Endocrine Abstracts

Introduction: Fine needle aspiration (FNA) is the first-line diagnostic test for evaluating thyroid nodules. This test can effectively distinguish between neoplastic and non neoplastic nodules. The Bethesda System suggest that thyroid nodules with non diagnostic (ND), atypia/follicular lesions of undetermined significance (A/FLUS) aspiration should undergo repeat sampling. We aimed to investigate the clinical validity of repeated FNA in the management of patients with thyroid nodules in our institution.

Methods/design: In this study we evaluated 668 nodules of 529 patients who undergone repeated sampling in Başkent University Hospital between 2000 and 2014.

Results: The majority of patients were female (n=421, %79.6). The mean age of patients was 60.1±14.5 years. First evaluation revealed that 467 (89.9%) of nodules were benign, 180 (26.9%) were non diagnostic and 21 (3.1%) were A/FLUS). Enlargement of the nodule (%27.9) was the most common indication for a repeated sampling followed by non-diagnostic cytology (%26.9). Re-aspiration altered the initial diagnosis in 84.4% and 66.7% of the non-diagnostic and (A/FLUS) patients but only in 10.7% of patients with a benign cytology the initial diagnosis was changed. We evaluated the outcome of patients whose initial and repeated cytological diagnosis are non diagnostic and A/FLUS (Table 1). Outcome data was obtained 23 (65.7%) of these patients.

Conclusion: Repeat FNA is useful in cases whose initial diagnosis is non diagnostic or A/FLUS, but repeated aspiration for patients with an initial benign examination appears to not increase the expected likelihood of a malignant cytology.