Malignancy risk analysis in patients with inadequate fine needle aspiration cytology (FNAC) of the thyroid
Al Maqbali, Talib, Tedla, Miroslav, Weickert, Martin O. and Mehanna, Hisham M.. (2012) Malignancy risk analysis in patients with inadequate fine needle aspiration cytology (FNAC) of the thyroid. PLoS One, Vol.7 (No.11). e49078. ISSN 1932-6203
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Official URL: http://dx.doi.org/10.1371/journal.pone.0049078
Thyroid fine needle aspiration cytology (FNAC) is the standard diagnostic modality for thyroid nodules. However, it has limitations among which is the incidence of non-diagnostic results (Thy1). Management of cases with repeatedly non-diagnostic FNAC ranges from simple observation to surgical intervention. We aim to evaluate the incidence of malignancy in non-diagnostic FNAC, and the success rate of repeated FNAC. We also aim to evaluate risk factors for malignancy in patients with non-diagnostic FNAC.
Materials and Methods
Retrospective analyses of consecutive cases with thyroid non diagnostic FNAC results were included.
Out of total 1657 thyroid FNAC done during the study period, there were 264 (15.9%) non-diagnostic FNAC on the first attempt. On repeating those, the rate of a non-diagnostic result on second FNAC was 61.8% and on third FNAC was 47.2%. The overall malignancy rate in Thy1 FNAC was 4.5% (42% papillary, 42% follicular and 8% anaplastic), and the yield of malignancy decreased considerably with successive non-diagnostic FNAC. Ultrasound guidance by an experienced head neck radiologist produced the lowest non-diagnostic rate (38%) on repetition compared to US guidance by a generalist radiologist (65%) and by non US guidance (90%).
There is a low risk of malignancy in patients with a non-diagnostic FNAC result, commensurate to the risk of any nodule. The yield of malignancy decreased considerably with successive non-diagnostic FNAC.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RC Internal medicine|
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Library of Congress Subject Headings (LCSH):||Thyroid gland -- Cancer -- Diagnosis, Needle biopsy|
|Journal or Publication Title:||PLoS One|
|Publisher:||Public Library of Science|
|Official Date:||19 November 2012|
|Access rights to Published version:||Open Access|
1. British Thyroid Association (2007) Royal College of Physicians: British Thyroid
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