Ultrasound fine needle aspiration (US FNA) in an Endocrinology Department: our reality and results quality
Cristina Ribeiro, Sandra Paiva, Sofia Gouveia, Graça Fernandes, Miguel Melo, Jacinta Santos, Alexandra Vieira, Márcia Alves, Francisco Carrilho & Manuela Carvalheiro
Introduction: High-resolution US and US FNA are techniques of great relevance in the evaluation of thyroid nodules. They are being used much more often by endocrinologists all over the world. In our Endocrinology Department, we started them in 2006; since then they have been progressively amplified. We present our results of US FNA performed from January 2007 until December 2009.
Patients and methods: Two thousand eight hundred and seventy-seven FNA were performed in this period. Data were collected according to the gender and age of the patients, thyroid nodules size and location, and cytological diagnosis. Statistically, SPSS 16 was used.
Results: In these biopsies, 85.6% of the cytological diagnosis were colloid nodules (n=2462); 5.8%, insufficient for diagnosis (n=166); 3.6%, follicular tumours (n=105); 1.8%, lymphocytic thyroiditis (n=51); 1.5%, papillary carcinoma (n=44); 0.7%, reactive lymphadenitis (n=19); 0.2%, lymphoma (n=6); 0.2%, parathyroid adenoma (n=6); 0.1%, medullar carcinoma (n=4); 0.1%, lesions of uncertain benignity (n=4). The mean age was 57±15 (1392) years, with statistically significant difference among some groups, particularly the lymphomas (statistically older) and the thyroiditis, (statistically younger). 87.8% of the patients were female (n=2525) and 12.2% were male (n=350). The nodule size ranged from 0.7 to 7.0 cm (mean=1.93±0.85). On what concerns to the nodule location 44.2% were in the right lobe (n=1270), 42.8% in the left lobe (n=1231) and 5.5% in the isthmus (n=157).
Discussion: The huge number of FNA performed as well as the good results, with a small number of nondiagnostic cytology, confirms the advantages of this exam executed by endocrinologists. The best understanding of thyroid nodular disease and the accuracy of the practitioner are important in the evaluation of these patients.