Ultrasound-guided fine-needle aspiration biopsy in the management of thyroid disease

Rosen, Irving B.; Azadian, Abbas; Walfish, Paul G.; Salem, Shia; Lansdown, Edward; Bédard, Yvan C.

doi:10.1016/s0002-9610(05)80329-0

Cited by 134 publications

(76 citation statements)

References 5 publications

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“…Nonetheless, there are scant published data concerning the accuracy of FNAB in previously irradiated patients. 19,20 Our results suggest that the sensitivity and specificity of FNAB in irradiated patients are similar to those described in the general population. 14 In our study, it was noted that FNAB yielded inadequate samples in 19% of patients, similar to the inadequate sample rate of 17% reported for the general population 14 but lower compared with the rate of 24% recently reported by Hatipoglu and colleagues in a cohort of adults who received irradiated for benign conditions in early childhood.…”

Section: Discussionsupporting

confidence: 80%

“…14 In contrast, the false negative rate was not elevated in two previously published series in which FNAB was applied to individuals who had a history of head and neck irradiation. 19,20 Given the limited data available, it is not possible to draw definitive conclusions about the utility of FNAB in the evaluation of thyroid nodules that arise after therapeutic neck irradiation during childhood. Further research in this area is needed.…”

Section: Discussionmentioning

confidence: 99%

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Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

Acharya

Sarafoglou

LaQuaglia

et al. 2003

Cancer

172

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BACKGROUNDRecent data indicate that the risk of developing a thyroid neoplasm clearly is increased after high‐dose, therapeutic radiation therapy during childhood. To better understand the time course, natural history, and histopathology of thyroid lesions that develop after high‐dose irradiation, the authors undertook a retrospective study of all survivors of childhood and adolescent malignancies who were treated at Memorial Sloan‐Kettering Cancer Center and who developed a clinically apparent thyroid neoplasm.METHODSThe authors searched the data base of the Department of Pediatrics, the hospital‐based tumor registry, and the hospital medical records database for patients with thyroid neoplasms.RESULTSThirty‐three patients were identified who developed a thyroid neoplasm after therapeutic radiation. Primary diagnoses were Hodgkin disease (n = 18 patients), non‐Hodgkin lymphoma (n = 10 patients), acute lymphoblastic leukemia (n = 2 patients), acute myeloid leukemia (n = 1 patient), Wilms tumor (n = 1 patient), and neuroblastoma (n = 1 patient). The median age at the time of diagnosis of the primary malignancy was 12.0 years (range, 3.7–18.3 years), the median radiation dose to the thyroid gland was 2400 centigrays (cGy; range, 1000–4200 cGy), and the median interval from the time of radiation therapy until the recognition of thyroid disease was 13.0 years (range, 6.2–30.1 years). Thirteen of 33 thyroid lesions (39%) were malignant (11 papillary carcinomas and 2 follicular carcinomas). Age at diagnosis, gender ratio, and time elapsed since initial treatment did not differ between patients with malignant and benign lesions, but the median radiation dose to the thyroid was lower in patients who had malignant disease compared with patients who had benign disease (2000 cGy vs. 2950 cGy; P = 0.03). Disease was confined to the neck in all patients who had malignant thyroid lesions; after a median follow‐up of 6.5 years (range, 0.9–12 years), none of the patients developed progressive or recurrent disease.CONCLUSIONSData from this study suggest that a high proportion of clinically apparent thyroid neoplasms that develop after therapeutic radiation for a childhood malignancy are malignant. However, most of these thyroid malignancies do not appear to behave in an aggressive fashion. Because thyroid neoplasms may not become evident for decades after radiation therapy, all individuals who are at risk require life‐long follow‐up. Cancer 2003;97:2397–403. © 2003 American Cancer Society.DOI 10.1002/cncr.11362

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

Acharya

Sarafoglou

LaQuaglia

et al. 2003

Cancer

172

View full text Add to dashboard Cite

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“…The relative rate of PMC is increasing in patients with differentiated thyroid carcinoma (DTC) mainly due to more frequent use and improvement of ultrasonography and fine-needle aspiration biopsy, and also more accurate histopathological examination of surgical specimens [29]. Recently, it has been reported that papillary microcarcinomas appear to have similar biology to other papillary thyroid carcinomas [30].…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Carcinoma in Ultrasonography-guided Fine Needle Aspiration Cytology of Thyroid Nodules

