Clinical Outcomes for “Suspicious” Category in Thyroid Fine-Needle Aspiration Biopsy: Patient's Sex and Nodule Size Are Possible Predictors of Malignancy

Abstract

Context.—Fine-needle aspiration (FNA) is recommended as an initial screening tool for the diagnosis of thyroid nodules. Approximately 10% of thyroid FNA diagnoses are “suspicious for neoplasm,” warranting surgical resection. Objectives.—To examine the role of a patient's age, sex, size of nodule, and morphologic features as possible predictors of malignancy in patients with cytologic diagnosis of “suspicious for neoplasm.” Design.—Cytopathology slides and reports of 402 consecutive thyroid FNAs from 2000–2005 interpreted as “suspicious” were reviewed. Of these, 180 cases that had subsequent surgical resection were selected. Results.—Of the 108 cases suspicious for follicular neoplasm on cytologic evaluation, histologic follow-up showed malignancy in 26 (24%). Of the 37 cases suspicious for Hürthle cell neoplasm, 15 (41%) had malignancy. Of the 35 cases suspicious for malignancy, 29 had malignant histologic diagnoses. Among cases with cytologic diagnoses of “suspicious for follicular or Hürthle cell neoplasm,” the rate of malignancy in female patients was 22% as compared to 43% in male patients (P = .02). The rate of malignancy in nodules less than 2 cm was 19% compared to 47% in nodules measuring 2 cm or larger (P < .001). These differences were statistically significant. No statistically significant difference was noted between the age of the patient and the rate of benign versus malignant diagnosis. Conclusions.—Malignant tumors were more frequent in male patients with a cytologic diagnosis of “suspicious for follicular or Hürthle cell neoplasm” than in female patients. Risk of malignancy was higher in nodules measuring 2 cm or larger. Age of the patient was not a predictor of malignancy.

A Cross Sectional Study to Assess the Association of Thyroid Autoantibodies with Thyroid Malignancies in a Tertiary Care Hospital in Bangladesh

“…Many clinical risk factors, such as male gender, younger age, large nodule size, and single nodule, have long been recognized as predictors of malignancy in patients with thyroid nodules [49][50][51]. When we investigated such clinical variables as risk factors for cancer, we found no such difference regarding age, sex and nodule number.…”

Predictors of Malignancy in Patients with a Thyroid Nodule That Contains Hürthle Cells

“…9,12 On the contrary, this study and others found that the age of the patients was not a predictor of malignancy. 10,16 Malignant tumors were more frequent in male patients than in female patients. 5,10,12 However, tumor size, which may correlate with the risk of malignancy, has been a subject of controversy.…”

“…10,16 Malignant tumors were more frequent in male patients than in female patients. 5,10,12 However, tumor size, which may correlate with the risk of malignancy, has been a subject of controversy. Risk of malignancy was higher in nodules measuring 2 cm or larger.…”

Long-term outcomes of cytologically benign thyroid tumors: a retrospective analysis of 3,102 patients at a single institution

“…Table 5 The tumor-volume doubling rate (TV-DR) in 667 patients who were followed without surgery for >10 years TV-DR (/year) >0. separate criterion for recommending surgical therapy or determining the extent of thyroidectomy is controversial [2,4,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Several surgical series have reported higher malignancy rates in nodules >3-4 cm, but these studies suffered from both selection bias and potential sampling error [19,33].…”