Thyroid diagnostic modalities (fine needle aspiration and core needle biopsy) with histology correlation: a tertiary centre experience

AimsTo determine the proportion of thyroid fine needle aspiration (FNA) and core needle biopsy (CNB) cases reported at a single institute into each UK Royal College of Pathologists (RCPath) Thy1-5 and local T category, respectively. Where subsequent histology was available, malignancy rates, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were compared for both procedures.Methods1591 FNAs (2010–2018) and 514 CNBs (2013–2018) cases were identified, together with paired histology excision specimens.ResultsThe FNA samples were classified as: Thy1: 45.3%, Thy2/Thy2c: 22.1%, Thy3a/Thy3f: 28%, Thy4: 1.6% and Thy5: 3%; while the CNB were classified as: T1: 7.2%, T2: 22.4%, T3 59.3%, T4: 1% and T5: 10.1%. Comparison of FNA and CNB classified as Thy5/T5 showed a 100% risk of malignancy (ROM), sensitivity (98% vs 100%), specificity (14.1% vs 12.1%), PPV (29.4% vs 29.4%), NPV (94.9% vs 100%) and accuracy (36.5% vs 35.6%), respectively, for a diagnosis of malignancy. ROMs for other categories were: Thy1/T1 (9% vs 6.7%), Thy2/T2 (5.1% vs 0%), Thy3/T3 (17.5% vs 18.4%) and Thy4/T4 (73.3% vs 100%).ConclusionsThe proportion of cases in each RCPath Thy category has remained relatively stable during the 9-year study period, with the exception of the Thy3a category, which has increased over time. This finding is in line with other more recent reports in the literature and the proportion of T3 cases in the CNB group. The proportion of Thy2/Thy2c cases has also reduced over time, reflecting a local change in the triaging protocol for probable benign lesions. Both FNA and CNB showed comparable performance in our study.

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Fine-Needle Aspiration Cytology versus Core-Needle Biopsy for Breast Lesions: A Dilemma of Superiority between the Two

Acta Cytologica ◽

10.1159/000517005 ◽

2021 ◽

pp. 1-6

Author(s):

Priyanka Verma ◽

Reetika Sharma ◽

Neelam Sharma ◽

Anchana Gulati ◽

Anupam Parashar ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Core Needle Biopsy ◽

Predictive Value ◽

Needle Biopsy ◽

Needle Aspiration ◽

Breast Lesions ◽

Aspiration Cytology ◽

Core Needle ◽

Fine Needle ◽

Needle Aspiration Cytology

Introduction: Core-needle biopsy (CNB) is a minimally invasive procedure used in preoperative diagnosis of breast lumps. It has been seen that in few years, the CNB seems to be replacing the fine-needle aspiration cytology (FNAC), although no study had yet conclusively proved a superiority of one over the other. Aims and Objectives: The aim of this study was to study the cytohistological spectrum of palpable breast lesions and to evaluate the diagnostic accuracy of FNAC versus CNB for breast lesions. Materials and Methods: The study was a cross-sectional study conducted in the Department of Pathology and Surgery, over a period of 1 year in 152 patients. All the patients were subjected to FNAC and CNB. Cytosmears were stained with May-Grunwald Giemsa and hematoxylin and eosin was done on CNB and excision biopsy (EB) specimens. Sensitivity and specificity were calculated in percentage with 95% confidence interval with reference to CNB/surgical specimens. Kappa statistics were used to compare the level of agreement between FNAC versus CNB and CNB versus surgical specimens. Results: A total of 152 patients were taken for FNAC and CNB. EB was performed in only 104 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNAC verses CNB in correlation with subsequent histopathology were found to be (93.40 vs. 94.06%), (97.50 vs. 100.00%), (99.00 vs. 100.00%), (84.78 vs. 33.33%), and (94.52 vs. 94.23%), respectively. Conclusion: CNB has overcome the pitfall of FNAC but CNB cannot replace FNAC but both procedures are complementary to each other.

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Comparison of Usefulness of Ultrasound-Guided Fine Needle Aspiration and Core Needle Biopsy in Diagnosis of Cervical Lymphadenopathy

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2020.01116 ◽

2021 ◽

Vol 64 (8) ◽

pp. 568-575

Author(s):

Ju Yong Kang ◽

Jung Jun Kim ◽

Brian Kim ◽

Myung-Chul Lee ◽

Ik Joon Choi

Keyword(s):

Malignant Lymphoma ◽

Fine Needle Aspiration ◽

Core Needle Biopsy ◽

Predictive Value ◽

Needle Biopsy ◽

Cervical Lymphadenopathy ◽

Needle Aspiration ◽

Core Needle ◽

Fine Needle ◽

Significant Difference

Background and Objectives The purpose of this study is to compare diagnostic outcome and safety of fine needle aspiration (FNA) and core needle biopsy (CNB) in patients with cervical lymphadenopathy. Subjects and Method This retrospective studies were conducted on 164 cases with cervical lymphadenopathy that had undergone FNA, and 44 cases that had undergone CNB. The cytopathological results from FNA and CNB were compared with the histopathological results confirmed by excisional biopsy in the nodes according to different sizes and radiological levels, respectively. Diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were evaluated according to disease entities.Results FNA is more accurate than CNB in most of the sizes and at all cervical levels. However, there is no statistically significant difference between the results of the two tests. Sensitivity and NPV for diagnosis of malignant lymphoma are higher with FNA than with CNB. However, specificity and PPV for malignant lymphoma are higher with CNB than with FNA. Also CNB showed superior sensitivity, PPV and NPV for metastatic lymphadenopathy. Conclusion Although CNB is beneficial in reducing the false negative rate, it still has several limitations. Since CNB has no statistically significant advantage over FNA, FNA can be a good alternative method with less complication and high diagnostic value for lesions where CNB is difficult to perform.

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