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Characteristics of False-Negative Thyroid Fine-Needle Aspirates
Andrew A Renshaw1, Edwin W Gould
1Department of Pathology, Baptist Hospital of Miami and Miami Cancer Institute, Miami, FL, USA.
Acta Cytologica
|November 14, 2017
Summary
The study found a 2.7% false-negative rate in thyroid fine-needle aspirations (FNA), with interpretive errors often involving subtle malignant cell features. The risk of malignancy for a benign FNA diagnosis was 3.5%.
Area of Science:
- Endocrinology
- Cytopathology
- Surgical Pathology
Background:
- False-negative results in thyroid fine-needle aspiration (FNA) are not well understood.
- Characterizing these errors is crucial for improving diagnostic accuracy.
Purpose of the Study:
- To analyze the incidence and causes of false-negative thyroid FNA results.
- To determine the risk of malignancy associated with benign FNA diagnoses.
Main Methods:
- A retrospective correlation of thyroid FNA results with histologic follow-up was performed.
- Data from 13,733 aspirations between 1997 and 2016 were analyzed.
Main Results:
- A 2.7% false-negative rate was identified, with causes including interpretation (n=6), sampling (n=7), and new nodules (n=5).
- Interpretive errors were less frequent when the indeterminate rate exceeded 13% (p=0.01).
- The sensitivity for 9-mm papillary carcinomas was 44.3%.
Conclusions:
- The overall false-negative rate for thyroid FNA was 2.7%, with a 3.5% risk of malignancy for benign diagnoses.
- Interpretive false-negative cases often involved rare cells with poorly developed malignant features.
- No significant difference in false-negative rates or malignancy risk was observed between patients who underwent resection and those who did not.
