Fine‐needle aspiration versus large‐needle biopsy or cutting biopsy in evaluation of thyroid nodules

Abstract

This report describes our experience with both fine-needle aspiration (FNA) biopsies and large-needle biopsies (LNB) or core biopsies (CB) performed at the same time on 23 patients out of a series of 309 patients examined by the FNA technique. There was no significant differences in diagnostic accuracy of tissue obtained with the FNA technique when compared with the LNB or CB biopsy technique. While FNA always yielded tissue adequate for diagnosis, the LNB, and/or CB technique yielded tissue insufficient for diagnosis in four of 26 biopsies (15.4%). We believe that the FNA is better able to sample a mass with fewer insufficient specimens. Using FNA, the diagnosis can be rendered more rapidly, at lower cost, and with decreased potential for complications. The adequacy of the FNA biopsies can be assessed immediately using a modified Wright stain (Diff-Quik). Repeat biopsies can be performed that better sample the lesions with increased patient acceptance.

Thin core needle biopsy crush preparations in conjunction with fine-needle aspiration for the evaluation of thyroid nodules

“…Although a few studies have compared thyroid FNA and CB, [9][10][11][12][13][14][15]28,29 to our knowledge, only 1 study 29 has described the practice of FNA followed by CB in nondiagnostic or suboptimal FNA cases during the same procedure. A few studies have reported higher accuracy with combined FNA/CB than with either procedure alone.…”

“…[9][10][11][12][13][14] To our knowledge, there are not enough studies to demonstrate the benefits of concurrent CB in improving the adequacy or accuracy of thyroid biopsy. Nearly all studies agree that the advantage of CB is providing adequate material for evaluation when such material is not readily available by FNA.…”

Techniques for thyroid FNA: A synopsis of the National Cancer Institute Thyroid Fine‐Needle Aspiration State of the Science Conference

“…52 Limitations of CNB include the need for local anesthesia, local discomfort, and decreasing patient acceptance of repeat biopsies. 45 …”

How to combine ultrasound and cytological information in decision making about thyroid nodules

“…Cytological diagnosis was adenomatous hyperplasia, which was compatible with US findings, but surgery was undertaken because there was a malignant mass in the right thyroid mass. The final diagnosis after surgery was adenomatous hyperplasia or without FNAB [35][36][37][38][39][40][41][42][43][44][45]. A few studies demonstrated that a combined approach of FNAB/core biopsy showed higher adequacy [36,44] and accuracy [35,39,42] than either procedure alone, although core biopsies showed better adequacy than FNAB [38,43].…”