Thyroid Microcarcinoma: Fine-Needle Aspiration Diagnosis and Histologic Follow-up

Abstract

The increased sensitivity of many imaging modalities (ultrasound, computed tomography scan, magnetic resonance imaging) has resulted in the identification of thyroid nodules, measuring 1 cm or less. Usually these small lesions are regarded as incidental and are not sampled by fine-needle aspiration (FNA). However, some of these lesions undergo FNA because of suspicious radiology findings (multifocality, calcification, etc) or in patients with a history of radiation to the head and neck region. We present FNA findings and histologic follow-up of 39 thyroid nodules that measured 1.0 cm or less. All FNAs were performed under ultrasound guidance. The lesions ranged in size from 0.2 to 1.0 cm. Twenty-two lesions were diagnosed as papillary carcinoma (PTC), 4 as medullary carcinoma (MC), and 13 as suspicious for PTC on FNA. Histologic follow-up showed PTC in 35 and MC in 4 cases; 11 PTC were multifocal (31%) and lymph node metastases were present in 8 (16%) cases. Ultrasound-guided FNA is effective in the sampling of thyroid cancers that are 1.0 cm or less. The present study shows that some of these lesions can be clinically significant.

The fine-needle aspiration biopsy efficacy of small thyroid nodules in the area of recently normalized iodine supply

“…Some reports suggest that the smaller the size of aspirated lesion the higher the rate of inadequate specimens (24,27,33). Other reports from Japan and Korea suggest that if the staff performing FNAB of the thyroid is experienced enough, it is possible to aspirate reliably even very small lesions -with diameters of 2-3 mm (13,34). In these Asian countries, specialists more often diagnose very small thyroid lesions whichbecause of the specific epidemiological situation -less frequently coexist with other larger lesions but are microcarcinomas more frequently than in the countries with low iodine supply.…”

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

“…Under US guidance, sufficient cytological material has been obtained from nodules as small as 2 mm in diameter (53). Inadequate cytologic samples obtained by US-guided FNAB in nonpalpable nodules was w18.5% of all cases (127, 133, 134) and 22.5 and 33% in nodules %10 mm (127,130,135,138).…”

Clinical application of carbon nanoparticle lymph node tracer in the VI region lymph node dissection of differentiated thyroid cancer

“…The metastasis rate of the VI region lymph nodes was reported to be as high as 50-70% (Yang et al, 2002). Metastases of the VI region lymph nodes have important prognostic value for accurate clinical staging, surgical planning, postoperative treatment, follow-up programs, assessment of recurrence risk, and prognosis (Zhang, 2011).…”