Comparison of Consecutive Results from Fine Needle Aspiration and Core Needle Biopsy in Thyroid Nodules
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There are papers suggesting the complementary role of core needle biopsy (CNB) in the diagnosis of thyroid nodules. By comparing the result of CNB and fine needle aspiration (FNA) cytology performed in consecutive cases of thyroid nodules, the role of CNB was evaluated. Retrospective reviews of 2131 FNA and 275 CNB which were performed as first-line biopsy for 2406 thyroid nodules in 2187 patients were performed. The ultrasound (US) feature of thyroid nodule was classified following the risk of malignancy suggested by American Thyroid Association (ATA) guideline. Rate of unsatisfactory and cellular atypia could be decreased significantly by first-line CNB in all US group, and the nodules with highly suspicious feature showed significant decrease in inconclusive result by first-line CNB. However, increased rates of architectural and follicular neoplasm (FN) were identified in CNB group especially in intermediate and low suspicious nodules, and the first-line CNB could not decrease the inconclusive result in these US groups. The diagnostic rate of neoplasm diagnosed by surgery following the result of architectural atypia or FN was not different between FNA and CNB even with significantly higher rate in CNB group. Furthermore, the sensitivity for follicular neoplasm (21.2 vs. 61.9%) was significantly higher in CNB group. The CNB can be considered in nodules with highly suspicious feature with advantage of significantly lower inconclusive diagnostic rate than FNA group. However, significantly increased diagnosis of architectural atypia or FN in other nodules by CNB is recognized and should be evaluated in future to understand the meaning.
KeywordsThyroid nodule Fine needle aspiration Core needle biopsy Papillary thyroid carcinoma Follicular neoplasm
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Conflict of Interest
The authors declare that they have no conflict of interest.
No specific funding was disclosed.
- 4.Jung CK, Min HS, Park HJ, Song DE, Kim JH, Park SY, Yoo H, Shin MK (2015) Pathology Reporting of Thyroid Core Needle Biopsy: A Proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group. Journal of pathology and translational medicine 49 (4):288–299. doi: 10.4132/jptm.2015.06.04 CrossRefPubMedPubMedCentralGoogle Scholar
- 5.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 (2016) 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 : official journal of the American Thyroid Association 26 (1):1–133. doi: 10.1089/thy.2015.0020 CrossRefGoogle Scholar
- 6.Paja M, del Cura JL, Zabala R, Corta I, Lizarraga A, Oleaga A, Exposito A, Gutierrez MT, Ugalde A, Lopez JI (2016) Ultrasound-guided core-needle biopsy in thyroid nodules. A study of 676 consecutive cases with surgical correlation. European radiology 26 (1):1–8. doi: 10.1007/s00330-015-3821-1 CrossRefPubMedGoogle Scholar
- 7.Ahn SH, Kim SD, Jeong WJ (2017) Comparison of risk of malignancy in a subgroup with atypia of undetermined significance/follicular lesion of undetermined significance: A meta-analysis. Head & neck. doi: 10.1002/hed.24768
- 8.Kim SD, Han SH, Jeong WJ, Kim H, Ahn SH (2017) Differences in Clinical Features Between Subcategories of "Atypia/Follicular Lesion of Undetermined Significance". Endocrine pathology. doi: 10.1007/s12022-017-9486-3
- 11.Karstrup S, Balslev E, Juul N, Eskildsen PC, Baumbach L (2001) US-guided fine needle aspiration versus coarse needle biopsy of thyroid nodules. European journal of ultrasound : official journal of the European Federation of Societies for Ultrasound in Medicine and Biology 13 (1):1–5CrossRefGoogle Scholar
- 12.Hakala T, Kholova I, Sand J, Saaristo R, Kellokumpu-Lehtinen P (2013) A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy. Journal of clinical pathology 66 (12):1046–1050. doi: 10.1136/jclinpath-2013-201559 CrossRefPubMedGoogle Scholar
- 14.Trimboli P, Nasrollah N, Guidobaldi L, Taccogna S, Cicciarella Modica DD, Amendola S, Romanelli F, Lenzi A, Nigri G, Centanni M, Giovanella L, Valabrega S, Crescenzi A (2014) The use of core needle biopsy as first-line in diagnosis of thyroid nodules reduces false negative and inconclusive data reported by fine-needle aspiration. World journal of surgical oncology 12:61. doi: 10.1186/1477-7819-12-61 CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Yi KS, Kim JH, Na DG, Seo H, Min HS, Won JK, Yun TJ, Ryoo I, Kim SC, Choi SH, Sohn CH (2015) Usefulness of core needle biopsy for thyroid nodules with macrocalcifications: comparison with fine-needle aspiration. Thyroid : official journal of the American Thyroid Association 25 (6):657–664. doi: 10.1089/thy.2014.0596 CrossRefGoogle Scholar