Câncer da tireóide detectado pela punção aspirativa por agulha fina guiada pelo ultra-som

Yokozawa, Tamotsu

doi:10.1590/s0004-27301998000400010

Cited by 3 publications

(7 citation statements)

References 14 publications

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“…Nossos pacientes não foram avaliados com ultrassonografia que, apesar de contribuir para o aumento da sensibilidade e da especificidade no diagnós-tico das lesões de tireóide (11)(12)(13), não é empregada de rotina em nosso serviço em nível ambulatorial. A ultrassonografia foi utilizada em casos selecionados para auxiliar a responder questões clínicas específicas de um determinado paciente, como, por exemplo, para a detecção de recorrência de carcinoma diferenciado de tireóide, para guiar a PAAF em pacientes com nódulos impalpáveis, muito pequenos ou complexos (sólidos com degeneração cístico-hemorrágica) e para auxiliar na indicação cirúrgica de pacientes com resultado indeterminado à PAAF (14).…”

Section: Pacientes E Métodos Pacientes E Métodosunclassified

Punção aspirativa de tireóide com agulha fina em um hospital geral: estudo de 754 punções

Murussi

Pereira

Brasil

et al. 2001

Arq Bras Endocrinol Metab

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A punção aspirativa com agulha fina (PAAF) é considerada o método diagnóstico inicial e o de melhor relação custo-benefício na avaliação da doença nodular da tireóide. Apesar das vantagens do procedimento, o sucesso do método depende da experiência do patologista e da habilidade técnica na obtenção de amostras adequadas. Neste trabalho avaliamos a eficácia do procedimento em um hospital geral de ensino. Foram realizadas 754 punções em um período de 3 anos. Cada nódulo palpável foi aspirado por médicos residentes de endocrinologia com agulha fina por 4 a 6 vezes. O material foi corado pelos métodos de Giemsa e de Papanicolaou. O resultado anatomopatológico foi obtido de 93 pacientes. A PAAF foi realizada em 663 pacientes (613F/50M), com idade média de 50±14 anos (12 a 93). Nos exames citopatológicos, os diagnósti-cos foram: bócio colóide (58,5%), neoplasia folicular ou suspeito (8,2%), tireoidite de Hashimoto (5,3%), carcinoma papilar (2,3%), carcinoma anaplásico (0,4%), carcinoma medular (0,1%) e insatisfatório (25,2% ABSTRACT ABSTRACTFine-needle aspiration (FNA) biopsy is considered the routine initial and the most cost-effective procedure in the evaluation of thyroid nodules. Notwithstanding the advantages of the procedure, it depends heavily on the pathologist's experience and on technical skills to obtain adequate smears. The aim of this paper is to evaluate the procedure efficacy in a general teaching hospital. Smears obtained from 754 FNA were examined over a 3-year period. Each palpable nodule was aspirated by an endocrinology resident with a fine-needle 4 to 6 times. Material were stained by Giemsa and Papanicolaou techniques. Histopathologic examination was done on 93 patients. FNA biopsy was performed in 663 patients (613F/50M), mean age of 50±14 years (range 12 -93). FNA results were: colloid nodule (58.5%), follicular neoplasm or suspicious (8.2%), Hashimoto's thyroiditis (5.3%), papillary carcinoma (2.3%), anaplastic carcinoma (0.4%), medullary carcinoma (0.1%), and unsatisfactory (25.2%). Neoplasias were detected in 41 (44%) of 93 surgeries undertaken, and most of the carcinomas were of papillary type (65.6%). There were 24% follicular carcinomas among the follicular neoplasms. The

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Section: Pacientes E Métodos Pacientes E Métodosunclassified

Punção aspirativa de tireóide com agulha fina em um hospital geral: estudo de 754 punções

Murussi

Pereira

Brasil

et al. 2001

Arq Bras Endocrinol Metab

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“…As in the present case, hyperthyroidism is most commonly associated with a papillary cancer (2)(3)(4)(5)8), and the cytological diagnosis is straightforward provided enough material is obtained by FNAB (15). However, in a few patients the cytological diagnosis of follicular cancer is challenging, since capsular or blood vessel invasion, as required for diagnosis, may not be evident.…”

Section: Discussionmentioning

confidence: 72%

“…Fine-needle aspiration biopsy (FNAB) coupled with cytological examination is the most effective procedure for the diagnosis of thyroid cancer (15). However, this method is limited when small amount of cells is obtained.…”

Section: Discussionmentioning

confidence: 99%

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Papillary carcinoma of the thyroid in an autonomously functioning nodule

