Skip to main content

Advertisement

SpringerLink
Log in

Does Fine-Needle Aspiration Cytology Optimize the Surgical Management of Thyroid Disorders in Endemic Goiter Region?

  • Published:
Endocrine Pathology Aims and scope Submit manuscript

Abstract

Aim

The aim of this study was to determine the diagnostic value of fine-needle aspiration cytology (FNAC) before thyroidectomy in an endemic goiter region.

Methods

One hundred patients with preoperative FNAC of thyroid nodules who underwent thyroidectomy were recruited. FNAC were classified into five groups. 0, no thyroid cells; 1, normal thyroid cells; 2, degenerative thyroid cells without evidence of malignacy; 3, follicular or oncocytary neoplasia; and 4, malignant thyroid cells. FNAC was compared with postoperative histopathological diagnoses.

Results

Only 76% of the FNAC allowed an adequate cytological examination. In 15 patients (15%), carcinomas were found in the postoperative histopathological diagnosis (including four follicular carcinomas). In the 48 patients of FNAC groups 3 and 4, nine carcinomas (18.7%) were found (including four follicular carcinomas). In the 28 patients of groups 1 and 2, there was only one papillary carcinoma (3.5%). In the 24 patients of group 0, there were two papillary, two follicular, and one anaplastic carcinomas (total of 20.8%). The sensitivity, specificity, and likelihood ratio (LR) of the FNAC for benign nodules were 90%, 40.9%, 0.24, respectively. The LR for malignant nodules was 13.2, and that for follicular neoplasia was 0.55.

Conclusions

Despite the high prevalence of carcinoma in an endemic goiter region, FNAC disappointed its diagnostic expectation. The lower specificity of FNAC may be caused by a higher prevalence of thyroid nodules in an endemic goiter region or by the absence of a specialized cytopathologist.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Barroeta JE, Wang H, Shiina N, Gupta PK, Livolsi VA, Baloch ZW. Is fine-needle aspiration (FNA) of multiple thyroid nodules justified? Endocr Pathol. 17(1):61–5, 2006.

    Article  PubMed  Google Scholar 

  2. Belfiore A, Giuffrida D, La Rosa GL, Ippolito O, Russo G, Fiumara A, et al. High frequency of cancer in cold thyroid nodules occurring at young age. Acta Endocrinol. 121(2):197–202, 1989.

    PubMed  CAS  Google Scholar 

  3. Caplan RH, Kisken WA, Strutt PJ, Wester SM. Fine-needle aspiration biopsy of thyroid nodules, Thyroid nodule. Postgrad Med. 90:183–90, 1991.

    PubMed  CAS  Google Scholar 

  4. Chiu WY, Chia NH, Wan SK, Yuen CH, Cheung MT. The investigation and management of thyroid nodules—a retrospective rewiev of 183 cases. Ann Acad Med Singapore. 27:196–9, 1998.

    PubMed  CAS  Google Scholar 

  5. Dwarakanathan AA, Staren ED, D’Amore MJ, Kluskens LF, Martirano M, Economou SG. Importance of repeat fine-needle biopsy in the management of thyroid nodules. Am J Surg. 166:350–2, 1993.

    Article  PubMed  CAS  Google Scholar 

  6. Godinho-Matos L, Kocjan G, Kurtz A. Contribution of fine needle aspiration cytology to diagnosis and management of thyroid disease. J Clin Pathol. 45(5):391–5, 1992.

    Article  PubMed  CAS  Google Scholar 

  7. Hegedus L, Karstrup S. Ultrasonography in the evaluation of cold thyroid nodules. Eur J Endocrinol. 138(1):30–1, 1998.

    Article  PubMed  CAS  Google Scholar 

  8. Jaeschke R, Guyatt GH, Sackett DL. Users’ guide to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me caring for my patients? JAMA. 271:703–7, 1994.

    Article  PubMed  CAS  Google Scholar 

  9. Kikuchi S, Perrier ND, Ituarte PH, Treseler PA, Siperstein AE, Duh QY, et al. Accuracy of fine-needle aspiration cytology in patients with radiation-induced thyroid neoplasms. Br J Surg. 90(6):755–8, 2003.

    Article  PubMed  CAS  Google Scholar 

  10. Koike E, Noguchi S, Murakami T, Ohshima A, Kawamoto H, Yamashita H. Effect of combining ultrasonography and ultrasound—guided fine-needle aspiration biopsy findings for the diagnosis of thyroid nodules. Eur J Surg. 167:656–61, 2001.

