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Published on: November 10, 2014
Fine-needle aspiration biopsy of thyroid lesions processed by thin-layer cytology: one-year institutional experience
Guido Fadda1, Esther Diana Rossi, Marco Raffaelli
1Division of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Catholic University of Sacred Heart, Rome, Italy. guidofadda@rm.unicatt.it
Insights
Thin-layer cytology (TLC) improves thyroid fine-needle aspiration biopsy (FNAB) accuracy, reducing inadequate and indeterminate diagnoses. This method maintains high diagnostic accuracy for thyroid nodules.
Area of Science:
- Pathology
- Cytopathology
- Endocrinology
Background:
- Fine-needle aspiration biopsy (FNAB) is crucial for thyroid nodule classification.
- Thin-layer cytology (TLC) has emerged as a promising technique in thyroid cytology.
Purpose of the Study:
- To evaluate the efficacy of thin-layer cytology (TLC) in diagnosing thyroid nodular lesions.
- To compare TLC's diagnostic performance against conventional smears (CS).
Main Methods:
- Retrospective analysis of 2006 thyroid FNAB cases processed using TLC in 2004.
- Comparison with control series from 2002-2003 processed by both TLC and CS.
- Classification based on established morphologic criteria, with histological confirmation for 311 surgical cases.
Main Results:
- Inadequate diagnosis rates decreased with TLC: 11.3% in 2004 vs. 13.3% (2003) and 18.2% (2002).
- Indeterminate diagnosis rates also reduced: 16.9% in 2004 vs. 20.7% (2003) and 24.8% (2002).
- Diagnostic accuracy, sensitivity, and specificity ranged from 80% to 100%.
Conclusions:
- Thin-layer cytology (TLC) effectively reduces inadequate and indeterminate diagnoses in thyroid FNAB.
- TLC maintains or improves preoperative diagnostic accuracy for thyroid nodules.
- Stored material from TLC allows for successful application of ancillary techniques.
Abstract:
Fine-needle aspiration biopsy (FNAB) is important for classifying thyroid lesions. Thin-layer cytology (TLC) has been adopted in thyroid cytology with encouraging results and its efficacy in diagnosing nodular lesions in a 1-year period was evaluated. All 2006 thyroid FNAB processed by TLC only in the year 2004 were examined. The 2002 and 2003 series, processed both by TLC and conventional smears (CS), were used as controls. All FNAB were classified according to previously published morphologic criteria. Surgery was performed on 311 cases: all 98 benign and 30 malignant lesions were histologically confirmed. The inadequate diagnoses resulted 11.3% in 2004, 13.3% in 2003, and 18.2% in 2002. The indeterminate diagnosis rate was 16.9% in 2004, 20.7% in 2003, and 24.8% in 2002. Sensitivity, specificity, and diagnostic accuracy values ranged from 80% to 100%. TLC is useful in reducing inadequate and indeterminate cases without decreasing the preoperative diagnostic accuracy. Ancillary techniques can be successfully applied to the stored material.
