Abstract
Thyroid core needle biopsy (CNB) has been used as an alternative to fine needle aspiration (FNA) cytology since the 1990s [1, 2]. The use of CNB is increasing as a second-line diagnostic tool for lesions in which FNA was nondiagnostic due to low cellularity or in which the FNA result was inconclusive [1, 3, 4]. It has been shown that CNB can reduce the rate nondiagnostic and indeterminate results more efficiently than FNA cytology [1, 4,5,6]. Although ultrasound-guided FNA cytology has been used as a gold-standard method for the preoperative screening of thyroid nodules, the inherent limitations of cytology include (1) nondiagnostic rate of 2–41% [7], (2) indeterminate results (atypia of undetermined significance [AUS]/follicular lesion of undetermined significance [FLUS], follicular neoplasm, and suspicious for malignancy) ranging from10% to 75% [8], and (3) difficulty applying ancillary testing on conventional cytology. Thyroid CNB provides a tissue sample that retains histologic architecture and cytologic findings. Furthermore, with sufficient tissue for histologic examination and additional ancillary testing, an accurate diagnosis is possible without the need for a repeat biopsy or subsequent surgery in diagnosing lesions of patients with lymphoma, diseases of nonthyroidal origin, and other rare thyroid diseases.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- AUS:
-
Atypia of undetermined significance
- CNB:
-
Core needle biopsy
- FLUS:
-
Follicular lesion of undetermined significance
- FNA:
-
Fine needle aspiration
References
Na DG, Baek JH, Jung SL, Kim JH, Sung JY, Kim KS, Lee JH, Shin JH, Choi YJ, Ha EJ, Lim HK, Kim SJ, Hahn SY, Lee KH, Choi YJ, Youn I, Kim YJ, Ahn HS, Ryu JH, Baek SM, Sim JS, Jung CK, Lee JH, Korean Society of Thyroid R, Korean Society of R. Core needle biopsy of the thyroid: 2016 consensus statement and recommendations from korean society of thyroid radiology. Korean J Radiol. 2017;18(1):217–37. https://doi.org/10.3348/kjr.2017.18.1.217.
Jung CK, Baek JH. Recent advances in core needle biopsy for thyroid nodules. Endocrinol Metab. 2017;32(4):407–12.
Jung CK, Min HS, Park HJ, Song DE, Kim JH, Park SY, Yoo H, Shin MK, Korean Endocrine Pathology Thyroid Core Needle Biopsy Study G. Pathology reporting of thyroid core needle biopsy: a proposal of the korean endocrine pathology thyroid core needle biopsy study group. J Pathol Transl Med. 2015;49(4):288–99. https://doi.org/10.4132/jptm.2015.06.04.
Liu N, Meng Z, Jia Q, He X, Tian W, Tan J, Zhang Y, Li X, Hu T, Zhou P, Wang S, Upadhyaya A. Ultrasound-guided core needle biopsy for differential diagnosis of thyroid nodules: a systematic review and meta-analysis. Mol Clin Oncol. 2017;6(6):825–32. https://doi.org/10.3892/mco.2017.1246.
Suh CH, Baek JH, Kim KW, Sung TY, Kim TY, Song DE, Choi YJ, Lee JH. The role of core-needle biopsy for thyroid nodules with initially nondiagnostic fine-needle aspiration results: a systematic review and meta-analysis. Endocr Pract. 2016;22(6):679–88. https://doi.org/10.4158/EP15986.OR.
Lee SH, Park GS, Jung SL, Kim MH, Bae JS, Lim DJ, Jung CK. Core-needle biopsy for the preoperative diagnosis of follicular neoplasm in thyroid nodule screening: a validation study. Pathol Res Pract. 2016;212(1):44–50. https://doi.org/10.1016/j.prp.2015.11.009.
Lee SH, Kim MH, Bae JS, Lim DJ, Jung SL, Jung CK. Clinical outcomes in patients with non-diagnostic thyroid fine needle aspiration cytology: usefulness of the thyroid core needle biopsy. Ann Surg Oncol. 2014;21(6):1870–7. https://doi.org/10.1245/s10434-013-3365-z.
Toll AD, Rossi ED, Ali SZ. Role of ancillary testing in thyroid fine needle aspiration: Review and update. J Am Soc Cytopathol. 2014;3(4):218–24. https://doi.org/10.1016/j.jasc.2014.04.002.
Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2017;27(11):1341–6. https://doi.org/10.1089/thy.2017.0500.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1–133. https://doi.org/10.1089/thy.2015.0020.
Suh CH, Baek JH, Park C, Choi YJ, Lee JH. The role of core needle biopsy for thyroid nodules with initially indeterminate results on previous fine-needle aspiration: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2017;38(7):1421–6. https://doi.org/10.3174/ajnr.A5182.
Min HS, Kim JH, Ryoo I, Jung SL, Jung CK. The role of core needle biopsy in the preoperative diagnosis of follicular neoplasm of the thyroid. APMIS. 2014;122(10):993–1000. https://doi.org/10.1111/apm.12244.
Suh CH, Baek JH, Lee JH, Choi YJ, Kim KW, Lee J, Chung KW, Shong YK. The role of core-needle biopsy in the diagnosis of thyroid malignancy in 4580 patients with 4746 thyroid nodules: a systematic review and meta-analysis. Endocrine. 2016;54(2):315–28. https://doi.org/10.1007/s12020-016-0991-9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Jung, C.K. (2019). Core Needle Biopsy for the Diagnosis of Thyroid Nodules: Pathologic Aspects. In: Kakudo, K. (eds) Thyroid FNA Cytology. Springer, Singapore. https://doi.org/10.1007/978-981-13-1897-9_65
Download citation
DOI: https://doi.org/10.1007/978-981-13-1897-9_65
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-1896-2
Online ISBN: 978-981-13-1897-9
eBook Packages: MedicineMedicine (R0)