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Large cystic/solid thyroid nodules: a potential false-negative fine-needle aspiration
1Department of Surgery, Washington University School of Medicine, St. Louis, Mo 63110, USA.
Surgery
|December 1, 1995
Summary
Large or cystic/solid thyroid nodules pose a high risk for false-negative fine-needle aspiration (FNA) biopsy results. Consider thyroid lobectomy for diagnosis in these cases, even with benign FNA findings.
Area of Science:
- Endocrinology
- Surgical Pathology
- Oncology
Background:
- False-negative fine-needle aspiration (FNA) biopsy results for thyroid nodules can lead to missed malignant lesions.
- Accurate diagnosis is crucial for effective thyroid cancer management.
Purpose of the Study:
- To identify specific characteristics of thyroid nodules associated with false-negative FNA cytologic interpretations.
- To improve diagnostic accuracy and patient outcomes for thyroid nodules.
Main Methods:
- Retrospective review of 90 patients undergoing preoperative FNA and subsequent thyroid surgery.
- Analysis of clinical data, nodule type and size, FNA cytology, and surgical pathology findings.
Main Results:
- Nodules with the highest malignancy probability were large (≥3 cm), cystic/solid, or both.
- Overall false-negative FNA rate was 11%.
- False-negative rates were higher for large, cystic/solid nodules (17-30%) compared to small, solid nodules (0-17%).
Conclusions:
- Large, cystic/solid thyroid nodules have a high risk of malignancy and false-negative FNA results.
- Thyroid lobectomy should be strongly considered for diagnostic purposes in these specific nodule types, even with benign FNA findings.
- This approach can help prevent delayed diagnosis and treatment of potentially malignant thyroid lesions.