The Incidence of Papillary Thyroid Carcinoma (PTC) in Nodules Not Biopsied by Fine Needle Aspiration.
Mohammed K Atieh, Mark E Fons, Guliz A Barkan, Swati Mehrotra, Razan Wafai, Alia Salhadar, Eva Wojcik, Umesh Kapur. Loyola Medical Center, Maywood, IL
Background: Fine needle aspiration biopsy (FNAB) of the thyroid is an integral part of the work-up in patients with thyroid nodules. Nodules less than 1.0cm are not usually biopsied unless radiologically suspicious. The aim of our study was to determine the incidence of PTC in thyroid nodules that were not biopsied by FNAB.
Design: A database search, of our Cytology records, identified 249 ultrasound-guided FNAB with surgical follow-up (2006-2010). We grouped the surgical resection specimen into three categories based on the initial FNAB diagnosis (Benign, Suspicious, or Malignant). Radiological and surgical correlation was utilized to determine the incidence of PTC in nodules that were not biopsied by FNAB. These nodules (with PTC) were sorted into three groups based on size (>1.0cm, 0.5-1.0cm, and <0.5cm).
117/249 FNAB had a benign cytologic diagnosis. 20 of these 117 FNAB showed PTC occurring in nodules not biopsied by FNAB [5 nodules >1.0cm, 6 nodules- 0.5 to 1.0cm, and 9 nodules <0.5cm].
23/249 FNAB had a suspicious cytologic diagnosis. 6 of these 23 FNAB showed PTC occurring in nodules not biopsied by FNAB [1 nodule >1.0cm, 0 nodules- 0.5 to 1.0cm, and 5 nodules <0.5cm].
109/249 FNAB had a malignant cytologic diagnosis. 20 of these 109 FNAB showed PTC occurring in nodules not biopsied by FNAB [4 nodules >1.0cm, 10 nodules- 0.5 to 1.0cm, and 6 nodules <0.5cm].
In summary, 46/249 nodules (18% of total) showing PTC were not previously biopsied by FNAB (10 nodules >1.0cm, 16- 0.5 to 1.0cm, and 20 were < 0.5cm).
Conclusions: -Our study shows that a significant number of nodules (18% of total), not biopsied by FNAB, harbor PTC.
-Ten nodules greater than 1.0cm, not biopsied by FNAB, were shown to harbor PTC. Most significantly, 5 of these 10 lesions were in patients with a benign multinodular goiter by ultrasound and FNA.
-This study has significant implications, as radiologic correlation should be an essential part in determining cytologic/histologic correlation.
Monday, February 28, 2011 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 48, Monday Morning