), and an fna sampling error in 1 (4%). the false-negative rate of fna was 19% and the false-positive rate was 6%.

Conclusions:

Diagnostic pitfalls and indeterminate fna diagnoses were predominantly due to overlapping cytologic criteria between ans, fns, and follicular variants of pcs. rendering a definite diagnosis on suboptimal fna samples is also a significant source of pitfalls.