ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION BIOPSY RESULTS OF THYROID NODULES IN A SINGLE CENTER
Abstract
Objective: To review the fine needle aspiration biopsy results of the thyroid (TFNAB) of 679 patients with nodular goiter who were diagnosed and followed in our center and to compare postsurgical diagnoses with pre-surgical TFNAB results in 27 patients. Method: Demographic and thyroid nodule characteristics on B-mode ultrasonography, TFNAB cytological findings and post-surgical histopathological results of all patients were retrospectively analyzed.
Results: Mean age (±SD) of 679 patients during TFNAB was 53±12 years of whom 116 (17%) were males (mean age: 56±13.5 years) and 563 (83%) were females (mean age: 52.4±11.8 years). No significant difference was observed in terms of age between males and females. Of 679 patients, 614 (90%) were in euthyroid, 42 (6%) were hyperthyroid and 23 (4%) were hypothyroid. TFNAB was performed once in 592 (87%) patients, twice in 93 (12%) patients, and thrice in 8 (1%) patients. 27/679 patients with TFNAB (3.9%) underwent thyroidectomy due to suspected malignancy; the remaining 652 patients were followed-up by USG and periodic clinical examinations. According to the TFNAB-based diagnoses of 27 operated patients, 3 were classified as Bethesda 6, 3 as Bethesda 5, 11 as Bethesda 4 and 10 as Bethesda 3. Among the 27 patients, 10 were malignant and 17 were benign, according to the post-surgical histopathological analysis. Malignancy was diagnosed on the post-surgical histopathological analysis in all patients who were categorized as Bethesda 6 and 5. However, only 3 of the 11 patients who were classified as Bethesda 4 and 10 of the patients who were classified as Bethesda 3 were reported as malignant. Considering 10 patients who were diagnosed as malignant on the post-surgical histopathological result, the rate of malignancy was 1.5 in all 679.
Conclusion: TFNAB results per se contribute to final diagnosis, particularly for nodules reported as Bethesda 5 and 6. However, in TFNAB results reported as Bethesda 3 and 4, cytological findings as well as clinical and USG features and if available, Elastosonographic or molecular genetics examinations should be taken into account for proper selection of patients for thyroidectomy.
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