scholarly journals Thyroid nodule size as an indicator for surgery

2018 ◽  
Vol 5 (7) ◽  
pp. 2401 ◽  
Author(s):  
Mohamed Abdulhameed Hatem ◽  
Sumayya Farheen
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Current Practice ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology

Background: Several authors have questioned the accuracy of fine- needle aspiration cytology (FNAC) in large thyroid nodules. It's the current practice to provide thyroidectomy to patient with thyroid nodules 4 cm or larger regardless of the FNAC results. The aim of the study is to answer two questions: is the size of nodule associated with higher risk of malignancy and is the size indication for surgery.Methods: Authors conducted a retrospective review of 201 patients who underwent thyroidectomy between 2011 and 2017 at Bahrain defense force hospital. Authors compared all thyroid nodules with benign FNAC and their final histopathology reports. Patients were divided into two groups based on the size of the nodule (< 4cm or >4cm) and indication of surgery.Results: 201 patients with thyroid nodule underwent thyroid surgery. 136 patients had nodule <4cm and 65 patients were ≥4 cm. For patients with nodules <4 cm, 37 patients (18.4%) had a malignancy, and for those with nodules ≥4 cm, 13 patients (6.4%) had a malignancy. comparison between size of the nodule, FNAC result and final histopathology: FNAC diagnosed 55 cases (27.3%) are malignant, final histopathology reported only 50 cases are malignant. But for benign cases FNAC and histopathology reports are showing same results, (p<0.05).Conclusions: Thyroid nodules ≥4 cm are not risk factor of malignancy. Thyroid nodules ≥4 cm with benign FNAC should not undergo thyroidectomy as false negative rate is low. Therefore, the decision for surgery ought not to be taken based on the size of the nodule.

scholarly journals A Study to Evaluate the Size of Thyroid Nodules as an Indicator for Malignancy

2020 ◽  
Vol 3 (1) ◽  
pp. 16-20
Author(s):  
Ajay Kumar Jha ◽  
Ajit Kumar Sinha
Keyword(s):  
Thyroid Nodules ◽  
Current Practice ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Indication For Surgery ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology

Background: Several authors have questioned the accuracy of fine- needle aspiration cytology (FNAC) in large thyroid nodules. It’s the current practice to provide thyroidectomy to patient with thyroid nodules 4 cm or larger regardless of the FNAC results. The aim of the study is to answer two questions: is the size of nodule associated with higher risk of malignancy and is the size indication for surgery. Subjects and Methods: This study included 20 patients who underwent thyroidectomy. We compared all thyroid nodules with benign FNAC and their final histopathology reports. Patients were divided into two groups based on the size of the nodule (< 4cm or >4cm) and indication of surgery. Results: 20 patients with thyroid nodule underwent thyroid surgery. 13 patients had nodule <4cm and 7 patients were 4 cm. For patients with nodules <4 cm, 3 patients had a malignancy, and for those with nodules 4 cm, 1 patients had a malignancy. For benign cases FNAC and histopathology reports are showing same results, (p<0.05). Conclusion: Thyroid nodules 4 cm are not risk factor of malignancy. Thyroid nodules 4 cm with benign FNAC should not undergo thyroidectomy as false negative rate is low. Therefore, the decision for surgery ought not to be taken based on the size of the nodule.

scholarly journals Ultrasound Parameters of Thyroid Nodules and the Risk of Malignancy: A Retrospective Analysis

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482094597
Author(s):  
Minxin Wang ◽  
Ping Sun ◽  
Xiaodong Zhao ◽  
Yongmei Sun
Keyword(s):  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Diagnostic Methods ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology

