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Frozen section and fine needle aspiration biopsy in thyroid surgery — needles and sections

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Abstract

Purpose

To review our own experience with fine needle aspiration biopsy (FNAB) and frozen section (FS) in thyroid surgery and to assess the value of FNAB and FS in predicting malignancy in patient with thyroid disease.

Methods

The records of 300 patients who underwent thyroid surgery between April 2001 and June 2006 were analyzed.

Results

Of the 153 patients who had preoperative FNABs performed, 8 (5.22%) were reported as indeterminate, 100 (65.35%) were read as benign, and 3 (1.96%) were read as malignant. Fourty two of the FNABs were inadequate for evaluation (27.45%). When occult papillary carcinomas were excluded, sensitivity, and accuracy rates for FNAB reached 100%. One hundred and ninety one patients had FSs performed. 184 (96.33%) of these were reported as benign, 4 (2.09%)were reported as malignant, 3 (1.57%) were deferred to permanent paraffin (PP) sections. When occult papillary carcinomas were excluded, sensitivity, and accuracy rates for FS were 42.85%, 43%, and 97.28% respectively.

Conclusions

Our data supports the use of FNAB in the confirmation of malignancy and the need for operation. The routine use of FS is not warranted. Selective use of FS when FNAB is nondiagnostic or indeterminate may provide additional information. Both FNAB and FS fail to reveal occult carcinomas of thyroid.

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References

  1. Sakorafas GH, Peros G (2006) Thyroid nodule: A potentially malignant lesion; optimal management from a surgical perspective. Cancer Treat Rev 32:191–202

    Article  PubMed  Google Scholar 

  2. Anton CR, Wheeler MT (2005) Frozen section of Thyroid and parathyroid specimens. Arch Pathol Lab Med 129:1575–1584

    PubMed  Google Scholar 

  3. Kuma K, Matsuzuka F, Yokozawa T (1994) Fate of untreated benign thyroid nodules: Results of long ter follow up. Word J Surg 18:495–499

    Article  CAS  Google Scholar 

  4. Cheng MSP, Morgan JL, Serpell JW (2002) Does frozen section have a role in the intraoperative management of thyroid nodules? ANZ J Surg 72:570–572

    Article  PubMed  Google Scholar 

  5. Wong Z, Muthu C, Craik J, Carter J, Harman R (2004) Role of intraoperative frozen section in the management of thyroid nodules. ANZ J Surg 74:1052–1055

    Article  PubMed  Google Scholar 

  6. Duek SD, Goldenberg D, Linn S, Krausz, Hershko DD (2002) The role fine-needle aspiration and intraoperative frozen section in the surgical management of solitary thyroid nodules. Surg Today 32:857–861

    Article  PubMed  Google Scholar 

  7. Leenhardt L, Menegaux F, Franc B, Delbot T, Mansour G, Hoang C, et al (2002) Selection of patients with solitary thyroid nodules for operation. Eur J Surg 68:236–241

    Article  Google Scholar 

  8. Gibb GK, Pasieka JL (1995) Assessing the need for frozen sections: Stil a valuable tool in thyroid surgery. Surgery 118:1005–1010

    Article  PubMed  CAS  Google Scholar 

  9. Nishiyama RH, Dressel DM (1997) Histologic and cytologic characteristics of thyroid cancers. In: Clark OH, Duh Q, editors. Textbook of endocrine surgery, Philadelphia: W.B. Saunders pp 182–189

    Google Scholar 

  10. Çetin B, Aslan S, Hatiboglu C, Babacan B, Onder A, Celik A, Cetin A (2003) Frozen section in thyroid surgery: Is it a neccessity? Can J Surg 47(1):29–33

    Google Scholar 

  11. Aggarwal SK, Jayaram G, Kakar A, Goel GD, Prakash R, Pant CS (1989) Fine needle aspiration cytologic diagnosis of the solitary cold thyroid nodule. Comparison with ultrasonography, radionuclide, perfusion study and xeroradiography. Acta Cytol 33:41–47

    PubMed  CAS  Google Scholar 

  12. Greenblatt DY, Woltman T, Harter J, Starling J, Mack E, Chen H (2006) Fine needle aspiration optimizes surgical management in patients with thyroid cancer. Ann Surg Oncol 13(6):859–863

    Article  PubMed  Google Scholar 

  13. Emeric GT, Duh QY, Siperstein AE, Burrow GN, Clark OH (1993) Diagnosis, treatment, and outcome of follicular thyroid carcinoma. Cancer 72:3287–3295

    Article  Google Scholar 

  14. Ogawa Y, Kato Y, Ikeda K, Aya M, Ogisawa K, Kitani K, Onoda N, Ishikawa T, Haba T, Wakasa K, Hirakawa K (2001) The value of ultrasound-guided fine needle aspiration cytology for thyroid nodules: An assessment of its diagnostic potential and pitfalls. Surg Today 31:97–101

    Article  PubMed  CAS  Google Scholar 

  15. Alexander EK, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, Marqusee E (2002) Assessment of nondiagnostic untrasound guided fine needle aspirations of thyroid nodules. J clin Endocrinol Metab 87(11):4924–4927

    Article  PubMed  CAS  Google Scholar 

  16. Block MA (1982) Fine needle aspiration and lesions the thyroid. Int Adv Surg Oncol. 5:1–27

    PubMed  CAS  Google Scholar 

  17. Lowhagen T, Willems JS, Lundell G, Sundblad R, Granberg PO (1981) Aspiration biopsy cyology in diagnosis of thyroid cancer. Word J surgery 5:61–73

    Article  CAS  Google Scholar 

  18. Hall TL, Layfield LJ, Phillippe A, Rosenthal RL (1989) Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer 63:718–725

    Article  PubMed  CAS  Google Scholar 

  19. Brooks AD, Shaha AR, Dumornay W, Huvos AG, Zakowski M, Brennan MF, Shah J (2001) Role of fine-needle aspiration biopsy and frozen section analysis in the surgical management of thyroid tumours. Ann Surg Oncol 8(2):92–100

    Article  PubMed  CAS  Google Scholar 

  20. Giuliani D, Willemsen P, Verhelst J, Kockx M, Vanderveken M (2006) Frozen section in thyroid surgery. Acta Chir Belg 106:199–201

    PubMed  CAS  Google Scholar 

  21. DeMay RM (1998) Frozen section of thyroid? Just Say no. Am J Clin Pathol 110:423–424

    PubMed  CAS  Google Scholar 

  22. Chang HY, Lin JD, Chen JF, Huang BY, Hsueh C, Jeng LB, Tsai JS (1997) Correlation of fine needle aspiration cytology and frozen section biopsies in the diagnosis of thyroid nodules. J Clin Pathol 50:1005–1009

    Article  PubMed  CAS  Google Scholar 

  23. Kini SR, Miller JM, Hamburger JI, Smith-Purslow MJ (1985) Cytopathology of follicular lesions of the thyroid gland. Diagn Cytopathol 1(2):123–132

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Oktay Irkorucu.

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Irkorucu, O., Tascilar, O., Cakmak, G.K. et al. Frozen section and fine needle aspiration biopsy in thyroid surgery — needles and sections. Indian J Surg 69, 140–144 (2007). https://doi.org/10.1007/s12262-007-0005-5

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  • DOI: https://doi.org/10.1007/s12262-007-0005-5

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