ECEESPE2025 Poster Presentations Thyroid (141 abstracts)
Differentiated thyroid carcinomas and its pre-operative characterization: a single centre study
Joana Vinhais 1 , Beatriz R Pereira 1 , David Verissimo 1 , Catarina Ivo 1 , Ana Cláudia Martins 1 , Mafalda Marcelino 1 , Dolores Passos 1 , Luís Lopes 1 , João Jácome de Castro 1 & João Nunes e Silva 1
1Portuguese Armed Forces Hospital, Endorinology Department, Lisbon, Portugal
JOINT3317
Background: EU-TIRADS classification and nodule’s size on ultrasonography (US) guide fine needle aspiration biopsy (FNAB) recommendation. Bethesda classification is the report system used to describe cytopathological findings of FNAB. These classification systems help estimate the risk of malignancy and select the appropriate treatment.
Aims: Assess the pre-operative EU-TIRADS and Bethesda classification of nodules diagnosed with differentiated thyroid carcinoma (DTC).
Methods: Retrospective observational study, including patients with anatomopathological diagnosis of DTC submitted to surgery between January/2017 and July/2024.
Results: We included 36 patients with 38 biopsied nodules. Patients diagnosed with DTC corresponded to nodules classified as EU-TIRADS 3, 4 and 5 (16%, 53% and 32%, respectively) on imaging and Bethesda I, II, III, IV or V (3%, 29%, 24%, 29% and 16%, respectively) on FNAB. Nodules classified as EU-TIRADS 5 on US, corresponded to Bethesda IV on FNAB (42%), followed by Bethesda V (33%). Eleven nodules were classified with benign cytology, Bethesda II: Six corresponded to EU-TIRADS 4 on US; 4 to EU-TIRADS 3; 1 to EU TIRADS 5. These patients were submitted to surgery due to dimensional criteria or symptomatic disease. Most patients (n = 7) had carcinomas ≤ 1 cm.
Discussion: In this sample, 85% of the patients with DTC had nodules classified as EU-TIRADS 4 or 5 on US, pointing to a strong correlation between US imaging and DTC. Nodules classified as Bethesda II on FNAB have a ROM of 0-3%, however they are among one of the most common FNAB results in this sample. This could be explained by the presence of small foci of DTC or multifocal carcinoma within large thyroid nodules, that can be missed in FNAB.
Conclusion: The presence of high suspicion features in US positively correlates with Bethesda IV and V in FNAB in 75% of the cases. Thyroid carcinoma can be present in nodules with Bethesda II on FNAB, pointing to the presence of false negatives in this category, especially in big nodules. This highlights the importance of combination of EU-TIRADS and Bethesda classifications, as well as of careful selection of biopsy sites and the need to collect several samples from the same nodule, especially in nodules >4 cm.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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