The incidence of cancer and rate of false-negative cytology in thyroid nodules greater than or equal to 4 cm in size

McCoy, Kelly L.; Jabbour, Noel; Ogilvie, Jennifer B.; Ohori, N. Paul; Carty, Sally E.; Yim, John H.

doi:10.1016/j.surg.2007.08.012

Cited by 209 publications

(240 citation statements)

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“…Recent studies reported a prevalence of incidental PTMC ranging from 3.1% in 385 (121) to 21% in 386 patients (99) operated upon for benign diseases of the thyroid. In multinodular goiter/nodules, PTMC has been observed in 2-15.2% of the cases (96,125). In patients operated upon for nodules measuring O1 and O4 cm in diameter, the presence of PTMC occurred in 3.1 and 15.2% of the cases respectively (120,125).…”

Section: Incidental Prevalencementioning

confidence: 99%

“…In multinodular goiter/nodules, PTMC has been observed in 2-15.2% of the cases (96,125). In patients operated upon for nodules measuring O1 and O4 cm in diameter, the presence of PTMC occurred in 3.1 and 15.2% of the cases respectively (120,125). The different results in the prevalence of incidental PTMC are likely due to the variable use and expertise in the use of US and US-guided FNAB.…”

Section: Incidental Prevalencementioning

confidence: 99%

See 1 more Smart Citation

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

Roti

Uberti

Bondanelli

et al. 2008

European Journal of Endocrinology

279

223

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The authors review anatomical, clinical characteristics and prevalence of thyroid microcarcinoma. Diagnostic procedures and risk factors of aggressiveness at diagnosis and during follow-up are also covered. The possible clinical, pathologic and therapeutic risk factors are analyzed by meta-analysis study. Treatment procedures by different authors and guidelines suggested by societies are reported.European Journal of Endocrinology 159 659-673

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Section: Incidental Prevalencementioning

confidence: 99%

Section: Incidental Prevalencementioning

confidence: 99%

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

Roti

Uberti

Bondanelli

et al. 2008

European Journal of Endocrinology

279

223

View full text Add to dashboard Cite

show abstract

“…Diagnostic lobectomy/thyroidectomy has been recommended because of a high rate of false negativity of FNAB in large thyroid nodules in some studies, while many studies have reported that FNAB can be used with reliability in large nodules as well (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). In addition, there are publications showing that the prevalence of thyroid cancer increases as the nodule diameter increases (7,9,10). In this study, we aimed to determine the reliability of FNAB in thyroid nodules larger than 4 cm in size.…”

Section: Introductionmentioning

confidence: 99%

Reliability of fine needle aspiration biopsy in large thyroid nodules

et al. 2017

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Objective: Fine needle aspiration biopsy provides one of the most important data that determines the treatment algorithm of thyroid nodules. Nevertheless, the reliability of fine needle aspiration biopsy is controversial in large nodules. The aim of this study was to evaluate the adequacy of fine needle aspiration biopsy in thyroid nodules that are four cm or greater. Material and Methods:We retrospectively examined 219 patients files who underwent thyroidectomy for thyroid nodules that were greater than four centimeter between May 2007 and December 2012. Seventy-four patients with hyperthyroidism, and 18 patients without preoperative fine needle aspiration cytology were excluded from the study. Histopathologic results after thyroidectomy were compared with preoperative cytology results, and sensitivity and specificity rates were calculated.Results: False-negativity, sensitivity and specificity rates of fine needle aspiration biopsy of thyroid nodules were found to be 9.7%, 55.5%, and 85%, respectively. Within any nodule of the 127 patients, 28 (22.0%) had thyroid cancer. However, when only nodules of at least 4 cm were evaluated, thyroid cancer was detected in 22 (17.3%) patients. Conclusion:In this study, fine needle aspiration biopsy of large thyroid nodules was found to have a high falsenegativity rate. The limitations of fine-needle aspiration biopsy should be taken into consideration in treatment planning of thyroid nodules larger than four centimeters.Keywords: Fine needle aspiration biopsy, thyroidectomy, thyroid cancer, thyroid nodule ABSTRACT Turk J Surg

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“…However, the meaning of both parameters is controversial. Indeed, while some authors suggested that large nodules are at higher risk of malignancy (McCoy et al, 2007;Wharry et al, 2014), others Nakamura et al, 2015) did not support this hypothesis. Size cannot therefore be unequivocally considered a useful means of distinguishing benign from malignant nodules.…”

Section: Discussionmentioning

confidence: 98%

Retrospective cytological evaluation of indeterminate thyroid nodules according to the British Thyroid Association 2014 classification and comparison of clinical evaluation and outcomes

Giusti¹,

Massa²,

Balestra³

et al. 2017

J. Zhejiang Univ. Sci. B

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Abstract:The cytology of 130 indeterminate nodules (Thy 3) was retrospectively reviewed according to the British Thyroid Association 2014 classification. Nodules were divided into Thy 3a (atypical features) and Thy 3f (follicular lesion) categories. Histology was available as a reference for 97 nodules. Pre-surgical evaluations comprised biochemical tests, color-Doppler ultrasonography (US), semi-quantitative elastography-US (USE), contrast-enhanced US (CEUS), and mutation analysis from cytological slides. Thyroid malignancy was the final diagnosis for 19% of surgicallytreated nodules. No statistically significant difference in the risk of malignancy was found between Thy 3a (26%) and Thy 3f (14%) nodules. Histology of the Thy 3a and Thy 3f nodules showed a higher incidence of Hurtle cell adenomas in Thy 3f (29%) than in Thy 3a (3%) nodules (P=0.01). The only pre-surgical difference concerned the BRAF V600E mutation, which was positive in some Thy 3a but not in any Thy 3f nodules (P=0.04). Receiver-operating characteristic (ROC) analysis was used to obtain cut-off values from US (score), USE (ELX 2/1 strain index), and CEUS (time-topeak index and peak index) data. The cut-off values were similar for Thy 3a and Thy 3f nodules. Data showed that malignancy can be suspected if the US score is >2, ELX 1/2 strain index >1, time-to-peak index >1, and peak index <1. In a sub-group of 24 revised nodules (12 Thy 3a and 12 Thy 3f) with histology as a reference, the diagnostic power of cumulative pre-surgical analysis by means of US, USE, and CEUS showed high positive and negative predictive values (83% and 100%, respectively) for the presence of malignancy in Thy 3a and Thy 3f nodules. In conclusion, in our series of revised Thy 3 nodules, malignancy was low and displayed no significant differences between Thy 3a and Thy 3f categories. The use of cut-offs based on histology as a reference could reduce surgery. Our data support the conviction that, in mutation-negative Thy 3a and Thy 3f nodules, observation should be the first choice when not all instrumental results are suspect.

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The incidence of cancer and rate of false-negative cytology in thyroid nodules greater than or equal to 4 cm in size

Cited by 209 publications

References 21 publications

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

Reliability of fine needle aspiration biopsy in large thyroid nodules

Retrospective cytological evaluation of indeterminate thyroid nodules according to the British Thyroid Association 2014 classification and comparison of clinical evaluation and outcomes

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