Fine-Needle Aspiration Cytology of Thyroid Nodules with Hürthle Cells: Cytomorphologic Predictors for Neoplasms, Improving Diagnostic Accuracy and Overcoming Pitfalls

In light of the rising rate of incidentally detected subcentimetre thyroid nodules due to improved surveillance and diagnostic imaging, the decision of whether to perform fine needle aspiration cytology is increasingly pertinent. We aim to assess (1) the sampling adequacy of fine needle aspiration cytology, (2) malignancy rate, (3) thyroidectomy rate and (4) diagnostic accuracy of fine needle aspiration cytology. A total of 245 subcentimetre nodules in 220 patients underwent fine needle aspiration cytology between 2011 and 2014. Medical records were reviewed for cytology results, subsequent management and histopathological results in the event the patient underwent thyroidectomy. Sampling adequacy was calculated as the percentage of diagnostic results (Bethesda II–VI). Malignancy rate was defined as the percentage of Bethesda IV–VI diagnoses. Amongst patients with Bethesda IV–VI diagnoses who underwent thyroidectomy, their cytology reports were correlated with post-operative histopathological findings. The sampling adequacy of fine needle aspiration cytology was 77.1%. Malignancy rate (Bethesda IV–VI) was 9.7%. The respective malignancy rates in the < 5 mm nodule group and ≥ 5 mm nodule group were 6.67 and 10.0%. In total, 79.2% (19/24) of the malignant nodules underwent surgical excision. The rest declined surgery and/or were lost to follow-up. Amongst the malignant nodules which were surgically resected, 84.2% (16/19) had definitive malignant histology. Five of these demonstrated multifocal carcinoma and/or extrathyroidal extension of carcinoma on histology. Initial fine needle aspiration cytology and subsequent histopathological diagnoses matched in all cases except for three that had false-positive fine needle aspiration cytology results. Majority of our patients with suspicious cytology results subsequently underwent thyroidectomy, notwithstanding the relatively lower diagnostic accuracy of fine needle aspiration cytology in subcentimetre thyroid nodules.

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Fine Needle Aspiration Cytology of Thyroid Nodules: Evaluation of Diagnostic Accuracy

Tzu Chi Medical Journal ◽

10.1016/s1016-3190(08)60054-3 ◽

2008 ◽

Vol 20 (4) ◽

pp. 296-303 ◽

Cited By ~ 2

Author(s):

Chih-En Tseng ◽

Chang-Kuo Wei ◽

Chin-Sung Kuo ◽

Shih-Tang Yan ◽

Pin-Fan Chen ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

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Thyroid Imaging Reporting and Data System and Ultrasound Elastography: Diagnostic Accuracy as a Tool in Recommending Repeat Fine-Needle Aspiration for Solid Thyroid Nodules with Non-Diagnostic Fine-Needle Aspiration Cytology

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2015.10.011 ◽

2016 ◽

Vol 42 (2) ◽

pp. 399-406 ◽

Cited By ~ 10

Author(s):

Vivian Youngjean Park ◽

Eun-Kyung Kim ◽

Jin Young Kwak ◽

Jung Hyun Yoon ◽

Min Jung Kim ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Data System ◽

Ultrasound Elastography ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

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The diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules is not affected by coexistent chronic autoimmune thyroiditis: Results from a cyto-histological series of patients with indeterminate cytology.

Acta Endocrinologica ◽

10.1530/eje-21-0094 ◽

2021 ◽

Author(s):

Mario Rotondi ◽

Martina Molteni ◽

Carlo Cappelli ◽

Laura Croce ◽

Alessandro Caputo ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Chronic Autoimmune Thyroiditis ◽

Needle Aspiration Cytology ◽

Indeterminate Cytology

Objective Indeterminate cytological result at Fine-needle-aspiration-cytology (FNAC) remains a clinical challenge for endocrinologists. Aim of the present study was to evaluate whether a coexistent Chronic-Autoimmune-Thyroiditis (CAT) might affect the diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules. Design and Methods A retrospective cohort study was designed including all nodules receiving an indeterminate cytology result (TIR3A or TIR3B) undergoing thyroid surgery and subsequent histological confirmation. Patients were stratified in two groups according to the presence or absence of CAT. The hypothesis to be tested was whether follicular cell alterations induced by CAT might increase the rate of indeterminate cytological results in histologically benign thyroid nodules. Additional control groups were represented by nodules with determinate cytology, either benign (TIR 2) or malignant (TIR5). Results: One-hundred-eighty-nine indeterminate thyroid nodules were included (67 TIR3A and 122 TIR3B). At post-surgical histology 46 nodules (24.3%) were malignant. No significant differences were observed in the rate of histologically proven malignancy between patients without CAT and patients with CAT in the TIR3B (29.4% vs 32.4%; p=0.843) nor TIR3A (13.0% vs 11.4%; p=1.000) nodules. The rate of coexistent CAT was similar between TIR3B and TIR5 nodules harboring PTC at histology (30.4% vs 39.4%, p=0.491) and between indeterminate nodules and a control group of TIR2 nodules (39.2% vs 37.0%; p=0.720). Conclusions: The similar rates of histologically proven malignancy found in cytologically indeterminate nodules in the presence or absence of concomitant CAT, would not support that CAT itself affects the diagnostic accuracy of fine-needle aspiration cytology.

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