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Updated: May 27, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Published on: November 10, 2014

Thyroid fine-needle aspiration: does case volume affect diagnostic yield and interpretation?

Jeffrey J Houlton¹, Gordon H Sun, Nella Fernandez

¹Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Academic Health Center, 231 Albert Sabin Way, Cincinnati, OH 45267-0528, USA. houltojy@ucmail.uc.edu

Archives of Otolaryngology--Head & Neck Surgery

|November 23, 2011

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Thyroid fine-needle aspiration (FNA) interpretation is affected by case volume, with low-volume pathologists reporting more atypical results. However, case volume did not significantly impact the diagnostic yield of thyroid FNA procedures.

Area of Science:

Endocrinology
Pathology
Cytopathology

Background:

Thyroid fine-needle aspiration (FNA) is a crucial diagnostic tool for evaluating thyroid nodules.
The interpretation of FNA results can be complex and may be influenced by various factors, including pathologist experience and case volume.

Purpose of the Study:

To investigate the impact of case volume on the diagnostic yield and interpretation accuracy of thyroid FNA.
To compare the FNA results between low-volume and high-volume pathologists and clinicians.

Main Methods:

Retrospective case series analysis of thyroid FNA procedures performed in 2009.
Involved data from an academic tertiary referral center and two community hospitals.
Analyzed diagnostic distribution and yield based on the number of FNAs performed by clinicians and interpreted by pathologists.

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Last Updated: May 27, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Published on: November 10, 2014

Main Results:

A total of 790 thyroid FNAs were reviewed, with interpretations including benign, atypical, malignant, and nondiagnostic.
Low-volume pathologists (<50 FNAs interpreted) were more likely to report atypical results (32% vs 13%) and less likely to report benign results (50% vs 70%) compared to high-volume pathologists (≥50 FNAs interpreted).
Atypical findings by low-volume pathologists were more likely to have benign permanent results (64% vs 42%). Clinician case volume did not significantly affect the rate of nondiagnostic FNAs.

Conclusions:

Pathologist case volume significantly influences thyroid FNA interpretation, leading to more atypical and fewer benign classifications in low-volume practitioners.
Clinician case volume did not demonstrate a significant impact on the diagnostic yield, as evidenced by similar rates of nondiagnostic FNAs.