Abstract
Objectives
Thyroid nodules are common, and the majority are discovered incidentally on physical examination or imaging studies. Certain features on ultrasound (US) have been traditionally associated with malignant lesions and others with benign lesions. The aim of this study was to investigate the efficacy of US in determining malignancy in thyroid lesions diagnosed as indeterminate or malignant according to the cytological findings on fine needle aspiration biopsy (FNAB).
Methods
The records of 270 patients, referred to a single clinic with multinodular goiter were evaluated retrospectively, and 400 thyroid nodules sized larger than 5 mm in diameter were selected for the study. After exclusion of nodules classified as benign according to the FNAB findings, 203 thyroid nodules were included in this study. The nodules were divided into two groups on the basis of the FNAB findings: group 1 consisted of 82 nodules with indeterminate cytology and group 2 consisted of 121 nodules with cytological findings of malignancy or suspicious for malignancy.
Results
The diagnostic accuracy of ill-defined borders was 69.5% in group 1 (indeterminate) and 56% in group 2 (p=0.04). The diagnostic accuracy of solid composition was 50% in group 1 and 73% in group 2 (p=0.01). Positive correlation was demonstrated between ill-defined margins and malignant histology in group 1 (r=0.411, p=0.001), and between microcalcifications and malignant histology in group 2 (r=0.247, p=0.002).
Conclusions
In this study, the only US finding shown to be correlated with malignant histology in thyroid nodules of indeterminate cytology on FNAB was ill-defined margins. More precise US criteria are needed to decide on surgery in patients with thyroid nodules of indeterminate cytology.
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References
Datta RV, Petrelli NJ, Ramzy J. Evaluation and management of incidentally discovered thyroid nodules. Surg Oncol 2006;15:33–42.
Ogilvie JB, Piatigorsky EJ, Clark OH. Current status of fine needle aspiration for thyroid nodules. Adv Surg 2006; 40:223–38.
VanderLaan PA, Marqusee E, Krane JF. Clinical outcome for atypia of undetermined significance in thyroid fine-needle aspirations: Should repeated fna be the preferred initial approach? Am J Clin Pathol 2011;135:770–5.
Cooper DS, Doherty GM, Haugen BR, et al. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167–214.
Remonti LR, Kramer CK, Leitão CB, et al. Thyroid ultrasound features and risk of carcinoma: A systematic review and metaanalysis of observational studies. Thyroid 2015;25:538–50.
Kim EK, Park CS, Chung WY, et al. New sonographic criteria for recommending fine needle aspiration biopsy of nonpalpable solid nodules of the thyroid. Am J Roentgenol 2002;178:687–91.
Sidawy M, Del Vecchio D, Knoll S. Fine needle aspiration of thyroid nodules: correlation between cytology and histology and evaluation of discrepant cases. Cancer 1997;81:253–9.
Frates MC, Benson CB, Charboneau JW, et al. Society of radiologists in ultrasound. Management of thyroid nodules detected at US: Society of radiologists in ultrasound consensus conference statement. Radiology 2005;237:794–800.
Kim EK, Park CS, Chung WY, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002;178:687–91.
Papini E, Guglielmi R, Bianchini A, et al. Risk of malignancy in nonpalpable thyroid nodules: Predictive value of ultrasound and color Doppler features. J Clin Endocrinol Metab 2002; 87:1941–6.
Peccin S, de Castro JA, Furlanetto TW, et al. Ultrasonography: is it useful in the diagnosis of cancer in thyroid nodules? J Endocrinol Invest 2002;25:39–43.
Kim EK, Park CS, Chung WY, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002;178:687–91.
Solbiati L, Arsizio B, Ballarati E, et al. Microcalci-fications: a clue in the diagnosis of thyroid malignancies. Radiology 1990;117:140.
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Ercetin, C., Sahbaz, N.A., Arici, S. et al. Cytological and Ultrasound Findings in Indeterminate Lesions of the Thyroid Gland. Hellenic J Surg 90, 22–26 (2018). https://doi.org/10.1007/s13126-018-0430-x
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DOI: https://doi.org/10.1007/s13126-018-0430-x