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Background
To assess the use and usefulness of fine-needle aspiration cytologic biopsy (FNAB)
of the thyroid in our hospital.
Methods
All cytology slides and charts of patients who had FNAB of the thyroid done in our
hospital in 1993 were reviewed. Charts of all patients having thyroid surgery in our
hospital in 1993 were reviewed to determine the pathological diagnosis and whether
FNAB had been performed preoperatively. Finally, we reviewed all consecutive thyroid
surgery cases for an 8-year period, and we calculated the yearly percentage of malignancy.
Results
Fifty-five FNAB were done in 53 patients. In 21 patients the FNAB gave indication
for thyroid surgery, yet surgery was done in only 12 (57.1%). Forty-two patients had
surgery for a thyroid nodule, but only 20 patients (47.6%) had a preoperative FNAB.
There were 3 malignancies among the 20; 2 were correctly predicted by FNAB. The FNAB
was correct in 18 of 20. In all, 378 thyroid operations were done from 1987 to 1994.
The yearly proportion of thyroid malignancy ranged from 11% to 29%, but showed no
change corresponding with increasing diagnostic sophistication.
Conclusions
Fine-needle aspiration cytologic biopsy in the workup of patients with thyroid masses
is strikingly underutilized in our institution. While accurate in 90% of cases where
used, FNAB appears to play a minor role in the surgeon's decision regarding surgery.
As a result of these findings, we developed a grading system for better communication
of the FNAB report and a clinical guideline to improve the evaluation of patients
with thyroid masses.
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Article info
Footnotes
**Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
Identification
Copyright
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
