The role of fine needle aspiration in the diagnosis of thyroid nodules: Analysis of 795 consecutive cases

Abstract

The utility of fine needle aspiration (FNA) and physical examination for selecting patients with palpable thyroid nodules for surgery was evaluated in 795 consecutive cases. Surgery was performed in 216 patients based upon the cytological diagnosis and clinical criteria. Excluding 42 patients who were lost to follow-up, the remaining 537 were regularly followed up (range, 2-10 years). Cytological findings were classified as malignant, histologic control recommended (suspicious), follicular tumor, benign, and unsatisfactory. Thirty-six aspiration biopsies were positive for malignancy and the diagnosis was confirmed histologically in 34 of them. In 65 patients with final histological diagnosis of malignancy, cytology was positive in 34, suspicious in 20, benign in 3 cases, and unsatisfactory in 8. All patients with cytological diagnosis of follicular tumor had a benign lesion at histology. There were two false positive and three false negative cytological results among the 216 histologically confirmed cases. Excluding unsatisfactory specimen sensitivity, specificity and the predictive value for a positive and a negative result were respectively 95%, 97.5%, 94.5%, and 97%. We conclude that FNA is a very reliable diagnostic test in the evaluation of thyroid nodules and is the best guidance in addition to clinical criteria for selecting patients to be submitted to surgery.

Fine Needle Aspiration in the Management of Thyroid Nodules: Experience at King Khalid National Guard Hospital, Jeddah

“…[2][3][4] The specificity of 92% and the sensitivity of 89% achieved in our study correlates with reports of other studies establishing that FNA of thyroid is a safe, reliable and effective method for differentiating benign from malignant nodular thyroid lesions in our center. The performance and organization of the FNA clinic by pathologists and strict specimen adequacy rules have proved to be useful and likely responsible for the high sensitivity and specificity achieved.…”

“…Fine needle aspiration (FNA) cytology is considered a minimally invasive, quick, cheap, effective and accurate primary mode of screening, diagnosing, and triaging patients with thyroid diseases. [2][3][4] Occasionally, this technique can be therapeutic, especially in cytic lesions.…”

A study on the clinical manifestations and the incidence of benign and malignant tumors in a solitary thyroid nodule

“…33,34 Many studies have shown the importance of FNAC procedure and its accuracy for early diagnosis of thyroid nodules and also for differentiation of benign and malignant thyroid nodules. 8,9,[35][36][37][38] Hence in the present study also all the STNs were subjected to FNAC (Fine needle aspiration cytology) analysis to differentiate the histological subtypes and the incidence of benign and malignant lesions. We divided our FNAC cases into four groups into Benign, Malignant, Follicular and Indeterminate groups respectively.…”

Fine-Needle Aspiration Biopsy of Thyroid Nodules

“…[4][5][6] With experienced physicians performing needle biopsy, and experienced cytopathologists interpreting the results, the accuracy of FNA has been reported as 95-97%. [7][8][9] The technique has been used less extensively in children. [10][11][12] To date, only five papers pubished in English have documented series involving the use of FNA for diagnosing thyroid nodules in children.…”