Filip Gabalec1, Jan Cáp, Ales Ryska, Tomás Vasátko, Vera Ceeová. 1. Second Department of Internal Medicine, Faculty of Medicine, Charles University and Teaching Hospital in Hradec Králové, Sokolská 581, 500-05 Hradec Králové, Czech Republic. gabalec@fnhk.cz
Abstract
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.
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.
Authors: Naykky Singh Ospina; Spyridoula Maraka; Ana Elena Espinosa de Ycaza; Juan P Brito; M Regina Castro; John C Morris; Victor M Montori Journal: Endocrine Date: 2016-05-03 Impact factor: 3.633
Authors: Nigel Glynn; Mark J Hannon; Sarah Lewis; Patrick Hillery; Mohammed Al-Mousa; Arnold D K Hill; Frank Keeling; Martina Morrin; Christopher J Thompson; Diarmuid Smith; Derval Royston; Mary Leader; Amar Agha Journal: BMC Endocr Disord Date: 2016-08-02 Impact factor: 2.763
Authors: Agnaldo José Graciano; Carlos Takahiro Chone; Carlos Augusto Fischer; Giuliano Stefanello Bublitz; Ana Jacinta de Aquino Peixoto Journal: Braz J Otorhinolaryngol Date: 2014-07-22