Aim: Patients with thyroid nodules, usually undergo FNA, prior to considering surgery however the results may not be conclusive. Our aim is to compare the cytology results in patients who have had two FNAs with post-operative histology.
Methods: All patients who have had thyroidectomy and two pre-operative FNAs over 7 years were identified. Post-operative histology and FNA cytology was collected from pathology records. Standard Thy classification was used for FNA cytology.
Results: Fifty nine patients were analysed of whom 14 patients had malignant nodules on histology. Forty two patients (71%) had Thy1 on first FNA and 21 (36%) had Thy 1 on second FNA. The proportions of malignancy to abnormal FNA were:
Thy 1+ Thy 1: n=19, malignant 4
Thy 1+ Thy 2: n=4, malignant 0
Thy 1+ Thy 3: n=17, malignant 6
Thy 1+ Thy 4: n=1, malignant 1
Thy 1+ Thy 5: n=1, malignant 0
Thy 2+ Thy 2: n=4, malignant 0
Thy 2+ Thy 3: n=2, malignant 0
Thy 3+ Thy 1: n=1, malignant 1
Thy 3+ Thy 3: n=4, malignant 1
Thy 5+ Thy 5: n=1, malignant 1
Conclusion: There is a 21% chance of having a malignant lesion if patient has two Thy1 samples. Patients with two Thy2 samples did not have malignancy. Seven out of twenty patients with at least one Thy3 were malignant. Multiple clinical factors and MDT decision making is vital in approaching patients with thyroid nodules.