Diagnosis of thyroid carcinoma

Area of Science:

• Endocrinology
• Oncology
• Cytopathology

Background:

• Thyroid carcinoma, though a frequent endocrine neoplasm, is rare overall (0.5-1.5% of human malignancies).
• Differentiated thyroid cancers have good prognoses, while aggressive forms are rare with poor outcomes.
• Distinguishing benign from malignant thyroid lesions early is clinically difficult due to overlapping features.

Purpose of the Study:

• To evaluate the diagnostic efficacy of fine-needle aspiration (FNA) cytology for thyroid nodules.
• To compare FNA cytology with traditional diagnostic methods for thyroid lesions.
• To establish an optimal diagnostic algorithm for thyroid nodule evaluation.

Main Methods:

• Retrospective analysis of over 12,000 nodular lesions evaluated since 1982.
• Comparison of FNA cytology results with traditional clinico-semeiological and instrumental parameters.
• Integration of FNA cytology with morphofunctional, immunological, and hypothalamo-pituitary axis assessments.

Main Results:

• FNA cytology demonstrated significantly higher diagnostic reliability compared to traditional techniques.
• Scintigraphy and echography showed non-specific findings, lacking reliability in differentiating benign from malignant nodules.
• Genetic-molecular markers are emerging for specific conditions like familial medullary thyroid carcinoma.

Conclusions:

• Fine-needle aspiration (FNA) cytology is the technique of choice for screening thyroid nodules.
• A rigorous diagnostic algorithm integrating FNA with other tests is essential for managing thyroid nodule disease.
• Accurate diagnosis guides appropriate surgical intervention for solitary or prominent thyroid nodules.