2008

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Abstract. Objective: The purpose of this study was to assess the rate of malignancy in thyroid nodules incidentally detected at sonography and to determine the diagnostic value of ultrasonography-guided fine needle aspiration cytology (USgFNAC) in thyroid nodules. Methods: Five hundred patients (84 men and 416 women) who had thyroid incidentalomas underwent USgFNAC at Konkuk University Hospital between August 2005 and July 2006. Thyroid sonography and guided aspiration was performed on all single nodules and on dominant nodules with suspected malignancy in cases of multinodular goiter. Results: Five hundred fifty-eight nodules from 500 patients were aspirated using ultrasonography guidance. The USgFNAC results for all patients were as follows: 307 (61.4%) benign, 108 (21.6%) suggestive of malignancy, 56 (11.2%) indeterminate, and 29 (5.8%) inadequate for cytologic diagnosis. The rate of malignancy was significantly higher in women than in men (23.6% in women vs 11.9% in men, p<0.01). Ultrasonographic characteristics that had a significant association with thyroid malignancy included solid echocomponent, hypoechogenecity, ill defined margin, and presence of microcalcifications (p<0.05). Eighty-eight patients underwent surgical resection. The positive predictive value of USgFNAC was 90.2% (74/82), and the accuracy index was 84.1% (74/ 88). In 80 patients with well-differentiated thyroid carcinoma after surgery, 49% (39/80) had lesions smaller than 1 cm. Conclusion: The rate of malignancy in incidental thyroid nodules on USgFNAC was 21.6%. Ultrasonographic features could be useful in differentiating between benign and malignant nodules.

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“…Moreover, the method of screening differed between studies, with some studies using more sensitive methods than others. Physical examination is not a reliable method for detecting thyroid nodules, and ultrasound scans are generally required for thyroid nodule screening (28) followed by fine-needle aspiration biopsy (FNAB) for the management of suspected lesions (29).…”

Section: Introductionmentioning

confidence: 99%

Malignant and benign thyroid nodules after total body irradiation preceding hematopoietic cell transplantation during childhood

Vivanco

Dalle²,

Alberti³

et al. 2012

European Journal of Endocrinology

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Background: The risk of radiation-induced benign and malignant thyroid nodules is well known. Objective: The aim of this study was to determine the occurrence of thyroid nodules and carcinomas after fractionated total body irradiation (TBI) preceding hematopoietic stem cell transplantation (HSCT) for malignant hematological disease during childhood. Methods: We conducted a retrospective university hospital-based observational study. The participants were 76 patients receiving fractionated TBI between 1989 and 2009 as part of the conditioning regimen for HSCT to treat malignant hematological disease, with a median age of 8.2 (5.7-11.4) years, for whom the last ultrasound examination was performed at a median age of 14.2 (11.2-17) years. The main outcome measure was cumulative incidence of thyroid nodules detected by ultrasound scans followed by biopsy if necessary. Results: Thyroid nodules were examined in 21 (28%) patients, six (29%) of whom were diagnosed with thyroid carcinoma at the age of 2.2-18.6 years after TBI. The cumulative incidence of nodule occurrence increased with increasing time from diagnosis. The 10-year cumulative incidence of benign and malignant thyroid nodules was 16% (95% confidence interval (CI) 4-27%) and 8% (95% CI 0-16%) respectively. Seventeen (22%) patients had hypothyroidism (compensated nZ12, in five patients it was transient). No significant independent risk factors were identified in the multivariable competing risk model as a function of nodule occurrence. Conclusion: Short-term and life-long monitoring, with screening for nodules of the thyroid gland using ultrasound scans, is recommended for survivors subjected to TBI for HSCT during childhood.

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Ultrasound-guided fine-needle aspiration biopsy in the management of thyroid disease

Cited by 134 publications

References 5 publications

Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence

High Prevalence of Carcinoma in Ultrasonography-guided Fine Needle Aspiration Cytology of Thyroid Nodules

Malignant and benign thyroid nodules after total body irradiation preceding hematopoietic cell transplantation during childhood

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