Calegaro

Dias²,

Bae

et al. 2003

Arq Bras Endocrinol Metab

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The association of differentiated thyroid cancer and a functioning nodule is very low. We report on a case of papillary carcinoma in an autonomously functioning thyroid nodule in a 39 year-old female patient. The nodule extended to the whole right lobe and 131 I scintigraphy has detected a "hot" nodule and a partial suppression of 131 I uptake in the left lobe. Serum TSH levels (RIA) were undetectable (<1.0µUI/mL), but total T3 (190ng/dL) and T4 (8.5µg/dL) were normal. The patient underwent a partial thyroidectomy and an adenomatous nodule was found with a small central nucleus (7mm) hosting a papillary carcinoma. Whole body scans detected only residual thyroid uptake and the patient was subsequently treated with 100mCi of 131 I. The patient has been on replacement therapy with 150µg of L-thyroxine and free of tumor recurrence for 12 years after surgery. In conclusion: the present report confirms other published cases in which the presence of a "hot" thyroid nodule does not exclude the concomitance of a well-differentiated thyroid carcinoma. A associação de câncer diferenciado da tiróide com nódulo funcionante é muito baixa. Apresentamos uma mulher de 39 anos com carcinoma papilar em nódulo autônomo funcionante da tiróide. O nódulo ocupava todo o lobo direito e o estudo cintilográfico com I 131 detectou um nódulo quente e supressão parcial da captação de I 131 pelo lobo esquerdo. Os níveis de TSH (RIE) eram indetectáveis (<1,0µUI/mL), mas os de T3 (190ng/dl) e T4 total (8,5µg/dl) normais. Submetida à tiroidectomia parcial, encontrou-se nódulo adenomatoso com um pequeno núcleo central (7mm) com carcinoma papilar. A pesquisa de corpo inteiro mostrou somente captação residual da tiróide e a paciente foi tratada com uma dose de 100mCi de I 131 . A paciente está recebendo terapia substitutiva com 150µg de L-tiroxina e 12 anos após a cirurgia não apresenta qualquer sinal de recorrência tumoral. Em conclusão: a paciente descrita confirma outros casos publicados de que a presença de um nódulo "quente" da tiróide não exclui a possibilidade da ocorrência de um carcinoma bem diferenciado. Descritores: Carcinoma papilar; Doença de Graves; Nódulo quente; Carcinoma da tiróide; Nódulo da tiróide T HE ASSOCIATION OF THYROID carcinoma and hyperthyroidism is presently considered more frequent than it was in the past (1). The most frequent association of thyroid carcinoma is with "hot" nodules, with apresentação de casos

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“…In addition, the technique for performing FNA, whether conventional or ultrasound-guided, can affect the cytology results. Yokozawa ( 13 ) found a failure in the diagnosis of malignancy in 15.8% by conventional FNA, in contrast to FNA by ultrasound. The main causes of failure being nodule with difficult palpation in 55.6%), inadequate cytology in 29.2%), and technical difficulty in 15.1%).…”

Section: Discussionmentioning

confidence: 99%

Correlation between thyroid fine needle aspiration and pathological examination: a 10 year retrospective study

Silva,

Borges,

Jardim

et al. 2023

Einstein (São Paulo)

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Objective To establish the diagnostic performance of fine-needle aspiration in detecting benign and malignant neoplasm in comparison with post-thyroidectomy histopathological findings among patients who received a thyroidectomy. Methods Retrospective observational data collected between 2011–2021 were included from patients who received partial or total thyroidectomy. The Bethesda system was used to classify neoplasms from fine-needle aspiration procedures as benign or malignant. Sample characteristics, diagnostic accuracy, sensitivity, specificity, and predictive values were evaluated. Results Patients (n=360) who underwent thyroidectomy were analyzed, of whom 142 (39.4%) and 218 (60.6%) had benign and malignant neoplasms, respectively. Using the Bethesda system, 23 (6.4%) were classified as unsatisfactory result (BI), 83 (23.1%) as benign (BII), 50 (13.9%) as atypia of undetermined significance (BIII), 23 (6.4%) as suspected follicular or Hürthle cell neoplasia (BIV), 102 (28.3%) as suspected malignancy (BV) and 79 (21.9%) as malignant (BVI). The fine-needle aspiration diagnostic accuracy for carcinomas was 92%, while the sensitivity and specificity were 94.4% and 86.9%, respectively. The negative and positive predictive values were 87.9% and 93.9%, respectively. Conclusion Fine-needle aspiration has high diagnostic accuracy, sensitivity and specificity, and is a reliable test for distinguishing between benign and malignant thyroid pathologies.

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Câncer da tireóide detectado pela punção aspirativa por agulha fina guiada pelo ultra-som

Cited by 3 publications

References 14 publications

Punção aspirativa de tireóide com agulha fina em um hospital geral: estudo de 754 punções

Punção aspirativa de tireóide com agulha fina em um hospital geral: estudo de 754 punções

Papillary carcinoma of the thyroid in an autonomously functioning nodule

Correlation between thyroid fine needle aspiration and pathological examination: a 10 year retrospective study

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