Fine needle biopsy and scintigram in the preoperative diagnosis of thyroid lesions

Fine needle biopsies (FNB) of the thyroid were examined from 860 patients. In 703 cases follicular cells without atypia were found and in this group of patients the clinical diagnosis was nodular goitre. Operations were performed in 138 patients and in 97 cases the cytological finding could be correlated to the histopathological diagnosis. In 33 of these patients thyroid carcinoma was histologically verified. In 26 of the carcinoma cases cytologic examination showed grave atypia or changes indicating carcinoma. The cases in which the cytological diagnoses were falsely negative are discussed. Moderate cellular atypia occurred in one case with papillary carcinoma. In two cases the cytological examination gave a false positive diagnosis of cancer, both representing thyroiditis of the lymphoid type. The scintigrams in patients with thyroid carcinoma are also presented. Cold nodules were found in 10/19 patients and a hot nodule in .1 patient. In 3 patients the scintigrams were normal and in another 5 inconclusive. The results indicate that thyroid scintigrams can only be used as a supplement to the physical examination and a guidance for FNB. The contribution of FNB in the decision to operate is discussed and it is concluded that FNB is a valuable adjunct in preoperative diagnosis of thyroid lesions. The best diagnostic results are obtained when there is a close cooperation between clinician, radiologist, cytologist and pathologist.