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Updated: Jul 4, 2026
Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Nondiagnostic thyroid fine-needle aspiration biopsies are no longer a dilemma
Melanie L Richards1, Elizabeth Bohnenblust, Kenneth Sirinek
1Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. richards.melanie@mayo.edu
Background:
Nondiagnostic fine-needle aspiration biopsy (ND-FNAB) of the thyroid leads to unnecessary thyroidectomy. The aims of this study were as follows: (1) to determine the risk of malignancy in ND-FNABs, and (2) to evaluate factors that may identify patients at risk for a ND-FNAB.
Methods:
A total of 241 patients who underwent FNAB and thyroidectomy were evaluated for factors associated with a ND-FNAB.
Results:
A total of 215 women and 26 men underwent FNAB and thyroidectomy. ND-FNAs occurred in 51 of 241 (21%) patients. Ultrasound guidance did not reduce the likelihood of a ND biopsy. Patients with nodules greater than 3 cm had more ND-FNAs. Twenty-one of 51 with a ND biopsy underwent a repeat FNAB. Repeat FNAB was ND in 29% of patients. There was malignant disease in 7 of 51 (14%) with a ND-FNAB. Patient age, sex, thyroid function, gland size, multiple nodules, and final pathology were not related to a ND-FNAB (P > .05).
Conclusions:
Most patients with a ND-FNAB have benign disease and low-risk patients with a ND-FNAB on repeat FNA warrant a more conservative approach.
