Endocrine Abstracts

Introduction: Fine-needle biopsy(FNB) is an essential diagnostic tool in the evaluation of thyroid nodules, however, follicular neoplasm(FN) does not exclude malignancy. Some sonographic and cytological features have been described as being associated with increased risk of malignancy. The authors aimed to identify demographic, sonographic and cytologic features associated with malignancy in patients with a cytological diagnosis of FN.

Methods: Descriptive study of all patients(pts) with a cytological result compatible with FN, who underwent thyroid surgery at our institution in 2010. Gender, age, nodule size, TSH, sonographic and cytological features were recorded. Statistical analysis was performed with SPSS, v.17.0, using chi-square and Mann-Whitney tests.

Results: 78 pts, 58 F(74%), 20 M(26%), mean age 48.5±14.7 years(22–79). FN: 69 patients (88.5%), Hurthle cell neoplasm: 9 patients(11.5%). Average nodule diameter: 25.2 mm(8–81). Single nodule: 48 pts(61.5%), multinodular goiter: 30 pts(38.5%). Histology: 12 pts with malignant lesions(15.4%) - papillary carcinoma:9 pts, follicular carcinoma: 2 pts, medullary carcinoma: 1 pt; 64 pts with benign lesions(82.1%) - follicular adenoma(including Hurthle cell): 47 pts(60.2%), nodular hyperplasia: 17 pts(21.8%), well-differentiated tumor of uncertain malignant potential (WDTUMP): 2 pts(2.6%). Incidental histological findings: papillary microcarcinoma(MP): 12 pts(15.4%), WDTUMP: 1 pt(2.6%). The average age of patients with malignant lesions was lower than the group with a benign histology(37.7±12.5 vs. 50.0±14.3), P=0.007. No statistically significant differences were found between malignancy and sonographic characteristics(eg size, echogenicity, texture, peripheral halo, borders, microcalcifications), cytological features and TSH.

Discussion: The retrospective nature of the study, the size and heterogeneity of the sample and the limited description of sonographic and cytological features were important limitations. The significantly lower age of pts with malignant disease may indicate the need for a more aggressive approach. Future studies will be necessary towards the confirmation of these results.

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