[Fine-needle Aspiration of Thyroid Nodules: Is it Worth Repeating?]

Authors:
Vera Fernandes
Vera Fernandes
Centro Hospitalar de São João
Portugal
Catarina Eloy
Catarina Eloy
Hospital de São João
Portugal

Acta Med Port 2017 Jun 30;30(6):472-478. Epub 2017 Jun 30.

IPATIMUP Diagnósticos. Instituto de Patologia e Imunologia Molecular. Universidade do Porto. Porto. Portugal; Departamento de Patologia. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.

Introduction: The fine-needle aspiration has a significant role in assessing the malignancy risk of thyroid nodules. There is uncertainty regarding the value of repeat fine-needle aspiration in benign nodules. This study aims to evaluate the concordance of results in consecutive fine-needle aspiration and to study the relevance of repetition in benign results.

Material And Methods: Retrospective study of the 4800 thyroid nodules fine-needle aspiration held in Instituto de Patologia e Imunologia Molecular da Universidade do Porto between January 1, 2014 and May 2, 2016. Of the initial sample, we selected the repeated fine-needle aspiration on the same nodule.

Results: The first fine-needle aspiration result of the 309 nodules underwent revaluation was non-diagnostic in 103 (33.3%), benign in 120 (38.8%) and atypia/follicular lesion of undetermined significance in 86 (27.8%). The agreement between the first and second fine-needle aspiration was significantly higher in cases with an initial benign result (benign: 85.8%, non-diagnostic: 27.2% and atypia/follicular lesion of undetermined significance: 17.4%, p < 0.005). The fine-needle aspiration repeating motifs in initially benign nodules (n = 78) were repetition suggestion in 58, nodule growth in 17 and suspicious ultrasonographic features in 3.

Discussion: The fine-needle aspiration repetition in nodules with initial non-diagnostic and atypia/follicular lesion of undetermined significance result changed the initial diagnosis in a significant proportion of patients, modifying their therapeutic approach. The high concordance of results in initially benign nodules makes fine-needle aspiration repetition not cost-effective in most cases.

Conclusion: The fine-needle aspiration should be repeated when the initial cytology result is non-diagnostic or atypia/follicular lesion of undetermined significance.

Download full-text PDF

Source
June 2017
5 Reads

Publication Analysis

Top Keywords

fine-needle aspiration
44
undetermined significance
16
atypia/follicular lesion
16
lesion undetermined
16
thyroid nodules
12
benign nodules
12
fine-needle
11
aspiration
11
aspiration repetition
8
non-diagnostic atypia/follicular
8
nodules
8
nodules fine-needle
8
initially benign
8
benign
7
initial
5
cases initial
4
benign 858%
4
non-diagnostic 272%
4
858% non-diagnostic
4
significance 278%
4

Similar Publications

[Repeated fine-needle aspiration cytology for the diagnosis and follow-up of thyroid nodules].

Braz J Otorhinolaryngol 2014 Sep-Oct;80(5):422-7. Epub 2014 Jul 22.

Hospital São José, Joinville, SC, Brazil.

Introduction: The recently-proposed Bethesda reporting system has offered clinical recommendations for each category of reported thyroid cytology, including repeated fine-needle aspiration (FNA) for non-diagnostic and atypia/follicular lesions of undetermined significance, but there are no sound indications for repeated examination after an initial benign exam.

Objective: To investigate the clinical validity of repeated FNA in the management of patients with thyroid nodules.

Method: The present study evaluated 412 consecutive patients who had repeated aspiration biopsies of thyroid nodules after an initial non-diagnostic, atypia/follicular lesion of undetermined significance, or benign cytology. Read More

View Article
February 2015

Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance.

Head Neck 2017 02 5;39(2):361-369. Epub 2016 Oct 5.

Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea.

Background: The purpose of this study was to evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeat fine-needle aspiration (FNA) for thyroid nodules that are initially read as atypia/follicular lesion of undetermined significance (AUS/FLUS) on FNA.

Methods: Among 2631 initial AUS/FLUS FNA results, 505 consecutive nodules (295 repeat FNAs and 210 CNBs) were retrospectively analyzed. The primary outcome was inconclusive (ie, nondiagnostic or AUS/FLUS). Read More

View Article
February 2017

Follow-up of atypia and follicular lesions of undetermined significance in thyroid fine needle aspiration cytology.

Cytopathology 2013 Dec 18;24(6):385-90. Epub 2012 Oct 18.

Departments of PathologyEndocrinology and Metabolism, Yildirim Beyazit University, Ankara Ataturk Research and Education Hospital, Ankara, Turkey.

Objective: To report our experience of atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) rate and outcome.

Methods: Among 7658 patients with 19 569 nodules, 524 (2.7%) nodules were diagnosed as AUS/FLUS on fine needle aspiration (FNA). Read More

View Article
December 2013

Malignancy risk and characteristics of thyroid nodules with two consecutive results of atypia of undetermined significance or follicular lesion of undetermined significance on cytology.

Eur Radiol 2015 Sep 5;25(9):2601-7. Epub 2015 Mar 5.

Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 120-752.

Purpose: To evaluate the malignancy risk and characteristics of thyroid nodules with two "Atypia of Undetermined Significance" or "Follicular Lesion of Undetermined Significance" (AUS/FLUS) results, and compare characteristics of malignancies with two AUS/FLUS results to those with one AUS/FLUS result.

Methods: Of 441 thyroid nodules with initial AUS/FLUS results, 236 underwent repeat fine-needle-aspiration (FNA), with 58 obtaining repeated AUS/FLUS results. Thyroid Imaging Reporting and Data System (TIRADS) categories were assigned, and clinico-pathological characteristics were compared between benign and malignant nodules and between malignancies with two consecutive AUS/FLUS results and those with one AUS/FLUS result. Read More

View Article
September 2015