Post-fine-needle biopsy infarction of thyroid neoplasms: a review of 28 cases

This report describes 28 cases of thyroids which had undergone infarction following fine-needle aspiration (FNA) biopsy procedure. Their cytologic diagnoses included 15 Hürthle cell tumors, eight papillary carcinomas, and five follicular neoplasms. Nine patients also had large-needle biopsy performed within 3 wk of FNA biopsy, three of which showed infarction and one had no surgical follow-up. Surgery was performed on 27 patients within 7 to 90 days. All 27 cases showed partial to total infarction. Histological and cytologic diagnoses were not in accordance in 12 cases, either due to complete fibrosis (two cases), obscuring of histologic details (four cases), or failure to recognize the thin rim of neoplastic tissue at the periphery, by pathologists unaware of the cytologic diagnoses (six cases). Fine-needle biopsy results should be made available to the surgical pathologists handling the surgically excised thyroid specimen. Also, partial or complete infarction must initiate careful examination, so as not to miss any neoplasms.