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Wiley InterScience | ||||||||||
  CytopathologyVolume 17 Issue 5, Pages 251 - 256 Published Online: 8 Sep 2006 Journal compilation © 2010 Blackwell Publishing Ltd The Official Journal of the British Society for Clinical Cytology and over 20 National affiliated Societies
Abstract | References | Full Text: HTML, PDF (Size: 461K) | Related Articles | Citation Tracking  Ultrasound-guided fine needle aspiration cytology in the diagnosis and management of thyroid nodules Copyright 2006 The Authors Journal compilation 2006 Blackwell Publishing Ltd KEYWORDS fine needle aspiration cytology • thyroid nodules • ultrasound scan • accuracy X. J. Cai, N. Valiyaparambath, P. Nixon, A. Waghorn, T. Giles and T. Helliwell Ultrasound-guided fine needle aspiration cytology in the diagnosis and management of thyroid nodules ABSTRACTObjective: To examine the accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of thyroid nodules and compare the inadequacy rates for ultrasound-guided and freehand FNAC. Methods: A retrospective study of 434 patients with thyroid nodules who underwent diagnostic FNAC over a 2-year period. Cytological diagnoses have been compared with the histological assessment of resection specimens in 69 cases. Results: The inadequacy rate was significantly lower from ultrasound guided FNAC (24/373 cases, 6.4%) than from freehand FNAC (8/61 cases, 13.1%) (P = 0.043). Seventy-six percentage of patients had a non-neoplastic cytological diagnosis and, after multidisciplinary review, the patients were reassured and assigned to clinical follow-up. Sixty-seven patients had a resection for cytological appearances consistent with non-neoplastic disease (n = 34), suspicious of follicular neoplasia (n = 23), or suspicious of malignancy (n = 10), and two patients had resections following inadequate cytology with ultrasound appearances suspicious of a neoplasm. The overall accuracy of FNAC analysis for malignancy was 97.0%, with sensitivity 83.3%, specificity 98.0%, positive predictive value 71.4% and negative predictive value 98.4%. The overall accuracy of FNAC analysis for the prediction of neoplasia was 97.5%, with sensitivity 80.5%, specificity 97.8%, positive predictive value 89.2% and negative predictive value 95.9%. Difficulties in cytological diagnosis were associated with lymphoid infiltrates and with degenerative changes in follicular adenomas. Conclusion: Ultrasound-guided FNAC has a significantly lower yield of inadequate aspirates than palpable FNAC. The ability of FNAC to predict neoplasia in 89% patients and to exclude neoplasia in 95.9% patients makes an important contribution to the multidisciplinary assessment of patients. Accepted for publication 15 June 2006 | 
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Professor Harald zur Hausen is a 2008 Nobel Laureate in Medicine or Physiology. He was recognized "for his discovery of human papilloma viruses causing cervical cancer". Zur Hausen serves as Editor-in-Chief of the 
