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Ultrasound‐guided fine‐needle aspiration biopsy of the thyroid: Role of on‐site assessment and multiple cytologic preparations
Author(s) -
Baloch Zubair W.,
Tam Diane,
Langer Jill,
Mandel Susan,
LiVolsi Virginia A.,
Gupta Prabodh K.
Publication year - 2000
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/1097-0339(200012)23:6<425::aid-dc14>3.0.co;2-3
Subject(s) - medicine , papanicolaou stain , fine needle aspiration , radiology , biopsy , thyroid nodules , cytology , thyroid , concordance , ultrasound , thyroid carcinoma , pathology , cancer , cervical cancer
Several studies have shown that ultrasound guidance can serve as a valuable aid in improving the diagnostic yield of fine‐needle aspiration (FNA) biopsy of thyroid nodules. In this study, we evaluated the combined impact of ultrasound‐guidance, rapid on‐site evaluation of FNA specimens, and different cytologic preparations (fresh and alcohol‐fixed smears, Millipore filter) and staining methods (Diff‐Quik and Papanicolaou stains) on the diagnostic yield of thyroid FNA. Ultrasound‐guided FNA was performed on 282 patients (313 cases) between November 1997 and April 1999. The diagnostic categories included: benign (198 cases, 63.2%); indeterminate (42 cases, 13.4%); suspicious for follicular variant of papillary carcinoma (26 cases, 8.3%), malignant (32 cases, 10.1%); and nondiagnostic (15 cases, 5%). The nondiagnostic cases also included 6 cystic lesions without any solid component and 3 thyroid‐bed aspirations. After excluding these, the nondiagnostic rate was only 2%. Histological follow‐up was available in 77 (77/313) cases. The concordance rate between cytological and histological diagnosis was 100% in malignant, 67% in suspicious, and 56% in indeterminate cases. All cases with histologic follow‐up were selected to evaluate the independent diagnostic efficacy of each aforementioned cytologic staining method. A definite diagnosis could be made solely on the basis of air‐dried, Diff‐Quik‐stained preparations in 50 (65%), alcohol‐fixed, Papanicolaou stained smears in 68 (88%), and Millipore filter preparations in 70 (91%) cases. We conclude that ultrasound‐guided FNA combined with on‐site evaluation and different cytologic preparations can significantly improve the diagnostic accuracy of thyroid FNA specimens. Diagn. Cytopathol. 2000;23:425–429. © 2000 Wiley‐Liss, Inc.