Fine-needle aspiration of thyroid nodules

IF 2.6 3区医学 Q3 ONCOLOGY Cancer Cytopathology Pub Date : 2000-11-10 DOI:10.1002/(SICI)1097-0142(19970825)81:4<253::AID-CNCR7>3.0.CO;2-Q

Mary K. Sidawy M.D., David M. Del Vecchio M.D., Stanley M. Knoll M.D.

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引用次数: 131

Abstract

BACKGROUND

The purpose of this study was to evaluate the results of thyroid fine-needle aspiration (FNA) and to determine the reasons for the discrepancies between the cytologic and histologic diagnoses.

METHODS

The authors evaluated the cytologic and histologic results of 133 FNAs obtained from 92 patients who underwent subsequent thyroidectomies.

RESULTS

The initial cytologic results were indeterminate in 39 of 133 cases (29%) because a neoplasm could not be ruled out. These cases corresponded histologically to 9 adenomatoid nodules (ANs), 14 follicular adenomas (FAs), and 16 malignant thyroid neoplasms. The reported FNA diagnoses of the remaining 94 cases (71%) were 48 ANs, 19 follicular neoplasms (FNs), 21 papillary carcinomas (PCs), and 6 cases of Hashimoto's thyroiditis (HT). Correlation of cytology and histology showed that 69 of 94 FNA results (73%) correlated with the histologic diagnoses, whereas 25 (27%) were discrepant. The discrepancies resulted from cytodiagnostic errors in 13 cases (52%), suboptimal smears in 11 (44%), and an FNA sampling error in 1 (4%). The false-negative rate of FNA was 19% and the false-positive rate was 6%.

CONCLUSIONS

Diagnostic pitfalls and indeterminate FNA diagnoses were predominantly due to overlapping cytologic criteria between ANs, FNs, and follicular variants of PCs. Rendering a definite diagnosis on suboptimal FNA samples is also a significant source of pitfalls. Cancer (Cancer Cytopathol) 1997; 81:253-9. © 1997 American Cancer Society.

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细针穿刺甲状腺结节

本研究的目的是评估甲状腺细针穿刺(FNA)的结果，并确定细胞学和组织学诊断之间差异的原因。方法:作者评估了92例甲状腺切除术患者的133个FNAs的细胞学和组织学结果。结果133例患者中有39例(29%)的初始细胞学结果不确定，因为不能排除肿瘤。这些病例在组织学上对应9例腺瘤样结节(ANs)， 14例滤泡性腺瘤(FAs)和16例恶性甲状腺肿瘤。其余94例(71%)的FNA诊断为ANs 48例，滤泡性肿瘤(FNs) 19例，乳头状癌(PCs) 21例，桥本甲状腺炎(HT) 6例。细胞学和组织学的相关性显示94个FNA结果中有69个(73%)与组织学诊断相关，而25个(27%)不一致。差异源于13例(52%)细胞诊断错误，11例(44%)涂片不理想，1例(4%)FNA抽样错误。FNA假阴性率为19%，假阳性率为6%。结论:诊断缺陷和不确定的FNA诊断主要是由于ANs、FNs和PCs的滤泡变异之间的细胞学标准重叠。对次优FNA样本进行明确诊断也是陷阱的重要来源。癌症(癌症细胞酚)1997;81:253-9。©1997美国癌症协会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Cytopathology 医学-病理学

CiteScore

7.00

自引率

17.60%

发文量

130

审稿时长

1 months

期刊介绍： Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.