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Exp Clin Endocrinol Diabetes 2016; 124(07): 448-451
DOI: 10.1055/s-0042-106082
Article
© Georg Thieme Verlag KG Stuttgart · New York

Fine Needle Aspiration Cytology vs. the Postoperative Histology – the Continuing Need for Multi-Disciplinary Approach?

G. Gill
1   Diabetes & Endocrinology, NHS, Stoke On Trent, United Kingdom of Great Britain and Northern Ireland
,
K. Kalyanasundaram
2   Stoke On Trent, NHS, United Kingdom of Great Britain and Northern Ireland
,
G. Varughese
3   Diabetes & Endocrinology, UHNM, Stoke On Trent, Great Britain and Northern Ireland
,
P. Wilson
3   Diabetes & Endocrinology, UHNM, Stoke On Trent, Great Britain and Northern Ireland
,
L. Varadhan
3   Diabetes & Endocrinology, UHNM, Stoke On Trent, Great Britain and Northern Ireland
› Author Affiliations
Further Information

Publication History

received 13 September 2015
first decision 29 March 2016

accepted 06 April 2016

Publication Date:
25 May 2016 (online)

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Abstract

We set out to investigate the concordance rates that were observed between fine needle aspiration cytology (FNA) compared with that of the post operative histology obtained for thyroid nodules over an 8 year period at a large university hospital.

A retrospective analysis of 355 cases was conducted; patients operated for hyperthyroidism were excluded for the purposes of this study. We identified malignancy in a total of 101 cases (28%) The chance of malignancy with 2 Thy1 specimens was 5% in this study and 9% was observed in those with a Thy 2 FNA. On the converse, 7% of patient had malignant cytology on FNA though post-operative histology turned out to be benign.

This therefore highlights the potential for discordance between thyroid FNA cytology and post-operative histology in the assessment of any thyroid nodule and thus reinforcing the need for a multidisciplinary approach in the assessment of all thyroid nodules.

Key words

thyroid - graves-disease - cancer
 

  • References

  • 1 Tunbridge WMG, Evered DC, Hall R et al. The spectrum of thyroid disease in a community: The Whickham survey. Clinical Endocrinology 1977; 7: 481-493
    CrossrefPubMedGoogle Scholar
  • 2 Hegedüs L. The thyroid nodule. New England Journal of Medicine 2004; 351: 1764-1771
    CrossrefPubMedGoogle Scholar
  • 3 Jemal A, Siegel R, Ward E et al. Cancer statistics, 2009. CA: A Cancer Journal for Clinicians 2009; 59: 225-249
    CrossrefPubMedGoogle Scholar
  • 4 AACE/AAES medical/surgical guidelines for clinical practice: Management of thyroid carcinoma. Endocrine Practice 2001; 7: 202-220
    CrossrefPubMedGoogle Scholar
  • 5 Dottorini ME, Mansi L, Perros P (ed.). British thyroid association, royal college of physicians. Guidelines for the management of thyroid cancer 2nd edition. Report of the thyroid cancer guidelines update group. European Journal of Nuclear Medicine and Molecular Imaging 2008; 35: 1218-1219
    CrossrefPubMedGoogle Scholar
  • 6 Kocjan G, Chandra A, Cross PA et al. The Interobserver reproducibility of thyroid fine-needle aspiration using the UK royal college of Pathologists’ classification system. American Journal of Clinical Pathology 2011; 135: 852-859
    CrossrefPubMedGoogle Scholar
  • 7 Cibas ES, Ali SZ. The Bethesda system for reporting thyroid Cytopathology. American Journal of Clinical Pathology 2009; 132: 658-665
    CrossrefPubMedGoogle Scholar
  • 8 Yang J, Schnadig V, Logrono R et al. Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations. Cancer 2007; 111: 306-315
    CrossrefPubMedGoogle Scholar
  • 9 Goellner JR. Fine needle aspiration Cytology: Lymph Node, thyroid and salivary gland. American Journal of Clinical Pathology 1990; 93: 838.1-838
    CrossrefPubMedGoogle Scholar
  • 10 Orlandi A, Puscar A, Capriata E et al. Repeated fine-needle aspiration of the thyroid in benign nodular thyroid disease: Critical evaluation of long-term follow-up. Thyroid 2005; 15: 274-278
    CrossrefPubMedGoogle Scholar
  • 11 Curtis RE, Rowlings PA, Deeg HJ et al. Solid cancers after bone marrow transplantation. New England Journal of Medicine 1997; 336: 897-904
    CrossrefPubMedGoogle Scholar
  • 12 Pacini F, Vorontsova T, Demidchik EP et al. Post-Chernobyl thyroid carcinoma in Belarus children and adolescents: Comparison with naturally occurring thyroid carcinoma in Italy and France 1. The Journal of Clinical Endocrinology & Metabolism 1997; 82: 3563-3569
    PubMedGoogle Scholar
  • 13 Boelaert K, Horacek J, Holder RL et al. Serum Thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. The Journal of Clinical Endocrinology & Metabolism 2006; 91: 4295-4301
    CrossrefPubMedGoogle Scholar
  • 14 Tan GH. Thyroid Incidentalomas: Management approaches to Nonpalpable nodules discovered incidentally on thyroid imaging. Annals of Internal Medicine 1997; 126: 226
    CrossrefPubMedGoogle Scholar
  • 15 Moon W-J, Jung SL, Lee JH et al. Benign and malignant thyroid nodules: US Differentiation – Multicenter retrospective study 1. Radiology 2008; 247: 762-770
    CrossrefPubMedGoogle Scholar
  • 16 Cappelli C. Thyroid nodule shape suggests malignancy. European Journal of Endocrinology 2006; 155: 27-31
    CrossrefPubMedGoogle Scholar
  • 17 Ravetto C, Colombo L, Dottorini ME. Usefulness of fine-needle aspiration in the diagnosis of thyroid carcinoma. Cancer 2000; 90: 357-363
    CrossrefPubMedGoogle Scholar
  • 18 Renshaw AA. Accuracy of thyroid fine-needle aspiration using receiver operator characteristic curves. American Journal of Clinical Pathology 2001; 116: 477-482
    CrossrefPubMedGoogle Scholar
  • 19 Al Maqbali T, Tedla M, Weickert MO et al. Malignancy risk analysis in patients with inadequate fine needle aspiration Cytology (FNAC) of the thyroid. PLoS ONE 2012; 7: e49078
    CrossrefPubMedGoogle Scholar
  • 20 Richard M. DeMay. The art and science of Cytopathology. Acta Cytologica 1996; 40: 606-606
    CrossrefPubMedGoogle Scholar