scholarly journals Punção Aspirativa de Nódulos da Tiroide: Vale a Pena Repetir?

2017 ◽  
Vol 30 (6) ◽  
pp. 472
Author(s):  
Vera Fernandes ◽  
Tânia Pereira ◽  
Catarina Eloy
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Significant Proportion ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Fine Needle ◽  
High Concordance ◽  
Benign Nodules ◽  
Cytology Result ◽  
Undetermined Significance

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.

scholarly journals Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy

2017 ◽  
Vol 9 (3) ◽  
pp. 100-103
Author(s):  
Saad Alqahtani ◽  
Saif Alsobhi ◽  
Riyadh I Alsalloum ◽  
Saleh N Najjar ◽  
Hindi N Al-Hindi
Keyword(s):  
Fine Needle Aspiration ◽  
Surgical Outcome ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Biopsy ◽  
Undetermined Significance

ABSTRACT Aim To correlate selected clinical and ultrasonographic (US) characteristics with the final histopathological diagnosis in patients with atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS), and whether this information can be used in planning the surgical approach. Materials and methods It is a retrospective study including the operated cases of AUS/FLUS from 2011 to 2014 treated at one center. Results This cohort included 87 women and 28 men. To test for independence between categorical variables, the chi-square test was used. There was no significant correlation between age or US variables and final pathological diagnosis. However, final diagnosis of malignancy was higher in men compared with women (64.3 and 41.4% respectively; p = 0.035). Furthermore, a significant association between the diagnosis of repeated fine needle aspiration biopsy (FNAB) and the final pathological diagnosis was noted (benign vs malignant, p = 0.005). Conclusion The FNAB has a significant role in the assessment of thyroid nodules. Our results showed no correlation between age, US variables, and the risk of malignancy. Male gender is associated with higher risk of malignancy. Clinical significance Determining the risk of malignancy and prediction of surgical outcome may help triaging cases for repeat FNA or proceeding to surgery. How to cite this article Alqahtani S, Alsobhi S, Alsalloum RI, Najjar SN, Al-Hindi HN. Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy. World J Endoc Surg 2017;9(3):100-103.

Thyroid peroxidase immunodetection as a tool to assist diagnosis of thyroid nodules on fine-needle aspiration biopsy

1994 ◽  
Vol 131 (5) ◽  
pp. 474-479 ◽  
Author(s):  
Catherine De Micco ◽  
Patricia Zoro ◽  
Stéphane Garcia ◽  
Lambert Skoog ◽  
Edneia M Tani ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Malignant Tumors ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Thyroid Peroxidase ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Benign Nodules

De Micco C, Zoro P, Garcia S, Skoog L, Tani EM, Carayon P, Henry J-F. Thyroid peroxidase immunodetection as a tool to assist diagnosis of thyroid nodules on fine-need aspiration biopsy. Eur J Endocrinol 1994;131:474–9. ISSN 0804–4643 In a previous work we have reported the presence in 96.9% of malignant and 4.2% of benign thyroid tumors of an immunological abnormality of the enzyme thyroid peroxidase, impeding the fixation of the anti-thyroid peroxidase monoclonal antibody termed "MoAb47". The present study has been designed to establish the ability of thyroid peroxidase immunodetection to assist the diagnosis of malignancy in fine-needle aspiration of thyroid nodules. The fixation of anti-thyroid peroxidase monoclonal antibody was investigated by immunohistochemistry on fine-needle aspirates of 150 surgically removed thyroid nodules (20 papillary carcinomas, five follicular carcinomas, 90 colloid adenomas, nine fetal adenoma, 13 atypical adenomas, five oncocytic adenomas, six Hashimoto's thyroiditis and two Graves' disease). The percentage of positive cells has been compared to the final histological diagnosis. In samples from 113/125 benign nodules 80–100% cells presented a positive immunoreaction, whereas all samples from malignant tumors yielded less than 80% positive cells. Benign nodules exhibiting less than 80% positive cells corresponded to three degenerative colloid nodules, five atypical follicular adenomas, two oncocytomas and two thyroiditis. According to results obtained in this series, with the value of 80% as the limit for discrimination between benign and highrisk nodules, the sensitivity of thyroid peroxidase staining for diagnosis of malignancy would be 100%, its specificity 90% and its overall accuracy 92%. Thyroid peroxidase staining with monoclonal antibody MoAb47 on fine-needle aspirates is a useful adjunct to conventional cytology for the investigation of patients with thyroid nodules. Catherine De Micco, Laboratoire d'Anatomie Pathologique, Faculté de Médecine Nord, Bd Pierre Dramard, 13916 Marseille Cedex 20, France

