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Inter‐ and intraobserver reproducibility of thyroid fine needle aspiration cytology: an analysis of discrepant cases
Author(s) -
Gerhard R.,
Da Cunha Santos G.
Publication year - 2007
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/j.1365-2303.2006.00430.x
Subject(s) - medicine , medical diagnosis , cytology , thyroid , fine needle aspiration cytology , kappa , radiology , pathology , concordance , cytopathology , thyroid nodules , fine needle aspiration , biopsy , linguistics , philosophy
Objective: To determine the inter‐ and intraobserver reproducibility and analyse the discrepant cases of fine needle aspiration cytology (FNAC) of the thyroid. Methods: Cases of thyroid FNAC with a corresponding histological diagnosis were reviewed regarding the original cytological diagnoses by two observers. The final cytological diagnoses (FCD) included both concordant and consensus diagnoses. The inter‐ and intraobserver reproducibility and efficacy of thyroid FNAC were calculated based on the FCD. Results: A total of 97 FNAC cases with corresponding histopathological specimens were analysed. Although inter‐ and intraobserver disagreement in the cytological diagnoses occurred in about one‐quarter of the cases analysed (24.7% and 23.7%, respectively), a substantial level of diagnostic interobserver (kappa = 0.71) and intraobserver (kappa = 0.66) reproducibility was observed. The efficacy of the method was 94.4%. Disagreement in the diagnosis was detected in 24 cases (24.7%), most of them (41.7%) for follicular lesions. Discordant cytological diagnoses between the two observers were represented by six (16.2%) of the 37 cases with an FCD of colloid nodule, five (41.7%) of the 12 cases of cellular follicular lesion, all three cases of follicular neoplasm, in two (6.3%) of the 32 cases of PTC, one (16.7%) of six cases of follicular neoplasm with a predominance of Hürthle cells and in one case of poorly differentiated neoplasia. Similarly, major disagreement in intraobserver cytological diagnoses was observed for the diagnosis of follicular lesions: 18 (78.3%) of a total of 23 discordant cases. Conclusion: As discrepancies in the cytopathological diagnosis can have repercussions in the management of patients, all cases with a cytological diagnosis of follicular lesions/neoplams should be reviewed in multidisciplinary meetings thus minimizing interobserver variability.