    Article  PubMed  CAS  Google Scholar 

  11. Kopald KH, Layfield LJ, Mohrmann R, Foshag LJ, Giuliano AE. Clarifying the role of fine-needle aspiration cytologic evaluation and frozen section in the operative management of thyroid cancer. Arch Surg. 124:1201–5, 1989.

    PubMed  CAS  Google Scholar 

  12. Kountakis Stilianos E, Skoulas Ioannis G, Maillard AA. The radiologic work-up in thyroid surgery: fine-needle biopsy versus scintigraphy and ultrasound. Ear Nose Throat J. 81:151–4, 2002.

    PubMed  CAS  Google Scholar 

  13. Layfield LJ, Mohrmann RL, Kopald KH, Guiliano AE. Use of aspiration cytology and frozen section examination for management of benign and malignant thyroid nodules. Cancer. 68:130–4, 1991.

    Article  PubMed  CAS  Google Scholar 

  14. Lee JK, Liu RS, Wu SY, Huang WS, Chou MC. Thallium-201 scan in evaluating thyroid nodules following equivocal fine-needle aspiration cytology. Nuklearmedizin. 45(5):201–5, 2006.

    PubMed  CAS  Google Scholar 

  15. Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med. 328(8):553–9, 1993.

    Article  PubMed  CAS  Google Scholar 

  16. Molitch ME, Beck JR, Dreisman M, Gottlieb JE, Pauker SG. The cold thyroid nodule: an analysis of diagnostic and therapeutic options. Endocr Rev. 5(2):185–99, 1984.

    Article  PubMed  CAS  Google Scholar 

  17. Piraino P, Sepulveda A, Lillo R, Pineda P, Liberman C. Cancer tiroideo. Comunicacion de 85 casos. Rev Med Chil. 128:405–10, 2002.

    Google Scholar 

  18. Ravetto C, Colombo L, Dottorini ME. Usefulness of fine-needle aspiration in the diagnosis of thyroid carcinoma. Cancer Cytopathol. 90:357–63, 2000.

    CAS  Google Scholar 

  19. Rossi M, Delbridge L, Phillips J, Rennie Y, Reeve TS. Fine needle biopsy of thyroid nodules: The importance of technique. ANZ J Surg. 60:879–81, 1990.

    Article  CAS  Google Scholar 

  20. Solymosi T, Toth GL, Bodo M. Diagnostic accuracy of fine needle aspiration cytology of the thyroid: impact of ultrasonography and ultrasonographically guided aspiration. Acta Cytol. 45:669–74, 2001.

    PubMed  CAS  Google Scholar 

  21. The Papanicolaou Society of Cytopathology Task Force on Standards of Practice. Guidelines of the Papanicolaou Society of Cytopathology for fine-needle aspiration procedure and reporting. Diagn Cytopathol. 17:239–47, 1997.

    Article  Google Scholar 

  22. Weiss ML, Pilz R, Deckart E, Kleinau E. Fine needle aspiration biopsy (FNAB) of thyroid in the diagnostics of thyroid malignancies—a 12 years’ experience-report. Radiobiol Radiother (Berl). 28(5):622–6, 1987.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Visceral-, Thoracic-, and Vascular Surgery, Philipps University of Marburg, Baldingerstraße, 35033, Marburg, Germany

    Iyad Hassan, Thomas Osei-Agymang, E. Domínguez Fernández & Matthias Rothmund

  2. Department of Nuclear Medicine, University of Giessen and Marburg, Marburg, Germany

    Thomas Behr

  3. Institute of Pathology, University of Giessen and Marburg, Marburg, Germany

    Peter Barth & Annette Ramaswamy

  4. Institute of Biometry, University of Giessen and Marburg, Marburg, Germany

    Hans Helge Mueller

  5. Department of Visceral-, Thoracic-and Endocrine Surgery, Klinikum Offenbach, Offenbach, Germany

    Andreas Zielke

Authors
  1. Iyad Hassan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Osei-Agymang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Domínguez Fernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Behr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter Barth
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Annette Ramaswamy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hans Helge Mueller
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Andreas Zielke
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Matthias Rothmund
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Iyad Hassan.

Additional information

T. Osei-Agyemang and I. Hassan contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hassan, I., Osei-Agymang, T., Fernández, E.D. et al. Does Fine-Needle Aspiration Cytology Optimize the Surgical Management of Thyroid Disorders in Endemic Goiter Region?. Endocr Pathol 19, 34–39 (2008). https://doi.org/10.1007/s12022-007-9011-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12022-007-9011-1

Keywords

Search

Navigation