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Abstract
One hundred and thirty-three euthyroid patients with solitary or dominant hypofunctioning
thyroid nodules underwent preoperative ultrasonography and needle aspiration cytology.
Histological confirmation was obtained in 88 patients undergoing thyroidectomy. Cytological
diagnoses included cancer with type, thyroiditis, adenoma, colloid nodule, cyst. Needle
aspiration was uncomplicated and did not result in recognizable implantation of tumor.
Overall malignancy rate was 17%, with 12 cancers in 75 solid lesions and three cancers
in 13 cycstic lesions. Neoplasm rate was 65%, or 88% if colloid nodules were included.
Adequate material for cytology, which was obtained in 94% of patients, showed tissue
correlation accuracy of 82%. No false positives were reported. False negative reports
occurred in 6.4% of all cases, in 4.9% of solid lesions, and in 16.7% of cystic lesions.
Correct correlation was seen in 10 of 15 (66%) of malignant cases, with the highest
accuracy for papillary (six of seven) and metastatic cancer (two of two) lesions.
Needle aspiration is safe, repeatable, simple, and is indicated particularly for patients
with nontoxic nodular goiter, who have been assigned to conservative management for
various reasons. Needle aspiration cytology provides the clinician with direct information
about the thyroid gland that is unobtainable by any other nonoperative technique.
However, owing to the possible limitations of this technique, normal or negative needle
aspiration cytology does not replace valid, accepted clinical criteria for selection
of patients for thyroidectomy to exclude malignancy. To date, implant cancer has not
occurred after needle aspiration and therefore the use of this diagnostic technique
in the preliminary investigation of nodular thyroid disease is justified.
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Article info
Footnotes
☆Supported by Mount Sinai Hospital of Toronto, Department of Medicine and Research Institute Funds.
☆☆Presented at the Thirty-fourth Annual Meeting of the Central Surgical Association, Buffalo, N. Y., March 3–5, 1977.
Identification
Copyright
© 1977 Published by Elsevier Inc.
