Fine-Needle Aspiration Biopsy of the Thyroid: An Appraisal

Gharib, Hossein; Goellner, John R.

doi:10.7326/0003-4819-118-4-199302150-00007

Cited by 1,070 publications

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“…These features can be seen in aspirates from Hashimoto's thyroiditis, nodular hyperplasia, follicular adenoma, and Hurthle cell adenoma. 20 The 6.1% false-negative rate for malignancy in our study was similar to that reported in the literature (2-7%) [10][11][12][13]21,22 and is generally attributed to cytologic misdiagnoses, often in the setting of a follicular variant of a papillary carcinoma. Cytologic diagnosis of this entity can be difficult due to the paucity of nuclear features of papillary carcinomas and the overlapping features with other follicular neoplasms.…”

Section: Discussionsupporting

confidence: 78%

“…26,30 Despite the improved aspiration technique and US guidance, up to 20% of initial aspirations are nondiagnostic. 7,9,21 The highest proportion of nondiagnostic specimens occur in nodules with a large cystic content, and malignancy has been observed in 5-10% of cases with nondiagnostic aspirates. [31][32][33] Therefore, repeated US-guided FNA should be performed in cases of nondiagnostic nodules aspirates.…”

Section: Discussionmentioning

confidence: 99%

“…This is similar to the estimated 10-20% malignancy rate in indeterminate thyroid aspirates reported in the literature. 12,21 In an attempt to avoid unnecessary surgery of thyroid nodules with follicular neoplasm, some authors have further stratified the indeterminate thyroid aspirates into high-and low-risk groups for a malignancy based on clinical parameters. [24][25][26] Baloch et al 24 reported male sex, age >40 years, and a nodule size >3 cm to be significantly associated with a higher likelihood of a malignancy.…”

Section: Discussionmentioning

confidence: 99%

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Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Lee

Kim

et al. 2007

J of Clinical Ultrasound

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Purpose. To analyze the discrepancies between the cytologic results of sonographically (US)-guided fine needle aspiration (FNA) of thyroid nodules and final histopathologic results and to discuss the limitations of US-guided FNA.Materials and Methods. The results of US-guided FNAs performed by a single experienced radiologist in 315 thyroid nodules in 292 patients (246 women, 46 men aged 12-79 years) were retrospectively correlated with their surgical pathologic results. The FNA results were classified as nondiagnostic, indeterminate, negative, or positive, whereas final pathologic diagnoses were classified as malignant or benign.Results. The FNA results were nondiagnostic in 31 cases (9.8%), indeterminate in 97 cases (30.8%), and determinate in 187 cases (59.4%). Of the 187 conclusive cases, 169 (90.4%) were concordant with the final pathologic results, whereas 18 (9.6%) were discordant with 14 false-positive and 4 false-negative results. These discrepancies were caused by atypical nuclear features. Among the 97 indeterminate and 31 nondiagnostic cases, a malignancy was found in 14 (14.4%) and 8 (25.8%) cases, respectively. In addition, 10 papillary carcinomas, which were not visualized on sonograms, were detected incidentally in thyroidectomy specimens.Conclusion. The diagnostic accuracy of US-guided FNA of thyroid nodule has limitations that should be minimized by careful interpretation of the cytologic findings and accurate sampling. V V C 2007 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Lee

Kim

et al. 2007

J of Clinical Ultrasound

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“…Nevertheless, even if the pre-operation FNAC is negative, it does not exclude with certainty the possibility of a carcinoma, especially in MNG where the error in sampling the right area is greater. When a comparison of the results for FNAC and final histopathology was made, the former had a sensitivity of 80.6% and a specificity of 87.1% [4][5][6][7][8][9] . The negative rate was only 7%.…”

Section: Discussionmentioning

confidence: 99%

Incidence of thyroid carcinoma in multinodular goitre: retrospective analysis in a medical college hospital

Kundapur

Dsouza

2014

Int Jour of Biomed Res

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“…[10] Thyroid FNA biopsy is the most reliable, safe, and cost-effective diagnostic tool used in the evaluation of thyroid nodules In patients who have thyroid nodule, fine needle aspiration biopsy (FNAB) is a useful tool for the diagnosis of thyroid cancer. [11][12][13][14] It should be noted that FNAB is an invasive procedure and, in addition to the possibility of errors in sampling and analysis, this Section: Radiology method is not cost effective for studying of all nodules and the experience of the physician performing the aspiration is also important. [15][16][17] Ultrasonography is the imaging study of choice for thyroid nodules The ultrasonography (USG) is the non-invasive and is highly sensitive in assessing nodule size and number.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Malignancy for Thyroid Nodule by Ultrasound Findings: A Cross Sectional Study

Bansal¹,

Gupta²

2018

AIMDR

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Background: Thyroid diseases are, debatably, among the commonest endocrine disorders worldwide. According to a projection from various studies on thyroid disease including thyroid nodules, it has been estimated that about 42 million people in India suffer from thyroid diseases. The ultrasonography is a non-invasive sensitive diagnostic in assessing thyroid nodule size and number. This study aimed to determine the ultrasound findings of thyroid nodules in patients and correlate it with clinical records. Methods: This was a cross-sectional study conducted at teerthanker Mahavir medical college and research centre. In these patients, high frequency 7.5-10.0 MHz probe was used for Ultrasound examination of a thyroid nodule. It includes diameter, echogenicity (Hyper, Hypo, Iso and An Echo), composition (Cystic, Solid, Mixed), microcalcifications (Presence and Absence), Borders (Irregular and Regular) and Halo (Presence and Absence). From Lew et al. guidelines ultrasound of nodule margins, suggestive of malignancy guidelines was adopted. A fine needle aspiration (FNA) biopsy was recommended to the referring physician is required. Results: Benign and malignant lesions were recorded in 88.9% and 11.1% patients respectively. On the other hand, histopathological findings revealed that 90.9% and 9.1% as benign and malignant correspondingly. In the present study, sensitivity, specificity and positive predictive values were 91%, 8.5% and 50% respectively. Whereas, the negative predictive value was 47%. Conclusion: Findings of the current study suggest that radiological evidences are reliable enough for the diagnosis of the benign and malignant thyroid tumours. However, studies on larger populations are warranted to establish guideline for the radiological diagnosis of thyroid tumours.

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Fine-Needle Aspiration Biopsy of the Thyroid: An Appraisal

Abstract: Fine-needle aspiration biopsy is safe, accurate, and cost-effective. The procedure has a central role in the management of thyroid nodules and should be used as the initial diagnostic test.

Cited by 1,070 publications

References 0 publications

Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Incidence of thyroid carcinoma in multinodular goitre: retrospective analysis in a medical college hospital

Diagnosis of Malignancy for Thyroid Nodule by Ultrasound Findings: A Cross Sectional Study

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