Keywords:
Metastases, Endocrine disorders, Cancer, Sampling, Efficacy studies, Biopsy, Ultrasound-Colour Doppler, Ultrasound, Thyroid / Parathyroids, Lymph nodes, Head and neck
Authors:
M. G. Gkeli1, M. Milatou2, K. Kavvadias1; 1Athens/GR, 2SERRES/GR
DOI:
10.1594/ecr2013/C-1672
Results
All the 285 patients had a known thyroid malignancy,
which was included in the DTC group.
55% of the patients were in the phase of primary staging and treatment of a preoperatively diagnosed DTC ( Fig. 10,
Fig. 11 ) and 45% had undergone TT with or without central neck dissection for DTC,
without a clinical known residual or recurrent thyroid cancer.
Cytological diagnosis could be made by Rt-Ug-FNNAC in 282 of the 285 patients yielding a diagnostic rate of 98.9%.
365 cervical lymph nodes underwent Rt-Ug-FNNAC.
The cytological diagnoses were metastasis in 176 nodes,
and benign findings in 189 nodes (see Table 2).
Cytological Results |
Rt-Ug-FNNAC (n) |
Metastases
|
176
|
Reactive Hyperplasia
|
144
|
Tuberculosis
|
2
|
Toxoplasmosis
|
1
|
Normal
|
42
|
Total
|
365
|
Table 2.
Rt-Ug-FNNAC of cervical lymph nodes and Cytological results
All 176 malignant nodes underwent surgery,
115 nodes under initially TT and lymph node dissection and 61 nodes under reoperative lymph node dissection.
False positive results were not mentioned.
From the 189 cytologically benign nodes,
42 nodes underwent surgery under an initial TT and lymph node dissection and 6 nodes underwent an excisional biopsy,
because of increase of their size or the presence of detectable Tg and the clinical suspicion of residual or recurrent thyroid cancer.
False negative results were not mentioned.
The rest 141 cytologically benign lymph nodes were unchanged or regressed spontaneously on U/S follow up and there was not any detectable Tg,
for a total of 36-month monitoring period and the diagnosis made by the Rt-Ug-FNNAC was considered correct.
In summary,
no false negative cytological results were referred.
In differentiation of benign from metastatic thyroid disease,
Rt-Ug-FNNAC had a sensitivity,
specificity,
and diagnostic accuracy of 100%.
Rt-Ug-FNNAC had positive and negative predictive values of 100% in the diagnosis of metastatic thyroid lymph node malignancy.
There were no procedure-related complications.