Annals of Surgical Oncology

, Volume 18, Issue 5, pp 1282–1289 | Cite as

Inadequate Cytology in Thyroid Nodules: Should We Repeat Aspiration or Follow-Up?

  • Jung Hyun Yoon
  • Hee Jung Moon
  • Eun-Kyung Kim
  • Jin Young Kwak
Endocrine Tumors



To evaluate how to correctly manage thyroid nodules showing inadequate cytology after ultrasound (US)-guided fine-needle aspiration biopsy (US-FNAB).

Materials and Methods

A total of 393 thyroid nodules with inadequate cytology in 351 patients (M:F = 40:311, mean age: 49.3 years) with surgery or follow-up US-FNAB for at least 1 year were included in this study. Among them, 293 (74.6%) were benign and 100 (25.4%) were malignant on final reference results. Clinical characteristics and US features were reviewed and compared.


Malignancy rates (39.5%) of nodules having suspicious US feature were significantly higher than those (10.9%) of nodules without any suspicious US feature (P < .001). Malignancy rates of solid nodules, mainly solid nodules, and mainly cystic nodules were 29.2, 16.7, and 9.5%, respectively, with significant differences (P = .016). Malignancy rates of nodules assessed as suspicious malignant to probably benign in composition are: 39.1–12.8% (P < .001) in solid nodules, 42.1–9.2% (P = .001) in mainly solid nodules, and 50.0–5.3% (P = .04) in mainly cystic nodules.


In nodules with inadequate cytology, follow-up US can be considered over repeat aspiration if there are no suspicious US features present, especially in mainly cystic nodules.


Nodule Papillary Thyroid Carcinoma Thyroid Nodule Malignant Nodule Malignancy Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Jung Hyun Yoon
    • 1
    • 2
  • Hee Jung Moon
    • 1
  • Eun-Kyung Kim
    • 1
  • Jin Young Kwak
    • 1
  1. 1.Department of Radiology, Research Institute of Radiological ScienceYonsei University College of MedicineSeoulSouth Korea
  2. 2.Department of Radiology, Bundang CHA HospitalPochon CHA UniversitySeongnamSouth Korea

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