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

Head & Neck ◽  
2016 ◽  
Vol 39 (2) ◽  
pp. 361-369 ◽  
Author(s):  
Young Jun Choi ◽  
Jung Hwan Baek ◽  
Chong Hyun Suh ◽  
Woo Hyun Shim ◽  
Boseul Jeong ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Core Needle ◽  
Fine Needle ◽  
Undetermined Significance

scholarly journals Diagnostic value of multiparametric ultrasound and the EU-TIRADS system for differentiation of focal thyroid lesions

2020 ◽  
pp. 29-37
Author(s):  
A. V. Pomortsev ◽  
O. S. Tokarenko
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Flow Mapping ◽  
Diagnostic Efficacy ◽  
Color Flow ◽  
Fine Needle ◽  
Benign Nodules ◽  
The Eu

Background. Over the last 15 years, there have been many recommendations for the management of patients with thyroid nodules, based on the assessment of various ultrasound (US) criteria in B-mode. In 2020, the EUTIRADS system (2017) was included in Russian Clinical Practice Guidelines. Shear wave elastography (SWE) increases the diagnostic efficacy of ultrasonic B-mode examination of thyroid nodules and can be recommended for inclusion in the existing classification system. Objective. To assess the diagnostic efficacy of multiparametric US combining SWE and color flow mapping in differentiating between benign and malignant thyroid nodules to define their stage according to the EUTIRADS system for deciding on the need for fine-needle aspiration biopsy. Material and methods. A total of 150 thyroid nodules from 116 patients were analyzed. Lesions were then classified according to the EU-TIRADS system, SWE with an assessment of the color map and tissue stiffness was performed (Emean). In all tumors, cytological and histological (in operated patients) verification was carried out. Results. After B-mode US with color flow mapping, differentiation of palpable thyroid abnormalities by the EUTIRADS system was carried out. 78 nodules were classified as EU-TIRADS 2 (52%), 42 – EU-TIRADS 3 (28%), 26 – EU-TIRADS 4 (17.3%), 4 – EU-TIRADS 5 (2.7%). On cytological examination 42 tumor nodules were detected. Of these, 6 (14.3%) cases were reported as papillary thyroid carcinoma, 36 (85.7%) as follicular neoplasm, 22 (61%) among the last prove to be follicular carcinoma. Qualitative and quantitative evaluation of elastograms was performed. Benign nodules were colored primarily in blue, while suspicious for malignancy revealed red areas of different size. Elasticity index in benign nodules was 24.3 ± 5.63 kPa for colloid goiter, 27.8 ± 6.35 kPa for cellular goiter; in suspicious for malignancy – 80.9 ± 50.9 kPa for follicular neoplasm, 114 ± 56.8 kPa – for papillary thyroid cancer. The stiffness cutoff value for malignancy indicated with ROC-analysis was estimated as 45.4 kPa. Mean elasticity index (kPa) was significantly higher in suspicious for malignancy nodules than in benign nodules (р < 0.05). Of 120 (80%) nodules, primarily assessed as benign and defined as EU-TIRADS 2 and 3, 18 (12%) nodules after SWE revealed areas of high stiffness exceeding the cutoff value. After that, these nodules were transferred to EU-TIRADS 4 and 5, and these stages require fine-needle aspiration. Of these, 11 (7.3%) cases were reported as follicular neoplasm, 6 (4%) among the last prove to be follicular thyroid carcinoma. Conclusion. Using multiparametric approach with SWE will give the opportunity to classify correctly the nodule according to the EU-TIRADS and to identify greater number of thyroid tumors for fine-needle aspiration. SWE made it possible to increase the specificity of US using the EU-TIRADS system. The characteristics of the SWE score were: sensitivity = 81%, specificity = 90.3%, positive predictive value = 88%, negative predictive value = 91%, and accuracy of comprehensive study = 88.4%.

