Clinicopathological characteristics of thyroid cancer misdiagnosed by fine needle aspiration

Abstract

Abstract. Fine-needle aspiration (FNA) is commonly used as a preoperative assessment to diagnose thyroid cancer. However, misdiagnosis of malignancy by FNA is not rare, even if image examination suggests the possibility of thyroid cancer. In the present study, the clinicopathological factors of patients whose preoperative FNA examination had not led to a diagnosis of thyroid cancer were examined. In total, 125 patients with thyroid cancer who underwent FNA and surgery (total thyroidectomy, subtotal thyroidectomy or hemithyroidectomy) at the Department of Surgery, Surgical Oncology and Science of the Sapporo Medical University Hospital between 2006 and 2013 were retrospectively analyzed. The patients were divided into two groups: Group A, malignancy determined by FNA, and group B, no malignancy. The groups were then compared by gender, age, tumor size, stage, tumor stage, lymph node metastasis, histology, surgical procedure methods, presence or absence of calcification and thyroglobulin levels. The mean age of the patients in group A (5 males and 59 females) was 53.0 years. The mean age in group B (11 males and 49 females) was 54.2 years. The mean tumor size in both groups was 1.6 cm. The mean thyroglobulin levels were 82.7 ng/ml in Group A and 525.5 ng/ml in group B. There were also significant differences between the groups for tumor stage (P=0.046), histological type (P=0.024) and thyroglobulin levels (P=0.035). The results of the present study suggested that it may be difficult to diagnose thyroid cancer by FNA in cases with non-papillary carcinoma and higher thyroglobulin levels.

Retrospective evaluation of patients with thyroidectomy in our region with thyroid

“…and when we look at the literature, the female / male ratio of patients who underwent thyroidectomy was reported as 71-96 / 6-28%, which is consistent with the literature[4][5][6][7][8][9][10][11][12].In the literature, the age range of patients who underwent thyroid surgery was reported as 30-60 years (70.5%), 50-59 years (28%), 41-60 years (56.8%)[11][12][13]. In Turkey, the age range was 40-59 years (57.4%), which was found to be compatible with the literature.…”

Optimal needle size for thyroid fine needle aspiration cytology

“…Concerning needle size, 25-to 27-gauge needles are commonly used in Western countries [1,2,4,5]. However, in Japan, the use of larger needles, such as 21-gauge or 22-gauge, is common [6][7][8]. Few studies have compared the adequacy of samples obtained with different-sized needles [1,5,[9][10][11][12], and the results were controversial.…”

Big gain, no pain: Thyroid minimally invasive FNA (Thy MIFNA): Proposal of novelty in terminology

“…However, to the best of our knowledge, the ideal needle size for US-guided FNA (henceforward, FNA) procedure has not been declared in a released well-accepted management guideline, up to now. On the contrary, a wide range of needle sizes, 20-27 gauge (G), have been used for application in the different geographic regions (e.g., 25-27-G in most Western countries and 21-22-G in Japan) 4 . Adequacy of the finer and thicker needles has been reported as similar by many authors 5 .…”

“…), with the nondiagnostic cytology (Category I, The Bethesda System for Reporting Thyroid Cytopathology [TBSRTC], 1st ed.) rate of 9.0% [3][4][5][6][7][8][9] . On the other hand, the size/bore of the fine needle for FNA application might also affect the comfort of the patient.…”