Characteristics of False-Negative Thyroid Fine-Needle Aspirates

Renshaw, Andrew A.; Gould, Edwin W.

doi:10.1159/000481722

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…It is important to underline the fact that, among patients who displayed growth in nodule volume at the end of the study, for 59 patients (79%) this started within the first five years of follow‐up. In addition, our data emphasized the high sensitivity rate of FNA, as the false‐negative score (3%) was superimposable to literature data obtained in larger series of nodules 26,27 …”

Section: Discussionsupporting

confidence: 85%

Ultrasound of benign thyroid nodules: A 120 months follow‐up study

Cappelli

Pirola

Gandossi

et al. 2021

Clinical Endocrinology

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Objective Some evidence suggests that most benign nodules exhibit no significant size increase during 5 years of follow‐up, although conflicting results have emerged. The aim of the present study is to evaluate the frequency and the magnitude of growth in benign nodules during 120 months of follow‐up. Design We reviewed the medical and imaging records of patients who were submitted to ultrasound‐guided FNA of thyroid nodules at our hospital from January 2007 to March 2009. We selected only patients with benign nodules who underwent annual ultrasound evaluation in our Department. Results Among 966 selected patients, 289 were lost during follow‐up, meaning that the total number of patients analysed was 677 (474 women and 203 men), with a mean age of 45.6 (16–71) years. In 559/677 patients (82.7%), the size of the nodule remained stable during follow‐up; 42 (6.2%) patients experienced spontaneous nodule shrinkage, and 75 (11.1%) patients showed nodule growth. Patients with or without nodule growth during follow‐up were superimposable at baseline for age, gender, TSH values, number of patients on levothyroxine treatment and nodule characteristics. All baseline variables in predicting nodular growth were entered to an adjusted multivariate logistic regression model. None of the parameters taken into account was associated with nodular growth. Conclusions In conclusion, the majority of benign nodules remained stable over the period of monitoring. On the basis of our experience, we recommend ultrasound examination at a distance of 2 and 5 years following cytological evaluation, then every 4–5 years from then on.

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Section: Discussionsupporting

confidence: 85%

Ultrasound of benign thyroid nodules: A 120 months follow‐up study

Cappelli

Pirola

Gandossi

et al. 2021

Clinical Endocrinology

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“…However, besides its wide usage as an effective triage test, it is also well-recognized that thyroid FNAB suffers from some limitations. 1,[4][5][6][7][8][9] Based on cellular and architectural features FNAB cannot distinguish between follicular patterned hyperplastic/ adenomatoid nodules, follicular adenoma and carcinoma, and some cases of follicular variant of papillary thyroid carcinoma. 10,11 Therefore, it is not unusual to consider thyroid FNAB as a screening test for follicular patterned lesions of thyroid and a diagnostic test for most papillary thyroid carcinoma and its variants, medullary thyroid carcinoma; and poorly differentiated and undifferentiated carcinoma.…”

Section: Introductionmentioning

confidence: 99%

The Bethesda System for Reporting Thyroid Cytology (TBSRTC): From look‐backs to look‐ahead

Baloch

LiVolsi

2020

Diagnostic Cytopathology

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The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formalized in October 2007 by experts in thyroidology at the National Institute of Health in Bethesda, Maryland. The first edition of the TBSRTC book was published in 2010 and the second edition in 2018. The TBSRTC is widely employed in cytology practices in the United States and has also served as a model for similar tiered classification schemes for reporting thyroid cytopathology specimens. The tremendous success of TBSRTC cannot be underscored, it has provided a diagnostic framework which is well aligned with the present and the future of thyroid nodule management.

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“…Consistent with our study, Shrestha et al 24 stated that the falsenegativity rates of >4 cm and 1-4 cm nodules in size were similar (7.1% and 6.3%, respectively), on the other hand it was statistically higher (15.8%) in nodules <1 cm in size. Renshaw et al 27 stated that the sensitivity of FNAB for 9 mm papillary carcinomas is 44.3%. Higher false-negative FNAB rates in small nodules can be explained by the technical difficulties and the sampling errors according to small size of the nodules.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the false negativity of fine-needle aspiration biopsy in thyroid nodules with indeterminate cytology

Özemir

2023

Cukurova Medical Journal

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Purpose: False negative results of fine needle aspiration biopsies (FNAB) remain one of the most important problems in the management of thyroid nodules. The aim of this study was to evaluate the factors affecting the false negative results of FNAB, especially in thyroid nodules with indeterminate cytology. Materials and Methods: Patients with thyroid nodules who underwent FNAB and subsequent thyroidectomy between January 2017 and January 2020 were included in the study. FNAB was performed on suspicious nodules according to the TIRADS classification. Nodules with "atypia/follicular lesion of undetermined significance (AUS/FLUS)", "non-diagnostic (ND)" cytology or "follicular neoplasm/suspicious for follicular neoplasm (FN/SFN)" according to FNAB were defined as "indeterminate cytology (IC)". Nodules were analyzed in two groups. Nodules with false negative FNAB were included in Group-1, while nodules with true positive and true negative FNAB were included in Group-2. Demographic and clinical data, pathologic results and genetic profiles of the patients were statistically compared for all patients and IC group separately. Results: The results of FNAB and final pathology were discordant in 94 patients (Group-1) and concordant in 233 patients (Group-2). In the IC subgroup, 56 of 95 patients were in IC/Group-1 and 39 patients were in IC/Group-2. The accuracy of FNAB was statistically significantly higher in the presence of extrathyroidal extension (71.4% vs. 30.8%), perineural/lymphovascular invasion (60.0% vs. 29.6%), classical variants (68.5% vs. 50.7%), non-encapsulated tumors (67.9% vs. 50.0%) and multicentricity (47.2% vs. 24.1%). In the IC group, the presence of thyroiditis (75.0% vs. 49.2%) and high serum Anti-TPO levels (60.0% vs. 30.7%) increased the rate of false negativity on FNAB. High serum Neutrophil to Lymphocyte Ratio (NLR) and small tumor size also increase the false negativity of FNAB, especially in IC group patients. Conclusion: The diagnostic accuracy of FNAB is increased in classical variant tumors and in tumors expected to be aggressive due to presence of extra-thyroidal extension, perineural/lymphovascular invasion, non-encapsulated tumors and multicentricity. It should be kept in mind that the false negative results of FNAB increase in the presence of thyroiditis, high level of serum anti-TPO and high level of NLR.

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Characteristics of False-Negative Thyroid Fine-Needle Aspirates

Cited by 10 publications

References 21 publications

Ultrasound of benign thyroid nodules: A 120 months follow‐up study

Ultrasound of benign thyroid nodules: A 120 months follow‐up study

The Bethesda System for Reporting Thyroid Cytology (TBSRTC): From look‐backs to look‐ahead

Factors affecting the false negativity of fine-needle aspiration biopsy in thyroid nodules with indeterminate cytology

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