Ultrasonography-guided fine-needle aspiration biopsy is the common choice for diagnosis of the suspected thyroid nodule. An algorithm(s) that finds the malignant potential of a nodule preoperatively, to overcome unnecessary diagnostic methods, does not exist. The objective of the study was to correlate thyroid nodule sizes measured by ultrasonography and risk of malignancy assessed by cytologic and histologic examinations. Data regarding fine-needle aspiration cytology and the results of histologic examinations of surgical specimens of 260 nodules were collected and analyzed. The macro or multiple calcifications, the complex echo pattern, and posterior region homogeneity were considered suspicious in ultrasonography. Bethesda system for classification of thyroid nodules was used for cytopathology. Histopathology performed as per the 2004 World Health Organization classification system. The benefit score analysis was performed for determination of clinical usefulness. Twenty-eight of 49 malignant nodules and 46 of 68 malignant nodules detected through ultrasound following fine-needle aspiration cytopathology and histopathology were <2 cm in size. A correlation was found for malignancy rate detected by ultrasonography-guided fine-needle aspiration cytology and those of the surgical specimen ( r = 0.945, P = .015, R 2 = 0.894). Ultrasonography-guided fine-needle aspiration cytology had 0.994 sensitivities, 0.721 accuracies, and 0.08 to 0.945 diagnostic confidence for the detection of malignant nodules. Nodule size less than 2 mm ( P = .011) was associated with the malignancy potential of thyroid nodules. Ultrasonography-guided fine-needle aspiration cytology had 19 (7%) results as a false negative and 1 (1%) results were false positive. Ultrasound-guided fine-needle aspiration cytopathology reported oversize of thyroid nodule than original but can predict the risk of malignancy. Level of Evidence: III.

Malignancy risk and false-negative rate of fine needle aspiration cytology in thyroid nodules ≥4.0 cm

Surgery ◽  
2016 ◽  
Vol 160 (2) ◽  
pp. 405-412 ◽  
Author(s):  
Nagihan Bestepe ◽  
Didem Ozdemir ◽  
Abbas Ali Tam ◽  
Fatma Dilek Dellal ◽  
Aydan Kilicarslan ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Malignancy Risk ◽  
Needle Aspiration Cytology

scholarly journals Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

2020 ◽  
Vol 19 (2) ◽  
pp. 84-89
Author(s):  
Shova Kunwar ◽  
Barsha Bajracharya ◽  
Kavita Karmacharya ◽  
Amar Narayan Shrestha
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Thyroid Lesion ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

scholarly journals Comparison of surgeon-performed ultrasound-guided fine needle aspiration cytology with histopathological diagnosis of thyroid nodules

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Muhammad Ayoob Jat
Keyword(s):  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Solitary Thyroid Nodule ◽  
Needle Aspiration Cytology

Objective: To assess the Solitary thyroid nodules by surgeon-performed ultrasound-guided FNAC and evaluate with the histopathological findings. Methods: This study includes 100 Consecutive patients of a solitary thyroid nodule which were presented to the Outpatients Department of Surgery during the period of two years from September 2016 to August 2018. Exclusion criteria were patients with extra-thyroid swelling, diffuse goiter and multinodular goiter. All patients with a solitary thyroid nodule underwent Surgeon –performed ultrasound-guided FNAC in the department of Radiology. After thyroid surgery, thyroid specimens were sent for histopathology and evaluate with FNAC findings. Results: The study included hundred patients with solitary thyroid nodule, 75(75%) female and 25 (25%) male with a ratio of F 3:1M. The age of the patients ranged from 15-75 years with a mean age of 35 years. The result of 100 cases of Surgeon –performed Ultrasound –guide FNAC of a solitary thyroid nodule were inconclusive in 10 cases (10%), Non-neoplastic in 60 cases (60%) and Neoplastic lesions in 30 cases (30%). After evaluation of findings from FNAC and histopathology, four cases with benign FNAC (adenomatous/colloid Goiter) turnout as neoplastic (papillary carcinoma) on histopathology and six cases with neoplastic FNAC (papillary carcinoma), just two cases turnout as benign (nodular colloid goiter with cystic degeneration) on histopathology. In present study Surgeon – performed Us FNAC has found to be 87.5% sensitive, 95.3% specific and 92.0% diagnostic accuracy. Conclusion: Surgeon – performed Ultrasound-guided FNAC is a safe, simple and accurate technique in the diagnosis of solitary thyroid nodule. doi: https://doi.org/10.12669/pjms.35.4.537 How to cite this:Jat MA. Comparison of surgeon-performed ultrasound-guided fine needle aspiration cytology with histopathological diagnosis of thyroid nodules. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.537 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Exploring the Diagnostic Efficacy of Fine-Needle Aspiration Cytology in Thyroid Nodules ≥ 4 cm: Results from a Tertiary Health Care Center in Jharkhand

