Fine-Needle Aspiration Cytodiagnosis of the « Cold » Thyroid Nodule

1989 ◽  
Vol 75 (5) ◽  
pp. 475-477 ◽  
Author(s):  
Michele Giansanti ◽  
Silvio Monico ◽  
Paolo Fugiani
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
False Negatives ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Test Efficiency ◽  
Needle Aspiration Cytology

The results of 1886 fine-needle cytoaspirations of solid, palpable thyroid nodules, « cold » on scintiscanning, performed between 1 January 1978 and 31 December 1986, were analyzed. In total 36 diagnoses of malignancy were made (1.9%). The results of cytologic and histologic examinations were compared in 114 cases to verify the diagnostic accuracy of this method; there was agreement in 98 cases and discordance in 16 consisting of 13 false negatives (11.4%) and 3 false positives (2.6 %). The sensitivity was 77.9 %, specificity 94.5 %, positive predictive value 93.8 %, negative predictive value 80 % and test efficiency 86 %. These values are in the range of those reported in the literature and confirm the validity of fine-needle aspiration cytology in the preoperative diagnosis of thyroid neoplasms.

scholarly journals Comparison of Elastographic Strain Index and Thyroid Fine-Needle Aspiration Cytology in 631 Thyroid Nodules

2013 ◽  
Vol 98 (12) ◽  
pp. 4790-4797 ◽  
Author(s):  
Flavia Magri ◽  
Spyridon Chytiris ◽  
Valentina Capelli ◽  
Margherita Gaiti ◽  
Francesca Zerbini ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Strain Index ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNAC results), and then tested in a replication set (252 FNAC results). In all cases, a SI value of ≥2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.

scholarly journals Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Do Hoon Koo ◽  
KwangSeop Song ◽  
Hyungju Kwon ◽  
Dong Sik Bae ◽  
Ji-hoon Kim ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
False Negative ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Accuracy Rates

Background. Fine-needle aspiration cytology (FNAC) is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system) were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.). Results. There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs) of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively. Conclusion. Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.

Diagnostic accuracy of fine needle aspiration cytology of thyroid nodules

Diagnosis ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 61-66
Author(s):  
Taskin Erkinuresin ◽  
Hakan Demirci
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

AbstractBackgroundRoutine application of fine needle aspiration cytology (FNAC) has decreased unnecessary referral of thyroid nodules for surgical treatment and has also increased the cancer rates found in surgery materials. Success of thyroid FNAC depends on skilled aspiration, skilled cytological interpretation and rational analysis of cytological and clinical data. The aim of this study was to determine the diagnostic accuracy rates of thyroid FNAC results obtained in our institution.MethodsThe data from FNAC and thyroidectomy reports of patients presenting with goiter and who had been evaluated from 1st January 2014 to 1st March 2018 were used. There were 149 patients in total who had undergone thyroidectomy following FNAC. The Bethesda System for Reporting Thyroid Cytology was used in all cytological diagnoses.ResultsThe sensitivity of thyroid FNAC for malignant cases was 57.89%, specificity was 88.10%, false-positive rate was 11.90%, false-negative rate was 42.11%, positive predictive value was 52.38%, negative predictive value was 90.24% and accuracy rate was 82.52%. “Focus number” variable was detected as the factor that affected the accurate prediction of FNAC and thyroidectomy results by the pathologist.ConclusionsThis study showed that there was a moderate conformity between thyroid FNAC and thyroidectomy cyto-histopathological diagnosis in malignant cases. As two or more nodules have a negative effect on the physician’s diagnosis of malignant nodules, we think that a more sensitive approach is needed in the determination of these cases. Sampling defects may affect this non-matching.

COMPUTED TOMOGRAPHY CORRELATION OF THORACIC LESIONS WITH TRANSTHORACIC FINE NEEDLE ASPIRATION CYTOLOGY AND BIOPSY

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Rajneesh Madhok ◽  
Ashish Gupta ◽  
Lalit Singh ◽  
Tanu Agarwal
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Ct Guided ◽  
Fine Needle ◽  
Malignant Lesions ◽  
Needle Aspiration Cytology ◽  
Adequate Tissue

INTRODUCTION: The study is an attempt to evaluate the sensitivity, specificity, positive predictive value, negative predictive value, p Value and complications of CT guided thoracic interventions fine needle aspiration cytology and core biopsy which are used for diagnosing benign and malignant thoracic lesions. MATERIAL AND METHODS: Study included 102 Patients (87 males and 15 females) with age group ranged from 15 to 87 years.A total of 143 CT guided interventions (84 FNAC’s and 59 core biopsies) were performed in 102 patients. The tissue obtained was sent to the laboratory for histopathological and cytological analysis for a final diagnosis which would contribute to patient management. RESULTS: All( 59) core biopsies were successful in procuring adequate tissue for histopathological analysis and the yield of core biopsies was 100% .However out of 84 FNAC’s only 4 were unsuccessful in procuring adequate tissue with a failure rate of 4.8%. Post procedural biopsy complications were only three (2.1%) which were small pneumothorax. There were 75 malignant lesions and 23 benign lesions based on cytology and histopathology (4 were excluded due to inadequate sample). There was good agreement between benign and malignant lesions diagnosed on CT and that diagnosed by pathology. The most common benign and malignant lesions were granulomatous lesion and squamous cell carcinoma. CONCLUSION: Percutaneous CT guided interventions like core biopsy and fine needle aspirations cytology are simple minimal invasive procedures with good patient acceptance and low morbidity and almost negligible mortality. CT guided interventions should be performed early for diagnosis of thoracic lesions.

