FNAB results of 520 patients in a mild-to-moderate iodine deficient city in Turkey

Goknur Yorulmaz; Ozgur Ilhan Celik; Serkan Yasar Celik; Bengur Taskiran

doi:10.1530/endoabs.63.P402

Introduction: Thyroid nodules are common in population. High resolution ultrasound and fine needle aspiration biopsy (FNAB) are advised as the first line diagnostic methods. Bethesda classification system is used to provide standardization of cytologic reports. We aimed to evaluate ultrasound guided FNAB results in a mild-to-moderate iodine deficient city of Turkey.

Methods: The patients (n=520), who underwent FNAB between December 2011 and December 2012 in an endocrinology unit of Batman District Hospital, were enrolled to the study. Nodules that were at least 1 cm diameter in size or smaller than 1 cm with suspicious ultrasonographic features were biopsied (n=635). Among the recruited subjects, 89 had simultaneous biopsies from 2 nodules and 13 had simultaneous biopsies from 3 nodules. FNAB was executed by using ultrasound guided 22 gauged needles. Sample adequacy and cytopathological definition was determined according to the Bethesda system for thyroid cytopathology. Nodules were divided into five groups according to the largest diameter.

Results: Four hundred and forty-three women and 77 men, 520 patients in total were aged 43.9±14.6 years, including, were enrolled into the study. Underlying pathology were multinodular goiter in 450 (86.5%) patients and solitary nodule in 70 (13.5%). 35 patients underwent thyroidectomy in our hospital and one patient had papillary thyroid cancer and one had follicular cancer. The remaining had benign pathology. Cytopathological results and distribution according to nodule size are shown in Table 1–2.

Table 1 Cytopathological results of 635 biopsies.
Subtypes	Frequency	Percent
I. Nondiagnostic or Unsatisfactory	165	25.9
II. Benign	443	69.7
III. Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance	19	3.0
IV. Follicular Neoplasm or Suspicious for a Follicular Neoplasm	3	0.5
V. Suspicious for Malignancy	5	0.9
VI. Malignant	0	0.0

Table 2 Distribution of cytopathological results according to nodule size.
Subtypes	Group ≤10mm	Group B 11-19 mm	Group C 20-29 mm	Group D 30-39 mm	Group E ≥40 mm
I. Nondiagnostic or Unsatisfactory	18	76	50	16	5
II. Benign	15	155	167	69	37
III. Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance	0	8	6	5	0
IV. Follicular Neoplasm or Suspicious for a Follicular Neoplasm	0	0	0	2	1
V. Suspicious for Malignancy	0	2	2	1	0
VI. Malignant	0	0	0	0	0

Discussion: Batman District Hospital is localized in a mild-to-moderate iodine deficient part of Turkey. Therefore multinodular goiter disease was much more prevalent than solitary nodules. Benign cytology was evident in most of the nodules biopsied. Although cytopathological evauation was made by 2 general pathologists, our rates were similar to current literature. More than half (56.5%) of the nodules were 2 cm or larger in size. Therefore large nodules requiring FNAB was a common clinical setting in case of multinodular goiter.

Endocrine Abstracts

P402