2018 ◽  
Vol 4 (02) ◽  
pp. 054-056
Author(s):  
Rajeev Bhardwaj ◽  
Rishabh Kumar Rana
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
False Negative ◽  
Needle Aspiration ◽  
Histopathologic Examination ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Malignancy Rate ◽  
Needle Aspiration Cytology

Abstract Background Any nodules of the thyroid, ≥ 4 cm, are generally associated with false-negative results for malignancy on fine-needle aspiration cytology (FNAC), which generally are confirmed cases of malignancy after histopathologic examinations. Methods A retrospective hospital-based study was done in which data of patients having thyroid lesions ≥ 4 cm were reviewed. We checked the FNAC and histopathologic examination done on these lesions. Ultrasonography (USG)–guided aspiration records were also assessed. Sensitivity and specificity of FNAC for the detection of neoplastic or malignant lesions was determined. Results A total of 192 patients (57 female) were included in study. Preoperative fine-needle aspiration (FNA) biopsies were categorized as negative for malignancy (n = 183, 63%), suspicious (n = 6, 4%), and malignant (n = 4, 2%). Final pathology of nodule was found to be benign in 157 (81.35%) patients, whereas in 36 (18.65%) patients, nodules were found to be malignant. Conclusion In this study, we found the malignancy rate of thyroid nodules ≥ 4 cm to be similar to the accepted malignancy rate of smaller thyroid nodules. We missed 32 cases of malignancy on FNAC. Because of high incidence of thyroid malignancy, all nodules ≥ 4 cm must undergo histopathologic examination.

scholarly journals Association between thyroid nodule size and malignancy rate

2020 ◽  
Vol 102 (1) ◽  
pp. 43-48
Author(s):  
M Jinih ◽  
F Faisal ◽  
K Abdalla ◽  
M Majeed ◽  
AA Achakzai ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Nodule Size ◽  
Malignancy Risk ◽  
Negative Rate

Introduction The diagnostic performance of ultrasound-fine needle aspiration to identify thyroid nodules harbouring malignancy remains variable. The aim of this study was to determine thyroid nodule size and cytological classification as predictors of malignancy risk. Materials and methods We conducted a retrospective cohort analysis at an academic hospital involving 499 consecutive patients who underwent thyroid surgery between 2004 and 2015. Results A total of 503 thyroid nodules (499 patients, 84% female; mean age 50.8 years, standard deviation, SD, 15.4 years) were analysed. Of these, 19.5% were malignant. The mean (± SD) nodule size was 3.28 ± 1.63 cm and 3.27 ± 1.54 cm for benign and malignant nodules, respectively. The odds of malignancy for thyroid nodules less than 3.0 cm was similar to those for nodules of 3.0 cm or greater (0.26 compared with 0.29; p=0.77). Overall, the sensitivity and specificity of fine-needle aspiration in this cohort were 71.4% and 100%, respectively. The overall false negative rate was 5.4%. When the cut-off of 3.0 cm was used, the false negative rate in thyroid nodules less than 3.0 cm was 0% compared with 7.0% in nodules of 3.0 cm or greater. Thus, class (p<0.01) but not nodule size (p=0.49), was associated with higher malignancy risk. Conclusions Our results suggest that thyroid nodule size did not accurately predict the risk of thyroid malignancy irrespective of fine-needle aspiration cytology. Routine diagnostic thyroid lobectomy solely owing to thyroid nodule size of 3.0 cm or greater is currently not justified.

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