Value of Repeated Fine Needle Aspiration Cytology in Patients with Nodular Goiter

Torre, Edelmiro Menéndez; Arribas, Javier Pineda; Esteban, Juan Pablo Martínez de; Carballo, María Teresa López; Miguel, C. De; Salvador, Pilar

doi:10.1159/000325859

Cited by 25 publications

(18 citation statements)

References 16 publications

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“…Although presenting a high negative predictive value, benign cytology does not definitively exclude malignancy in thyroid nodules and repetition of FNAC has been proposed for the detection of false-negative cases (3)(4)(5)(6)(7)(8)(9). Repetition of FNAC in all cases of nodules with an initial benign cytological diagnosis leads to a final diagnosis of malignancy in only approximately 2% of cases (3,4,(6)(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

“…Repetition of FNAC in all cases of nodules with an initial benign cytological diagnosis leads to a final diagnosis of malignancy in only approximately 2% of cases (3,4,(6)(7)(8)(9). Due to an indeterminate, suspicious or insufficient cytology result, about 13% of patients are referred for thyroidectomy exclusively based on the findings of repeat FNAC and most of these patients present benign histology (3,5,(7)(8)(9). Finally, some investigators defend the need for three cytology exams to ensure the benign character of the nodule (4,9), an approach that increases even further the relevance of the problems cited above.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, some investigators recommend repetition of FNAC in the case of nodules with an initial benign cytological diagnosis (3)(4)(5)(6)(7)(8)(9). In contrast to this management, it is found the fact that the first diagnosis remains unchanged in most cases (3,4,(6)(7)(8)(9) and that other patients are unnecessarily submitted to surgery because of an unsatisfactory or indeterminate biopsy (3,5,8,9). Thus, knowledge about the characteristics that identify, with a higher probability, nodules harboring malignancy despite benign cytology is important to reduce the number of cases of masked malignancy without exposing a large number of patients to a second procedure.…”

Section: Descritoresmentioning

confidence: 99%

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Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Rosário

Purisch

2010

Arq Bras Endocrinol Metab

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OBJECTIVE: To report the results of repeat fine-needle aspiration cytology (FNAC) in thyroid nodules with an initial benign cytological diagnosis that grow during follow-up and/or present suspicious ultrasonographic characteristics. SUBJECTS AND METHODS: The sample consisted of 456 patients with 895 nodules. FNAC was repeated after 12 to 18 months in the case of nodules with suspicious ultrasonographic characteristics, irrespective of growth, and when the nodules showed significant growth. RESULTS: Among the 895 nodules examined, 102 (11.4%) presented suspicious ultrasonographic characteristics. The second FNAC revealed malignancy in 18 (17.6%) nodules, including 20% (2/10) of those showing growth and 17.4% (16/92) that did not. Seventy-six (9.6%) of 793 nodules without suspicious characteristics presented growth. Only one case (1.3%) of malignancy was diagnosed by repeat FNAC. CONCLUSIONS: The study suggests ultrasonographic characteristics rather than growth as a criterion for repeat FNAC in the case of nodules with an initial benign cytological diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Descritoresmentioning

confidence: 99%

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Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Rosário

Purisch

2010

Arq Bras Endocrinol Metab

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“…Subsequent results have cumulatively changed in about 7% of the cases, and carcinoma was found in about 2%. This relevant number of carcinomas can be detected by repeated FNAC according to many authors (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Some authors tried to find out how many times FNAC should be repeated.…”

Section: Discussionmentioning

confidence: 99%

Benign fine-needle aspiration cytology of thyroid nodule: to repeat or not to repeat?

Gabalec

J²,

Ryška³

et al. 2009

European Journal of Endocrinology

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Context: Fine-needle aspiration cytology (FNAC) is the gold standard for evaluating thyroid nodules. It has a sensitivity rate of about 95%, i.e. false negative results represent up to 5% of cases. The value of repeated FNAC during follow-up is still controversial. Objective: To evaluate the usefulness of repeating the FNAC for initially benign nodules. Design and methods: All 5017 patients who underwent FNAC of the thyroid nodule in years 1991-2008 were retrospectively evaluated. Results: Repeated FNAC was performed in 574 nodules with initially benign results. The number of repetitions varied from one to six. Repeatedly benign results were found in 498 cases, and malignant/ suspicious results with initially benign cytology were found in 76 nodules (13.2%). Carcinoma was present in 13 out of the 58 surgically treated malignant/suspicious results of initially benign cytology. Conclusions: A change from a benign FNAC result to a malignant/suspicious one was present in more than 13% of the patients with initially benign cytology; malignancy has been recognised on the basis of repeated FNAC in 2.3% patients. In the majority of cases, the repetition corrected wrong cytological interpretation of results other than colloidal goitre, especially Hashimoto's thyroiditis and regressive changes. We believe that repeating FNAC in patients with benign cytology in about a 1-year horizon can reduce the rate of undiagnosed tumours.European Journal of Endocrinology 161 933-937

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“…In most cases, clinical and US examination and TSH measurement are appropriate in 6 to 18 months. A routine repeated FNA biopsy may be considered in patients with initially benign cytologic results because of the low, but not negligible, possibility of falsenegative results (119). Reaspiration under US guidance is recommended if a nodule significantly enlarges, if a cyst reappears, or in case of suspicious clinical or US changes (8,112).…”

Section: Clinical Follow-up or Levothyroxine Suppressive Therapymentioning

confidence: 99%

American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

Gharib¹,

Papini²,

Paschke³

et al. 2010

Endocrine Practice

832

819

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Value of Repeated Fine Needle Aspiration Cytology in Patients with Nodular Goiter

Cited by 25 publications

References 16 publications

Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Benign fine-needle aspiration cytology of thyroid nodule: to repeat or not to repeat?

American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

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