Histological results in the cases of thyroid cytology indeterminate or suspicious for malignancy
Antonio López-Guzmán1, Angel Luis Fraile1, Fernando Gómez Peralta1, Marcelo Francos1 & Cristina Álvarez Escola2
Introduction: Nodular thyroid disease is a common problem in clinical practice. Fine-needle aspiration (FNA) has become the principal test in the diagnosis of nodular thyroid disease. However, sometimes the information provided by this procedure is not definitive as it happens in those cases where the cytologic specimens are suspicious or indeterminate and a clear cytologic diagnosis can not be made. Based on that, we therefore undertook a study to investigate the histological results in our series of patients with thyroid cytology indeterminate or suspicious for malignancy.
Materials and methods: Two hundred and thirty three suspicious lesion specimens on FNA corresponding to 208 patients were studied (174 females and 34 males, mean age: 47.6±14.6 years, range: 1782). All cases were operated on and a pathological result was obtained in each case.
Results: Of the 233 specimens with the cytologic diagnosis of suspicious or indeterminate, in seventy nine of them (33.9%) the pathological result was malignant (19 follicular carcinoma, 26 papillary carcinoma, 14 Hürthle cell carcinoma, 13 follicular variant of papillary carcinoma and 7 medullary carcinoma); while in the remaining one hundred and fifty four (66.1%), the result was benign lesions (83 nodular hyperplasia, 41 follicular adenoma, 18 Hashimoto thyroiditis, 11 Hürthle cell adenoma and 1 case of Graves disease).
Conclusions: From our current results, it can be interred that cytologic findings indeterminate or suspicious for malignancy could appear in different thyroid conditions. The high percentage of thyroid carcinoma found in our series (33.9%) suggests that in the patients with thyroid lesions with a cytologic result of suspicious for malignancy or indeterminate, the lesion must be excised surgically to determine whether it is benign or malignant.