Reliability of fine needle aspiration biopsy in large thyroid nodules

Abstract

Objective: Fine needle aspiration biopsy provides one of the most important data that determines the treatment algorithm of thyroid nodules. Nevertheless, the reliability of fine needle aspiration biopsy is controversial in large nodules. The aim of this study was to evaluate the adequacy of fine needle aspiration biopsy in thyroid nodules that are four cm or greater. Material and Methods:We retrospectively examined 219 patients files who underwent thyroidectomy for thyroid nodules that were greater than four centimeter between May 2007 and December 2012. Seventy-four patients with hyperthyroidism, and 18 patients without preoperative fine needle aspiration cytology were excluded from the study. Histopathologic results after thyroidectomy were compared with preoperative cytology results, and sensitivity and specificity rates were calculated.Results: False-negativity, sensitivity and specificity rates of fine needle aspiration biopsy of thyroid nodules were found to be 9.7%, 55.5%, and 85%, respectively. Within any nodule of the 127 patients, 28 (22.0%) had thyroid cancer. However, when only nodules of at least 4 cm were evaluated, thyroid cancer was detected in 22 (17.3%) patients. Conclusion:In this study, fine needle aspiration biopsy of large thyroid nodules was found to have a high falsenegativity rate. The limitations of fine-needle aspiration biopsy should be taken into consideration in treatment planning of thyroid nodules larger than four centimeters.Keywords: Fine needle aspiration biopsy, thyroidectomy, thyroid cancer, thyroid nodule ABSTRACT Turk J Surg

Incidental thyroid cancer in patients undergoing surgery for benign multinodular goitre: A retrospective clinical study

“…A meta-analysis of 35 studies and 12,834 autopsies between 1949 and 2007 found ITC up to 11.2%.The interesting finding in this study is that there is no significant increase in prevalence in autopsy studies since the 1940s.This finding strongly supports the link between development of diagnostic methods and increase in the incidence of ITC in the present day [12]. In the diagnosis and follow-up of thyroid nodules clinically and radiologically as recommended in the American Thyroid Association (ATA) guidelines; Ultrasound guided FNAC because of its low cost and easy and simple method and Bethesda Scoring System for interpretation is widely preferred all over the world [13][14][15]. When the studies in the literature are examined, hyperthyroidism and benign MNG are the most common indications for patients operated with benign causes.…”

Clinical Utility of BRAF, NRAS, and TERT Promoter Mutation in Preoperative Thyroid Fine-Needle Aspiration Biopsy: A Diagnostic Study From Dharmais Cancer Hospital

“…It might be caused most of the cases were taken intraoperatively without ultrasound guidance. Other factors including the inadequate amount of cells for the analysis, fixation method, presence of non-homogenous nodule, and subjectivity of the pathologist who interprets the cytology slides could affect the FNAB results (Bozbiyik et al, 2017). As a consequence, many patients may undergo diagnostic surgery and raising the risk of morbidity if they are ultimately diagnosed as a benign disease.…”

Impact of molecular testing on thyroid nodule neoplastic diagnosis, stratified by 4-cm size, in a surgical series

“…Only 4 other series have reported on the adenoma rate of operated thyroid nodules ≥4 cm 8–11 . The overall surgical prevalence of adenoma varied widely at 6.3% 11 , 11% 10 and 28% 9 . The current study had the highest rate of adenoma reported to date, at 30% of operated nodules ≥4-cm.…”