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

Annals of Surgical Oncology volume 18, pages 1282–1289 (2011)Cite this article

Abstract

Background

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.

Results

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.

Conclusions

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.

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Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea

    Jung Hyun Yoon MD, Hee Jung Moon MD, Eun-Kyung Kim MD, PhD & Jin Young Kwak MD, PhD

  2. Department of Radiology, Bundang CHA Hospital, Pochon CHA University, Seongnam, South Korea

    Jung Hyun Yoon MD

Authors
  1. Jung Hyun Yoon MD
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  2. Hee Jung Moon MD
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  3. Eun-Kyung Kim MD, PhD
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  4. Jin Young Kwak MD, PhD
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Correspondence to Jin Young Kwak MD, PhD.

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Cite this article

Yoon, J.H., Moon, H.J., Kim, EK. et al. Inadequate Cytology in Thyroid Nodules: Should We Repeat Aspiration or Follow-Up?. Ann Surg Oncol 18, 1282–1289 (2011). https://doi.org/10.1245/s10434-011-1605-7

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  • DOI: https://doi.org/10.1245/s10434-011-1605-7

Keywords

  • Nodule
  • Papillary Thyroid Carcinoma
  • Thyroid Nodule
  • Malignant Nodule
  • Malignancy Rate