Endocrine Abstracts

Background: The most common method for evaluation of a suspicious thyroid nodule is a fine needle aspiration biopsy (FNAB). Together with ultrasound examination, thyroid scanning using pertechnetate and functional thyroid testing it helps in distinguishing between benign and malignant disease.

Objective: Aim of this study is to assess accuracy of FNAB in the diagnostic evaluation of thyroid nodules.

Patients: We retrospectively analyzed the medical records of the 84 patients who underwent FNAB of thyroid nodules.

Results: Fifty five of 84 patients had solitary thyroid nodule and 29 had multinodular goiter. Size of nodules was from 12 mm to over 60 mm measured by ultrasound. There were 27 cystic and 57 solid nodules. FNAB was performed on ‘cold’ nodules (57 nodules were non-functioning; scanning was not performed on cystic nodules). FNAB was non-diagnostic in 11 patients (13.09%), 6 with cystic and 5 with solid nodules. Benign finding was in 56 (66.67%), 21 with cystic and 35 with solid nodules. Papillary carcinoma was found in 3 (3.57%) and follicular neoplasm in also 3 (3.57%) and they underwent surgery (diagnoses of carcinoma were confirmed on histological results). In 11 patients (13.09%) finding was atypical. Six of these patient had nodules bigger then 2 cm and underwent surgery, and for 5 with smaller nodules the decision was made to be followed up and to repeat FNAB eventually. Final histological diagnoses in 3 of these 6 patients were benign.

Echogenicity, echo structure and shape did not show any significant difference between benign and malignant nodules in this study. Thyroid scanning in all patients showed non-functioning nodules. All the patients were euthyroid (normal TSH and T4). There were no complications of FNAB.

Conclusions: When the literature is reviewed and compared with the results of this study, the use of FNAB as a decision tool to operate is valid.