SFEBES2013 Poster Presentations Thyroid (37 abstracts)
Clinical performance of fine-needle aspiration biopsy of thyroid nodules in a tertiary referral centre
Nigel Glynn 1 , Mark Hannon 1 , Sarah Lewis 1 , Patrick Hillary 1 , Arnold D K Hill 2 , Frank Keeling 3 , Martina Morrin 3 , Claire McHenry 1 , Diarmuid Smith 1 , Chris Thompson 1 , Mary Leader 4 & Amar Agha 1
1Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Dublin, Ireland; 2Department of Surgery, Beaumont Hospital and RCSI Medical School, Dublin, Ireland; 3Department of Radiology, Beaumont Hospital and RCSI Medical School, Dublin, Ireland; 4Department of Pathology, Beaumont Hospital and RCSI Medical School, Dublin, Ireland.
Fine-needle aspiration biopsy (FNAB) is the tool of choice for evaluating thyroid nodules but there is a significant percentage of insufficient or indeterminate aspirates and falsely reassuring results have been reported in up to 6% of cases.
We aimed to examine our experience with FNAB among a large cohort of unselected patients with thyroid nodules.
239 consecutive patients (211 women) underwent FNA of a thyroid nodule between July 2008 and June 2010. Median follow-up 40 months. Data recorded include demographic and biochemical variables as well as Thy grading.
18% were initially diagnosed as Thy 1 (insufficient), 58% as Thy 2 (benign), 19% as Thy 3 (follicular neoplasm), 2% as Thy 4 (suspicious for malignancy) and 3% as Thy 5 (malignant). All patients classified as Thy 4 and 5 had malignancy diagnosed following thyroidectomy. 10 of 45 nodules (22%) classified as Thy3, were ultimately diagnosed as malignant following surgery. Four Thy 2 nodules changed classification following routine repeat FNAB; one patient was reclassified as Thy 5 and was diagnosed with papillary thyroid cancer and 3 were reclassified as Thy 3 – two were ultimately diagnosed with benign disease while one declined lobectomy.
Younger euthyroid patients were more likely to have adverse cytological features. There was no association between gender and histological outcome.
The rate of malignancy among Thy three nodules was high but comparable with reported data. All such nodules should be fully excised. Thy two nodules are very likely to be benign but repeat sampling after 6 months is recommended.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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