Abstract
Background
False-positive, false-negative, and indeterminate fine-needle aspiration (FNA) biopsy
results complicate the management of patients with thyroid nodules.
Methods
Thyroid FNA results from 240 consecutive patients (seen 1991 to 2002) were categorized
into four groups: positive for malignancy, negative for malignancy, indeterminate
for malignancy, and nondiagnostic. Indeterminate results included follicular neoplasm,
Hürthle cell neoplasm, and suspicious for papillary carcinoma. The FNA results were
compared with histopathologic analysis after thyroidectomy.
Results
The FNA results were 76 (32%) positive for malignancy, 53 (22%) negative for malignancy,
100 (42%) indeterminate for malignancy, and 11 (5%) nondiagnostic. There were 3 (4%)
false-positive and 2 (4%) false-negative FNA results. Among the 100 indeterminate
FNA results, carcinoma was found in 11 (15%) of 73 follicular neoplasms, 2 (20%) of
10 Hürthle cell neoplasms, and 14 (82%) of 17 suspicious for papillary carcinoma.
For the 73 patients with follicular neoplasms, nodule diameter >2 cm was associated
with an increased risk of malignancy (P <0.03).
Conclusions
False-negative FNA results are uncommon, supporting the practice of observation in
most of these patients. Among those with indeterminate biopsy results, high-risk subgroups
include patients with FNA results suspicious for papillary carcinoma and follicular
neoplasms >2 cm.
Keywords
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Article info
Publication history
Received in revised form:
August 21,
2003
Received:
July 11,
2003
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
