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Fine‐needle aspiration cytology of the thyroid: Ten years experience in a community teaching hospital
Author(s) -
Wu Howard HerJuing,
Jones Jennifer N.,
Osman Jailan
Publication year - 2006
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/dc.20389
Subject(s) - medicine , atypia , cytology , fine needle aspiration , indeterminate , thyroid cancer , radiology , thyroid , cancer , carcinoma , cytopathology , thyroidectomy , biopsy , pathology , mathematics , pure mathematics
Abstract We present our experience of fine‐needle aspiration (FNA) cytology of the thyroid in a community hospital setting and discuss the cancer probability of the indeterminate FNA results. There were 1,621 FNAs, 401 of which have follow‐up thyroidectomies during a 10‐yr period. The initial FNA diagnoses of these 401 cases were benign non‐neoplastic (BNN) 159, malignant 34, atypical 33, suspicious 19, follicular neoplasm (FN) 88, follicular lesion (FL) 51, and inadequate 17. There were no false‐positive cases. Cancer was found in 11 cases diagnosed as BNN (7%), 6 cases were due to sampling errors (incidental microcarcinomas), and 5 cases were due to failure to identify focal atypia in the smears of a follicular variant of papillary carcinoma. The false‐negative rate was 3%, with the exclusion of cases of incidental microcarcinomas. Among the indeterminate FNA results, the follow‐up operations revealed malignant tumors in 16 of 33 (48%) cases of atypical, 13 of 19 (68%) cases of suspicious, 29 of 88 (33%) cases of FN, and 7 of 51 (14%) cases of FL. Malignant tumors were also found in 2 of 17 (12%) of inadequate specimens with follow‐up. When compared to the cancer rate (3%) for FNA diagnosis of BNN, the likelihood of finding cancer in the thyroidectomy is 5 times more for a FL, 11 times more for a FN, 16 times more for atypical, and 23 times more for suspicious. The sensitivity and specificity are 87 and 100%, respectively. Diagn. Cytopathol. 2006; 34:93–96. © 2006 Wiley‐Liss, Inc.