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Credibility and clinical utility of thyroid fine-needle aspiration biopsy in a teaching hospital
1Department of Surgery, University of Texas Southwestern Medical School, Dallas, USA.
Background:
Fine-needle aspiration (FNA) biopsy allows cost-effective thyroid nodule management at referral centers. The authors examined its use at a teaching hospital for safety, accuracy, and clinical utility.
Methods:
Patients having thyroid FNA biopsy in 1991 were identified. Pathology results through 1993 were retrieved and selected charts through 1993 were reviewed. House staff, with faculty supervision, performed patient evaluations, FNA biopsy, and therapy.
Results:
There were 91 uncomplicated FNAs. Aspirates were diagnostically adequate in 78 (86%) cases. In 15 operations for neoplastic FNA biopsy, 14 (93%) tumors were confirmed. Twelve operations for clinical indications despite benign FNA biopsy yielded 2 (17%) adenomas. Fine-needle aspiration biopsy and frozen section were similarly accurate. No observed patients have had thyroidectomies. Patient management, operation in 15 cases and observation in 48 cases, was directed by FNA biopsy in 63 of 91 patients (69%).
Conclusion:
Thyroid FNA biopsy by house staff with faculty supervision is safe, accurate, allows efficient patient management, and can reduce frozen section use.