Endocrine Abstracts

JOINT984

Background: There are two types of thyroid nodule biopsy: fine-needle aspiration (FNAB) and core-needle (CNB). Multiple studies mainly from Eastern Asia demonstrate safety and efficacy of CNB, however it is very rarely used in Europe.

Methods: Retrospective analysis of the first 569 thyroid nodule CNBs performed in Romania. All CNBs were performed using 18G semi-automatic biopsy instruments. We used the Korean Thyroid Association reporting system (KTA-CNB) for histology reports.

Results: Of 569 CNBs, there were only 5 non-diagnostic results (0. 9%), 34 category III results (6%) and 63 category IV results (11%). Among nodules which previously underwent FNAB, CNB offered a conclusive result (either benign or malignant, KTA II, V and VI categories) in 80% of Bethesda 1, 80% of Bethesda 3, 68. 4% of Bethesda 4 nodules. There were no non-diagnostic results in these nodules. We performed on average 2. 2 passes per lesion. There were no major complications (none of complications required hospitalisation), some minor adverse events were limited to bruising, perithyroidal hematoma and pain during or after procedure. Four patients had intrathyroidal hematoma, three patients developed transitory hoarseness which resolved spontaneously in 20-90 minutes.

Conclusion: The CNB is a safe and reliable diagnostic procedure for thyroid nodules. It offers very low chance of non-diagnostic results, lower chance of inconclusive results with a better stratification of risk between different subcategories (III a-d, IV a-c). CNB is a procedure which improves patient experience by reducing the number of procedures needed to make a clinical decision. It is a useful and cost-efficient tool, especially in the absence of molecular testing. CNB offers additional advantage of immunohistochemistry in cases suspected for medullary thyroid cancer, lymphoma or metastatic lesions.