Fine needle cytology of complex thyroid nodules

Area of Science:

• Endocrinology
• Cytopathology
• Medical Imaging

Background:

• Complex thyroid nodules (CTN) present diagnostic challenges.
• Fine needle aspiration cytology (FNAC) is crucial for evaluating thyroid nodules.
• Optimizing sample adequacy is essential for accurate diagnosis.

Purpose of the Study:

• To assess if preliminary aspiration (ASP) of cystic components or using spinal needles improves cytological sampling adequacy in CTN.
• To compare the efficacy of stylet (Yale Spinal, YS) versus non-stylet (Neolus, NS) needles for FNAC in CTN.

Main Methods:

• Prospective study of 386 patients with CTN.
• Ultrasound-guided FNAC using YS and NS needles in alternate sequence.
• Subgroup analysis of preliminary aspiration (ASP+ vs. ASP-) in nodules with large cystic components.

Main Results:

• Adequate specimens were obtained in 94.8% of nodules using YS needles versus 84.5% with NS needles (P < 0.001).
• Stylet needles significantly reduced non-diagnostic specimens (5.2% vs. 15.5%).
• Preliminary aspiration showed no significant advantage in improving sample adequacy.

Conclusions:

• Stylet needles (YS) significantly enhance the adequacy of cytological sampling in CTN.
• Preliminary aspiration of large cystic components in CTN does not improve diagnostic yield.