Endocrine Abstracts

Introduction: There is no consensus about the usefulness of repeating the US-FNAB during the follow-up of nodules when a benign (Thy2) or indeterminate (Thy3) report is obtained at first US-FNAB.

Aim of the study: To investigate the clinical value of repeating US-FNAB after a previous adequate Thy2 or Thy3 US-FNAB.

Methods: We reviewed the US-FNABs performed from 2006 to 2009. All clinical data of the patients were collected and analyzed using the MoCyThy DATABASE, which is the part of the institutional database ENDOBASE (based on the MyQ1L open source technology) devoted to store data of all institutional US-FNABs. Among 7983 records, we searched out 288 patients (327 nodules) undergoing at least two consecutive adequate US-FNABs for a total of 686 US-FNABs. We compared the first US-FNAB (Thy2 or Thy3) at baseline with the results of the following US-FNABs (2nd or 3rd US-FNAB).

Results: Of the 327 baseline US-FNABs, 58% were Thy2 and 42% Thy3. Of the 189 Thy2 at baseline, 157 (83%) were confirmed as Thy2 at follow-up, while 32 (17%) did not confirm the first diagnosis: 29 (15%) of them were Thy3 and 3 (2%) Thy4. No modifications of volume or US-features were recorded in these Thy4 from baseline. Of the Thy3 at baseline, 55 (40%) were confirmed as Thy3 at the follow-up, 84 (60%) did not confirm the first diagnosis: of them 6 (4%) were Thy4/5 and 78 (56%) Thy2.

Conclusions: The outcome of a subsequent US-FNAB is often discordant compared with the first cytological diagnosis. A first cytological diagnosis of Thy2 does not completely exclude a malignant (Thy4) or an indeterminate (Thy3) lesion. A second US-FNAB after 6–12 months may be useful, in clinical practice, to definitively confirm benign lesions or to reduce the rate of malignant tumor or of follicular lesions unrecognized by the first US-FNAB.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.