OBJECTIVE: Thyroid nodules with nondiagnostic (ND) fine-needle aspirations (FNA) typically undergo repeat sampling. While repeat FNA is often diagnostic, little is known regarding the significance of repeatedly ND aspirates. Limited data suggest there is very low, if any, risk of malignancy for repeatedly ND FNAs. STUDY DESIGN: We performed a retrospective analysis of ND thyroid FNAs over a nearly 6-year period at our institution to further address this question. RESULTS: There were 834 ND thyroid FNAs, representing 694 distinct thyroid nodules. Repeat FNA was performed after an initial ND aspirate in 52% of cases (363/694); 19% (70/363) had at least one additional ND diagnosis on repeat FNA. Surgical follow-up was available for 57 cases. Malignancy was identified histologically in 21% (9/42) of nodules after a single ND FNA and in 20% (3/15) of nodules with 2 or more repeatedly ND aspirates. Accounting for all benign cytologic follow-up, the overall risk of malignancy was 4% [12/303; 3.5% (9/255) following a single ND FNA and 6.3% (3/48) after repeated ND FNAs]. CONCLUSION: We observed no modification of malignancy risk when repeated FNAs were ND. Clinical management for an ND aspirate should remain repeat aspiration along with clinical and sonographic correlation.
OBJECTIVE: Thyroid nodules with nondiagnostic (ND) fine-needle aspirations (FNA) typically undergo repeat sampling. While repeat FNA is often diagnostic, little is known regarding the significance of repeatedly ND aspirates. Limited data suggest there is very low, if any, risk of malignancy for repeatedly ND FNAs. STUDY DESIGN: We performed a retrospective analysis of ND thyroid FNAs over a nearly 6-year period at our institution to further address this question. RESULTS: There were 834 ND thyroid FNAs, representing 694 distinct thyroid nodules. Repeat FNA was performed after an initial ND aspirate in 52% of cases (363/694); 19% (70/363) had at least one additional ND diagnosis on repeat FNA. Surgical follow-up was available for 57 cases. Malignancy was identified histologically in 21% (9/42) of nodules after a single ND FNA and in 20% (3/15) of nodules with 2 or more repeatedly ND aspirates. Accounting for all benign cytologic follow-up, the overall risk of malignancy was 4% [12/303; 3.5% (9/255) following a single ND FNA and 6.3% (3/48) after repeated ND FNAs]. CONCLUSION: We observed no modification of malignancy risk when repeated FNAs were ND. Clinical management for an ND aspirate should remain repeat aspiration along with clinical and sonographic correlation.
Authors: Sang Hyun Choi; Jung Hwan Baek; Jeong Hyun Lee; Young Jun Choi; Min Ji Hong; Dong Eun Song; Jae Kyun Kim; Jong Ho Yoon; Won Bae Kim Journal: Eur Radiol Date: 2014-07-20 Impact factor: 5.315
Authors: Andre Isaac; Caroline C Jeffery; Hadi Seikaly; Hani Al-Marzouki; Jeffrey R Harris; Daniel A O'Connell Journal: J Otolaryngol Head Neck Surg Date: 2014-12-03
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