When Fine-Needle Aspiration Biopsy Cannot Exclude Papillary Thyroid Cancer

Mittendorf, Elizabeth A.; Khiyami, Amer; McHenry, Christopher R.

doi:10.1001/archsurg.141.10.961

Cited by 26 publications

(16 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rate of malignancy in lesions with suspicious cytology for papillary carcinoma was 52.7% in our series. Mittendorf et al reported it as 40% [35]. Our results suggest that all lesions with suspicious cytology for malignancy should be accepted as malignant and evaluated in terms of surgery.…”

Section: Rago Et Al Had Combined Conventional and Color Dopplermentioning

confidence: 49%

Ultrasonographic evaluation of thyroid nodules: comparison of ultrasonographic, cytological, and histopathological findings

Gül

Ersoy

Dirikoç

et al. 2009

Endocr

View full text Add to dashboard Cite

Thyroid ultrasonography (US) and fine needle aspiration biopsy (FNAB) are the most important tools in evaluating thyroid nodules. A total of 3,404 nodules in 2,082 cases referred to our clinic between 2005 and 2008 were analyzed retrospectively. Considering US features of nodules, risk factors predicting malignancy were: margin irregularity as the most important predictor, hypoechoic pattern and microcalcification (Odds ratios: 63.2, 13.3, 7.03, respectively). Cytologic results of the patients were as follows: 1,718 (82.5%) benign, 196 (9.4%) suspicious, 68 (3.3%) nondiagnostic, and 100 (4.8%) malignant. In histopathologic examination, we determined a malignancy rate of 7.59% (158/2082). We calculated the sensitivity of FNAB as 89.16%, specificity as 98.77%, positive predictive value as 96.10%, negative predictive value as 96.39%, and accuracy as 96.32%. In cytologic examination, the malignancy rate of subcentimetric (≤1 cm) nodules was higher than supracentimetric (>1 cm) nodules (5.1% vs. 1.5%, P = 0.001). In postoperative histopathologic examination, although the malignancy rate of subcentimetric nodules was higher than that of supracentimetric nodules, the difference was statistically insignificant (5.5%, 4.4%, respectively; P > 0.05). Cytologically diagnosed malignancy was detected in 4.5% of patients with multiple nodules, while it was present in 6% of patients with solitary nodule indicating no significant difference. However, postoperative histopathologic examination revealed a significantly higher malignancy rate in patients with solitary nodule compared to in patients with multiple nodules (11.7%, 6.5%; respectively, P < 0.001). The malignancy rate of patients operated for suspicious cytology was found to be 46.15%; for nondiagnostic cytology, it was 64.29%. In conclusion, ultrasonographically, hypoechoic pattern, microcalcification and margin irregularity of thyroid nodules are important features in determining the malignancy risk. The nodule size alone still remains inadequate to exclude malignancy risk.

show abstract

Section: Rago Et Al Had Combined Conventional and Color Dopplermentioning

confidence: 49%

Ultrasonographic evaluation of thyroid nodules: comparison of ultrasonographic, cytological, and histopathological findings

Gül

Ersoy

Dirikoç

et al. 2009

Endocr

View full text Add to dashboard Cite

show abstract

“…There is consent that in some circumstances, up to 10-20% of aspirated samples can be inadequate for these techniques, mainly because of a shortage of cellular material [4]. Intra-operative frozen section examination when it delivers follicular neoplasm interpretation is not helpful in decision making and defers final diagnosis until performing postoperative scrutinizing of all permanent histologic sections [5]. Such examination can be obtained only in 3-4 days postoperatively, and subsequently, secondary radical surgery can be performed not earlier than in the fifth day after first operation [6].…”

Section: Introductionmentioning

confidence: 99%

Selenoenzymes, Laboratory Parameters, and Trace Elements in Different Types of Thyroid Tumor

