Core Needle Biopsy Can Early and Precisely Identify Large Thyroid Masses.

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Large and rapidly growing thyroid masses pose diagnostic challenges due to potential compression and infiltration of vital neck structures.
• Accurate diagnosis of malignancy and histotype is essential for appropriate therapeutic strategies.

Purpose of the Study:

• To evaluate the diagnostic performance of fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) for large, rapidly growing thyroid masses.
• To compare the ability of FNAC and CNB to diagnose malignancy, determine histotype, and yield sufficient material for molecular analysis.

Main Methods:

• A prospective study involving 95 patients with large, rapidly growing thyroid masses.
• All patients underwent both FNAC and CNB during the same session.
• Diagnostic accuracy, histotype identification, and suitability for molecular analysis were assessed for both procedures.

Main Results:

• Core needle biopsy (CNB) yielded adequate samples in 96.8% of cases, compared to 80% for fine needle aspiration cytology (FNAC).
• CNB diagnosed malignancy in 96.8% of cases and identified histotype in all specimens, while FNAC diagnosed malignancy in 77.9% and histotype in only 21.6%.
• CNB provided optimal material for molecular analysis in all cases, with no reported complications for either procedure.

Conclusions:

• Core needle biopsy (CNB) demonstrates superior performance over FNAC for large, rapidly growing thyroid masses, particularly in histotype identification.
• CNB provides adequate material for molecular profiling, essential for precision medicine in treating potentially lethal thyroid cancers.
• CNB should be integrated into routine practice for early diagnosis and effective therapy of these thyroid conditions.