ECE2024 Poster Presentations Thyroid (58 abstracts)
Correlation between the expected risk of malignancy according to FNA and the actual percentage of malignancy found on pathological anatomy in thyroidectomies and hemithyroidectomies
Aurelio López Guerra 1 , Isabel Losada Gata 1 , Mónica Gómez-Gordo Hernanz 1 , Gloria Collado González 1 , Marta Pérez Noguero 1 , Ignacio Jiménez Hernando 1 , Blanca Farache Suberviola 1 , Amaya Morales Jaurrieta 1 , Laura Gonzalez Fernandez 1 & Alberto García Piorno 1
1Gregorio Marañón General University Hospital, Madrid, Spain
Introduction: The Bethesda system gives each Fine Needle Aspiration (FNA) category a risk of malignancy (B1: 5-10%, B2: 0-3%, B3: 10-30%, B4: 25-40%, B5: 50-75%, B6: 97-99%). Based on this risk, therapeutic decisions are made that influence the patient’s life. It is important to check whether the percentage of malignancy obtained in our daily clinical practice is similar to that expected according to this system.
Aim: To check whether the percentage of malignancy in the FNA performed in our hospital is similar to that expected according to the Bethesda system for each of its different categories.
Methods: The pathological anatomy service was asked for the list of thyroidectomies and hemithyroidectomies of thyroidectomies and hemithyroidectomies performed in the hospital from 2018 to 2021. The interventions that had FNA prior to surgery were analyzed, noting the Bethesda category of each one. The anatomopathological analysis of the surgical specimens was evaluated, differentiating between positive and negative for malignancy. Among those positive for malignancy, a subsequent adjustment was made, excluding those specimens that had been positive for malignancy because they presented a finding of incidental microcarcinoma (IM) in an area of the thyroid other than the one corresponding to the previous FNA.
Results: A total of 569 thyroid samples were received from thyroidectomies and hemithyroidectomies performed at the Hospital GregoRio Marañón. Preoperative FNA was performed in 450 procedures, distributed across Bethesda categories as follows: B1 (6.2%; n = 28), B2 (45.7%; n = 206), B3 (15.5%; n = 70), B4 (8.2%; n = 37), B5 (11.5%; n = 52), B6 (12.6%; n = 57). Of these, 164 were positive for malignancy. Malignancy percentages on pathologic anatomy within each FNA category were: B1 (28, 5%; n = 8), B2 (9.2%; n = 19), B3 (30%; n =21), B4 (37.8%; n = 14), B5 (86.5%; n = 45), B6 (100%; n = 57). Excluding incidental microcarcinomas detected in the sample not corresponding to the evaluated nodule, the following percentages were obtained: B1 25%, B2 3.4%, B3 21.4, B4 35%, B5 84.6%, B6 100%.
Conclusions: The observed malignancy rate in our setting, after excluding non-concordant incidental microcarcinomas, aligns with Bethesda system expectations for categories B3, B4, and B6. The malignancy rate was notably higher in category B1 (25% vs 5-10%) and category B5 (84.61% vs 50-75%), with category B2 slightly exceeding the upper limit (3.4% vs 0-3%).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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