scholarly journals Is it possible to eliminate the number of inappropriate thyroid surgeries combining scintigraphy and cytology?

2021 ◽  
Vol 3 (5) ◽  
pp. 01-03
Author(s):  
Smaroula Divani
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Follicular Carcinoma ◽  
Accurate Method ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Indeterminate Cytology

Objective: Although fine needle aspiration cytology (FNAC) is the most reliable, safe and accurate method for the clinical management of abnormal thyroid nodules, 5%-15% of cases lead to indeterminate diagnoses and surgery is the recommended practice for them as they may be malignant. Nevertheless, the majority of cases with indeterminate cytology are benign, so the risk of unnecessary surgery is significant. In our study we combined FNAC and scintigraphy in order to reduce the number of inappropriate surgeries. Subjects and Methods: From 219 patients with thyroid fine needle aspiration cytology 33(9 males and 24 females) aged 18-73 years, had indeterminate FNAC diagnoses and were referred for scintigraphy. Surgery was performed in all cases. The results of FNAC, scintigraphy and histology were collected and compared. Results: From 33 cases with indeterminate cytology 32 had a benign histological diagnosis and only one was malignant (follicular Ca). That case had a positive scan. All cases with negative thyroid scans (29/33) were benign. False positive scans were 3, whereas one scan was true positive with final diagnosis follicular carcinoma. Conclusion: This study showed that combining the FNAC with the thyroid scintigraphy in cases of thyroid nodules with indeterminate cytology it is possible to reduce the number of inappropriate surgeries from 32 to 3.

Utility of intraoperative frozen sections for thyroid nodules with prior fine needle aspiration cytology diagnosis

2017 ◽  
Vol 45 (9) ◽  
pp. 789-794 ◽  
Author(s):  
Sudarshana Roychoudhury ◽  
Fabiola Souza ◽  
Cecilia Gimenez ◽  
Ryan Glass ◽  
Rubina Cocker ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Frozen Sections ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Rotterdam Criteria for Sentinel Node (SN) Tumor Burden and the Accuracy of Ultrasound (US) -Guided Fine-Needle Aspiration Cytology (FNAC): Can US-Guided FNAC Replace SN Staging in Patients With Melanoma?

2009 ◽  
Vol 27 (30) ◽  
pp. 4994-5000 ◽  
Author(s):  
Christiane A. Voit ◽  
Alexander C.J. van Akkooi ◽  
Gregor Schäfer-Hesterberg ◽  
Alfred Schoengen ◽  
Paul I.M. Schmitz ◽  
...  
Keyword(s):  
Sentinel Node ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
The Us ◽  
Needle Aspiration Cytology ◽  
Positive Results

Purpose Sentinel node (SN) status is the most important prognostic factor for overall survival (OS) for patients with stage I/II melanoma, and the role of the SN procedure as a staging procedure has long been established. However, a less invasive procedure, such as ultrasound (US) -guided fine-needle aspiration cytology (FNAC), would be preferred. The aim of this study was to evaluate the accuracy of US-guided FNAC and compare the results with histology after SN surgery was performed in all patients. Patients and Methods Four hundred consecutive patients who underwent lymphoscintigraphy subsequently underwent a US examination before the SN procedure. When the US examination showed a suspicious or malignant pattern, patients underwent an FNAC. Median Breslow thickness was 1.8 mm; mean follow-up was 42 months (range, 4 to 82 months). We considered the US-guided FNAC positive if either US and/or FNAC were positive. If US was suggestive of abnormality, but FNAC was negative, the US-guided FNAC was considered negative. Results US-guided FNAC identified 51 (65%) of 79 SN metastases. Specificity was 99% (317 of 321), with a positive predictive value of 93% and negative predictive value of 92%. SN-positive identification rate by US-guided FNAC increased from 40% in stage pT1a/b disease to 79% in stage pT4a/b disease. US-guided FNAC detected SN tumors more than 1.0 mm in 86% of cases, SN tumors of 0.1 to 1.0 mm in 46% of cases, and SN tumors less than 0.1 mm in 23% of cases. Estimated 5-year OS rates were 92% for patients with negative US-guided FNAC results and 51% for patients with positive results. Conclusion US-guided FNAC of SNs is highly accurate. Up to 65% of the patients with SN-positive results in our institution could have been spared an SN procedure.

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