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Fine-needle aspiration of the thyroid and correlation with histopathology in a contemporary series of 240 patients. Am J Surg 2003 Dec;186(6):702-9; discussion 709-10

Date

12/16/2003

Pubmed ID

14672783

DOI

10.1016/j.amjsurg.2003.08.015

Scopus ID

2-s2.0-0346850981 (requires institutional sign-in at Scopus site)   225 Citations

Abstract

BACKGROUND: False-positive, false-negative, and indeterminate fine-needle aspiration (FNA) biopsy results complicate the management of patients with thyroid nodules.

METHODS: Thyroid FNA results from 240 consecutive patients (seen 1991 to 2002) were categorized into four groups: positive for malignancy, negative for malignancy, indeterminate for malignancy, and nondiagnostic. Indeterminate results included follicular neoplasm, Hürthle cell neoplasm, and suspicious for papillary carcinoma. The FNA results were compared with histopathologic analysis after thyroidectomy.

RESULTS: The FNA results were 76 (32%) positive for malignancy, 53 (22%) negative for malignancy, 100 (42%) indeterminate for malignancy, and 11 (5%) nondiagnostic. There were 3 (4%) false-positive and 2 (4%) false-negative FNA results. Among the 100 indeterminate FNA results, carcinoma was found in 11 (15%) of 73 follicular neoplasms, 2 (20%) of 10 Hürthle cell neoplasms, and 14 (82%) of 17 suspicious for papillary carcinoma. For the 73 patients with follicular neoplasms, nodule diameter >2 cm was associated with an increased risk of malignancy (P <0.03).

CONCLUSIONS: False-negative FNA results are uncommon, supporting the practice of observation in most of these patients. Among those with indeterminate biopsy results, high-risk subgroups include patients with FNA results suspicious for papillary carcinoma and follicular neoplasms >2 cm.

Author List

Sclabas GM, Staerkel GA, Shapiro SE, Fornage BD, Sherman SI, Vassillopoulou-Sellin R, Lee JE, Evans DB

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adenoma, Oxyphilic
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy, Fine-Needle
Carcinoma, Papillary
Child
Child, Preschool
Cytodiagnosis
Diagnostic Errors
Female
Humans
Male
Middle Aged
Thyroid Gland
Thyroid Neoplasms
Thyroid Nodule