Accuracy of Fine-Needle Aspiration of Thyroid

2001 ◽  
Vol 125 (4) ◽  
pp. 484-488 ◽  
Author(s):  
Mojghan Amrikachi ◽  
Ibrahim Ramzy ◽  
Sheldon Rubenfeld ◽  
Thomas M. Wheeler
Keyword(s):  
Fine Needle Aspiration ◽  
False Positive ◽  
Thyroid Nodules ◽  
False Negative ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Follicular Variant ◽  
Fine Needle

Abstract Context.—Fine-needle aspiration has become an accepted and cost-effective procedure for rapid diagnosis of thyroid lesions. The routine use of fine-needle aspiration has reduced the rate of unnecessary surgery for thyroid nodules. Objectives.—To determine the accuracy of fine-needle aspiration biopsy diagnosis and to discuss the possible pitfalls. Design, Setting, and Participants.—Reports of 6226 fine-needle aspiration biopsies of the thyroid performed during a period of 16 years (1982–1998) were reviewed. Computerized reports of the fine-needle aspiration biopsies were sent to the physicians who performed the procedures, and clinical follow-up information regarding the patients was requested. Twenty-four clinicians participated in the study. Histologic diagnoses were available for 354 cases. The cytopathologic diagnoses were correlated with the histologic findings or clinical outcomes. Results.—The cytologic diagnoses were as follows: 210 (3.4%) malignant, 450 (7.2%) suspicious, 3731 (60%) benign, and 1845 (29.5%) unsatisfactory. Most of the cases with negative or unsatisfactory aspirates were followed clinically or by repeat fine-needle aspiration. We identified 11 false-negative and 7 false-positive diagnoses. For aspirates considered sufficient for diagnosis, the sensitivity and specificity levels were 93% and 96%, respectively. Conclusions.—Fine-needle aspiration of the thyroid gland is highly accurate and has a low rate of false-negative and false-positive diagnoses. The major diagnostic problems are caused by diagnosis using a marginally adequate specimen, diagnosis of malignancy based on just 1 or 2 atypical cytologic features, or overlapping cytologic features of follicular neoplasm with those of follicular variant of papillary carcinoma.

Risk Stratification of Thyroid Nodules With Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) Cytology Using Ultrasonography Patterns Defined by the 2015 ATA Guidelines

2017 ◽  
Vol 126 (9) ◽  
pp. 625-633 ◽  
Author(s):  
Ji Hye Lee ◽  
Kyunghwa Han ◽  
Eun-Kyung Kim ◽  
Hee Jung Moon ◽  
Jung Hyun Yoon ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Fine Needle Aspiration ◽  
Clinical Characteristics ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
American Thyroid Association ◽  
Fine Needle ◽  
Malignancy Rate ◽  
Undetermined Significance

Purpose: The purpose of this study was to evaluate the predictive value of ultrasonography (US) patterns based on the 2015 American Thyroid Association (ATA) guidelines for malignancy in atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) nodules. Methods: From January 2014 to August 2015, 133 thyroid nodules that were initially diagnosed as AUS/FLUS on fine needle aspiration (FNA) were included in this study. Each nodule was assigned a category with US patterns defined by the ATA guidelines. Clinical characteristics and US patterns were compared between the benign and malignant nodules, and malignancy rates were calculated according to the ATA guidelines. Results: The malignancy rate in the very low suspicion group was 0.0% in AUS/FLUS nodules. When applying the ATA guidelines, significant differences existed for US patterns between the benign and malignant nodules in the AUS group ( P = .032) but not the FLUS group ( P = .168). Conclusions: Ultrasonography patterns by the 2015 ATA guidelines can provide risk stratification for nodules with AUS cytology but not for ones with FLUS cytology. For nodules with AUS/FLUS cytology with the very low suspicion pattern of the ATA guidelines, follow-up US might be recommended instead of repeat FNA.

Sign in / Sign up

Export Citation Format

Share Document