An introduction to benign thyroid disease: pathophysiologic, epidemiologic aspects and diagnostic methodology

Area of Science:

• Endocrinology
• Surgical Pathology
• Oncology

Background:

• Benign thyroid diseases require accurate preoperative diagnosis to guide management.
• Distinguishing benign from malignant thyroid nodules preoperatively is crucial for appropriate surgical intervention.

Purpose of the Study:

• To critically review the role of preoperative noninvasive diagnostic procedures for benign thyroid diseases.
• To assess the accuracy of fine needle aspiration (FNA) cytology in differentiating benign from malignant thyroid lesions.
• To compare FNA cytology with intraoperative frozen section (FS) analysis.

Main Methods:

• Retrospective analysis of over 13,000 sequentially examined thyroid nodules.
• Evaluation of the diagnostic accuracy of ultrasound-guided FNA cytology.
• Comparison of FNA cytology with intraoperative frozen section analysis.

Main Results:

• Ultrasound-guided FNA cytology demonstrated high accuracy in preoperative diagnosis.
• Approximately 3% of malignant thyroid nodules were detected, including occult or minimal carcinomas.
• FNA cytology reduced operation time and eliminated unnecessary surgeries for benign lesions.
• FNA is a cost-effective tool, reducing patient care costs by approximately 20%.

Conclusions:

• Preoperative FNA cytology is a valuable and accurate tool for managing thyroid nodules.
• FNA cytology improves surgical decision-making, reduces costs, and prevents unnecessary procedures.
• Emerging molecular biology methods show promise for detecting malignancies missed by conventional cytology.