Cito-histologycal correlations in nodular thyroid pathology
Joana Couto, Cláudia Lobo, Ana Paula Barbosa, Raquel Martins, Ana Paula Santos, Paula Monteiro, Teresina Amaro & Isabel Torres
Introduction: Fine needle biopsy (FNB) is a very important diagnostic tool in the assessment of thyroid nodules and plays a prominent role in therapeutic approach. It has a sensitivity around 83 to 85% and a specificity around 80 to 92%.
Aims: To correlate cytological (FNB) and final histopathological data in patients with nodular thyroid pathology.
Methods: A retrospective study of patients who underwent surgical procedure from January 2007 to November 2009, with FNB performed at our Institution. FNB and histopathological data were compared.
Results: Fifty-nine patients, 48 women (81%) e 11 men (19%) with a mean age of 51 years (minimum 14, maximum 82). FNB results: Papillary Carcinoma (PC): 32 (54%); Follicular tumor (FT): 18 (31%); Medullary Carcinoma (MC): 3 (5%); Hurthle cell tumor: 3 (5%); Follicular Carcinoma (FC): 2 (3%); Anaplastic carcinoma (AC): 1 (2%). Histopathological results: PC: 35 (59%); Follicular Adenoma(FA): 8 (14%); Hurthle cell FA: 7 (12%); MC: 4 (7%); FC: 2 (3%); Multinodular Follicular Hyperplasia: 2 (3%); AC: 1 (2%). The sensitivity and specificity for diagnosing malignant thyroid nodules were 100%. Of the 18 FT, 4 (22%) turned out to be malignant lesions and 14 (78%), benign lesions.
Conclusions: The high rate of malignancy found is explained by the fact that our Institution is a referral center for oncologic patients. FNB was highly sensitive and specific (100%) in diagnosing malignant nodular thyroid pathology. The percentage of malignancy found in the nodules classified as FT on FNB was similar to that found in literature (around 20%). These data confirm that FNB plays a key role in evaluating thyroid nodules.