scholarly journals Inadequate fine needle aspiration biopsy samples: Pathologists versus other specialists

CytoJournal ◽  
2009 ◽  
Vol 6 ◽  
pp. 9 ◽  
Author(s):  
GS Gomez-Macías ◽  
R Garza-Guajardo ◽  
J Segura-Luna ◽  
O Barboza-Quintana

Background: Fine needle aspiration biopsy (FNAB) is a simple, sensitive, quick and inexpensive method in which operator experience is essential for obtaining the best results. Methods: A descriptive study in which the aspiration biopsy cases of the Pathology and Cytopathology Service of the University Hospital of the UANL (2003–2005) were analyzed. These were divided into three study groups: Group 1, FNAB performed by a pathologist; Group 2, FNAB performed by specialists who are not pathologists, Group 3, FNAB guided by an imaging study with immediate evaluation by a pathologist. The samples were classified as adequate and inadequate for diagnosis, the organ, the size and characteristics of the lesions were taken into consideration. Results: A total of 1905 FNAB were included. In Group 1: 1347 were performed of which 1242 (92.2%) were adequate and 105 (7.7%) were inadequate. Of the 237 from Group 2, 178 were adequate (75.1%) and 59 inadequate (24.8%); in Group 3 there were 321 of which 283 (88.1%) were adequate and 38 (11.8%) inadequate. A statistically significant difference was found between FNAB performed by Group 1 (p< 0.001) and the other groups. A multivariate analysis was done where the organ punctured, the study groups, the size and characteristics of the lesion by study group were compared, finding that the most important variable was the person who performed the procedure. Conclusion: The experience and training of the person performing the aspiration biopsy, as well as immediate evaluation of the material when it is guided, substantially reduces the number of inadequate samples, improving the sensitivity of the method as well as reducing the need for open biopsies to reach a diagnosis.

2001 ◽  
Vol 40 (05) ◽  
pp. 148-154 ◽  
Author(s):  
U. Wartner ◽  
E. Kresnik ◽  
H. J. Gallowitsch ◽  
M. Heinisch ◽  
H. P. Dinges ◽  
...  

Summary Aim: The goal of this study was to assess the accuracy and limitations of ultrasound guided fine-needle aspiration biopsy (ug-FNAB) of solitary thyroid nodules. Methods: The ug-FNAB results of 538 patients with solitary thyroid nodules, who afterwards underwent thyroid surgery, were compared retrospectively with the histology. Patients with multinodular goiter were excluded from the study. Ug-FNAB was performed on growing and/or hypoechoic and/or hypofunctional nodules. The ug-FNAB results were grouped as follows: group 1: malignant (n = 44); group 2: malignancy cannot be ruled out (n = 173); group 3: non-malignant (n = 296), group 4: inadequate (n = 25). Results: When the cytological results of group 1 and group 2 were interpreted os being malignant and those of group 3 as being benign, sensitivity, specificity and accuracy of ug-FNAB were 96.7%, 65.8% and 69.5% respectively. The 62 thyroid carcinomas (TO biopsied presented in 59 cases a suspicious or malignant cytology (95.2%). The smallest TC diagnosed by ug-FNAB had a diameter of 0.5cm and 36.4% of all papillary TC ≤ 1 cm displayed stage pT4. The histology verified a TC in 18 cases out of the 173 ug-FNABs in group 2. Non-malignant ug-FNABs were confirmed by histology in 294 patients (99.3%) in group 3. In 4.65% of the ug-FNABs inadequate material was aspirated. Conclusion: Nodules with non-suspicious ug-FNAB results can be safely followed-up by sonography, as the cytological diagnoses were verified in more than 99% by histology. Papillary TC can be diagnosed with ug-FNAB very accurately. As stage pT4 was present in more than one third of patients with papillary TC ≤ T cm, ug-FNAB is also recommended for thyroid nodules 0.5-1 cm in diameter located adjacent to the thyroid capsule. However, microfollicular proliferations remain the limitation of ug-FNAB, as the cytology cannot distinguish between benign adenoma and follicular TC.


1972 ◽  
Vol 71 (3) ◽  
pp. 480-490 ◽  
Author(s):  
Göran Nilsson

ABSTRACT Cytodiagnostic fine needle aspiration biopsy specimens from toxic goitres were studied for signs of lymphoid infiltration. Comparison with histological sections of specimens obtained by surgery showed that an excess of lymphoid cells in the aspirate smears corresponded to a large number of lymphoid foci in these sections. Excess of lymphoid cells in the fine needle aspirates was also positively correlated with the occurrence of circulating thyroid antibodies against thyroglobulin and/or cytoplasmic antigen, but not with the presence of the long-acting thyroid stimulating factor, LATS. It also varied with age in that it was most common in the youngest patients and in patients between 40–55 years, while lymphoid infiltration was seldom seen in patients over 55 years. A finding of practical clinical interest was that in toxic goitres with cytological signs of lymphoid infiltration hyperthyroidism had less tendency to recur after treatment with thiocarbamide drugs than in those without such signs.


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