Purpose
Thyroid nodules are common in clinical practice and they are usually benign in nature.
Their risk of malignancy is low,
but not negligible and it is necessary to be excluded [1].
Thyroid fine needle aspiration biopsy (FNAB) is the procedure of choice in the management of thyroid nodules,
because of its simplicity,
accuracy and cost-effectiveness [1-3].
According to FNAB result,
the physician makes a decision whether the patient should be subjected to surgery or to follow-up.The purpose of this study is to evaluate the effects...
Methods and Materials
The study included 270 patients who underwent FNAB for the evaluation of thyroid nodules from September 2010 to May 2012.A single FNAB procedure was performed for each nodule from each patient.Size,
echogenicity and localization of all nodules were evaluated by ultrasonography (US) before the biopsy.
The criteria for the selection of the nodules for FNAB were microcalcifications; marked hypoechogenicity relative to surrounding strap muscles; poorly defined,
indistinct,
or blurred margins; direct invasion of the nodule through the thyroid capsule; central vascularity; and a shape greater...
Results
A total of 270 nodules were biopsied,
187 ( 69,3%) specimens were considered as adequate CM and 83 (30,7%) specimens were considered as inadequate CM.Age,
presence of heterogeneous echogenicity and nodule size > 3 cm were found to have prognostic significance in univariate analysis.
In multivariate logistic regression model,
advanced age (p=0.001,
OR=1.042,
95CI=1.018-1.068) and presence of heterogeneous echogenicity (p=0.017,
OR=0.511,
95CI=0.295-0.885) remained associated with an increased risk of inadequate CM obtainment after adjustment of other potential confounders (needle size 20 G usage) and variables...
Conclusion
In conclusion,
non-diagnostic FNAB remains a significant problem in the evaluation of thyroid nodules and can be as high as 30%.
Inadequate CM rates in elderly patients and heterogeneous nodules were significantly higher than others.
The nodule size and needle size used for sampling did not affect the adequacy of FNAB.
In addition,
the results of the present study reveals that US assessment of nodule structure are essential for biopsy in order to avoid vessels and cystic-necrotic areas.
References
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Schlumberger M,
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AACE/AME Task Force on Thyroid Nodules.
American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules.
Endocr Pract.
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63-102 (2006)
Cooper DS,
Doherty GM,
Haugen BR,
Kloos RT,
Lee SL,
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et al.
Management guidelines for patients with...
Personal Information
Mehmet Fatih İNCİ,
MD,
Kahramanmaraş Sütçü İmam University,
School of Medicine,
Department of Radiology,
Kahramanmaraş / TURKEY
Fuat ÖZKAN,
MD,
Kahramanmaraş Sütçü İmam University,
School of Medicine,
Department of Radiology,
Kahramanmaraş / TURKEY
Mürvet YÜKSEL,
MD,
Kahramanmaraş Sütçü İmam University,
School of Medicine,
Department of Radiology,
Kahramanmaraş / TURKEY
İsmail ŞALK,
MD,
Cumhuriyet University,
School of Medicine,
Department of Radiology,
Sivas / TURKEY
Murat ŞAHİN,
MD,
Kahramanmaraş Sütçü İmam University,
School of Medicine,
Department of Endocrinology,
Kahramanmaraş / TURKEY
