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Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Repeatedly nondiagnostic thyroid fine-needle aspirations do not modify malignancy risk
Vickie Y Jo1, Paul A Vanderlaan, Ellen Marqusee
1Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass., USA.
Acta Cytologica
|December 14, 2011
Summary
Repeatedly nondiagnostic (ND) fine-needle aspirations (FNA) of thyroid nodules do not increase the risk of malignancy. Continue with repeat FNA and clinical correlation for ND thyroid nodules.
Area of Science:
- Endocrinology
- Cytopathology
- Surgical Oncology
Background:
- Nondiagnostic (ND) fine-needle aspiration (FNA) results are common for thyroid nodules.
- Repeat FNA is standard, but the significance of multiple ND results is unclear.
- Existing data suggest a low risk of malignancy with repeatedly ND FNAs.
Purpose of the Study:
- To evaluate the malignancy risk associated with repeatedly nondiagnostic thyroid fine-needle aspirations.
- To determine if multiple ND FNA results alter the risk of thyroid cancer.
Main Methods:
- Retrospective analysis of 834 ND thyroid FNAs from 694 nodules over a 6-year period.
- Examined outcomes of repeat FNA and surgical follow-up.
- Calculated malignancy risk based on cytologic and histologic findings.
Main Results:
- Of 694 nodules, 52% had repeat FNA; 19% had at least one additional ND result.
- Malignancy was found in 21% of nodules after one ND FNA and 20% after multiple ND FNAs.
- Overall malignancy risk was 4%, with no significant difference between single and repeated ND FNAs.
Conclusions:
- Repeatedly nondiagnostic FNA results do not modify the risk of malignancy in thyroid nodules.
- Clinical management should involve repeat FNA with clinical and sonographic correlation for ND aspirates.
- The risk of malignancy remains low even after multiple nondiagnostic thyroid FNA procedures.