Zagrodzki

Nicol

Arthur

et al. 2009

Biol Trace Elem Res

View full text Add to dashboard Cite

This study was performed to investigate selenoenzyme activities and trace element concentrations in thyroid tissues, with reference to other parameters routinely used to characterize thyroid function. This was to reveal relevant parameters as possible additional markers of tumor grade, clinical course, and prognosis of thyroid disorders. The tissue samples were obtained during surgical treatment (total or near total thyroidectomy) of 122 patients with different types of thyroid tumor. For most of the investigated parameters in different groups of patients, we did not find statistically significant differences. In the majority of cases, thyroid benign or malignant tumors were not accompanied by significant derangement of the gland selenoenzymes and of either intrathyroidal or plasma concentration of selenium. Nevertheless, types I and II iodothyronine deiodinases were the most promising (among selenoenzymes) targets for diagnoses and possibly therapy of thyroid tumors. Higher activities of both enzymes in cases with Graves' disease, as compared with other thyroid lesions, suggest their involvement in the pathogenesis of this condition. Patients with struna nodosa had higher levels of thyroid Zn, Cu, and Pb as compared with papillary carcinoma subjects and also a higher level of Cu than follicular carcinoma cases. The above diagnostics may play a similar role to some of the general thyroid function indices, TSH, anti-TG, anti-TPO, and calcitonin, which can partially distinguish between various thyroid tumors. In conclusion, some of selenium status markers, when accompanied with general parameters, and trace elements can serve as factors with pathophysiologic relevance and be helpful in the identification of malignant disease. Multivariate statistical methods should be employed to tackle a broad array of thyroid tumor diagnostic data in a short time. Partial least squares model and other pattern recognition methods seem to be the most appropriate methods for that task. The miniaturization of all the steps of complex analytical procedure should be developed in a way to allow its completion as sensitive, robust, and efficient for use of the small quantity of material provided by fine-needle biopsy.

show abstract

“…A similar (98.7%) CH correlation was reported by Strickland et al [17] Mittendorf et al observed 100% CH correlation. For 622 FNAs there were 36 DC VI (6%) [18]. Albuja-Cruz et al submitted a study in which all analyzed patients (1086 FNA) had histopathological verification (lobectomy or thyroidectomy).…”

Section: Discussionmentioning

confidence: 99%

The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

Stanek-Widera¹,

Biskup-Frużyńska²,

Zembala‐Nożyńska³

et al. 2016

pjp

View full text Add to dashboard Cite

Fine needle aspiration biopsy (FNA) is the only diagnostic method that allows a preoperative diagnosis of thyroid carcinoma. An unequivocal diagnosis of a malignant change is achievable only in cases in which all cytological criteria of carcinoma are met. The aim of the study was to evaluate the necessity of repeat thyroid FNA in patients with papillary thyroid carcinoma verified on consultative examination (CE). We analyzed cytology reports of thyroid FNA and CE that resulted in the diagnosis of papillary carcinoma. Evaluation of the correlation of the cytological diagnosis with the histopathology report was based on data obtained after the surgery. Between 2010 and 2015 in the Institute of Oncology (IO) there were 184 cancers diagnosed on CE or in thyroid FNA performed primarily in IO. Additionally, 74 patients were subjected to repeat biopsy after confirmation of cancer in CE. Histopathological diagnosis of cancer was obtained in 62 (100%) cases that were doubly confirmed with cytological examination. The remaining 12 patients were operated on outside the institute. From 110 FNA primarily performed in the IO, histopathological verification was achievable in 92 cases, from which 92 (100%) provided a confirmation of cancer, and the remaining 18 patients were operated on outside the institute. High (100%) specificity of cancer diagnosis in FNA established primarily and verified on CE (second independent assessment) indicates that repeat FNA in order to confirm the diagnosis is unnecessary.

show abstract

When Fine-Needle Aspiration Biopsy Cannot Exclude Papillary Thyroid Cancer

Cited by 26 publications

References 23 publications

Ultrasonographic evaluation of thyroid nodules: comparison of ultrasonographic, cytological, and histopathological findings

Ultrasonographic evaluation of thyroid nodules: comparison of ultrasonographic, cytological, and histopathological findings

Selenoenzymes, Laboratory Parameters, and Trace Elements in Different Types of Thyroid Tumor

The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

Contact Info

Product

Resources

About