Fine Needle Aspiration of the Thyroid: A Cytohistologic Correlation and Study of Discrepant Cases
- 1 January 2004
- journal article
- research article
- Published by Mary Ann Liebert Inc in Thyroid®
- Vol. 14 (1), 35-41
- https://doi.org/10.1089/105072504322783821
Abstract
Objective: Fine needle aspiration (FNA) is a reliable method in the initial assessment of thyroid nodules. The purpose of this study was to evaluate the causes for discordance between the interpretation on FNA and the pathologic findings in the resected thyroid. Methods: A computer search of all thyroidectomy specimens with previous FNA from January 1998 to December 2001 was obtained from the files of the Lauren V. Ackerman laboratory of surgical pathology, Barnes-Jewish Hospital. Excluded from the study were those FNAs performed for suspected and confirmed metastatic disease to the thyroid as well as those cases unavailable for review. A total of 45 FNA cases were identified with cytologic and histologic discrepancies. Results: Of the 1253 individual thyroid FNA performed during the study period, 255 patients (20%) subsequently had an open surgical procedure on the thyroid. Of those who underwent surgery, 196 cases (77%) were concordant, whereas 45 patients (18%) were discordant, and 14 cases were excluded due to unavailability of slides for review (for example, returned consult slides). The causes of the 45 discordant cases were: 20 cases (44%) were unsatisfactory for diagnosis, 14 cases (31%) were due to interpretation error (false positive), and 11 cases (24%) were due to sampling error (false negative). Conclusions: The most common causes of our discrepant cases are those whose FNA diagnosis was interpreted as "unsatisfactory for diagnosis," in 20 (7.8%) of 255 surgical cases. The false negative rate due to sampling error in 11 (4%) of 255 cases was mainly due to the presence of microscopic papillary thyroid carcinoma (PTC); the false positive rate was due to interpretation error in 14 (6%) of 255 cases, and those were explained by the occurrence of overlapping cytologic features among adenomatous nodules, follicular neoplasms, the follicular variant of PTC, and Hashimoto's thyroiditis.Keywords
This publication has 16 references indexed in Scilit:
- Fine needle aspiration cytology of thyroid nodules: how accurate is it and what are the causes of discrepant cases?Cytopathology, 2001
- Ultrasound-Guided Fine-Needle Aspiration of the Thyroid Assessed by Ultrafast Papanicolaou Stain: Data from 1135 Biopsies with a Two- to Six-Year Follow-UpThyroid®, 2001
- Thyroid Papillary MicrocarcinomaActa Cytologica, 2001
- Fine‐needle aspiration cytology of the thyroidCancer, 2000
- Fine‐needle aspiration of the thyroid: Rate and causes of cytohistopathologic discordanceDiagnostic Cytopathology, 2000
- Fine-Needle Aspiration of Thyroid: An Institutional ExperienceThyroid®, 1998
- Follicular variant of papillary carcinoma of the thyroid: To what extent is fine-needle aspiration reliable?Diagnostic Cytopathology, 1996
- Fine-Needle Aspiration Biopsy of the Thyroid: An AppraisalAnnals of Internal Medicine, 1993
- Fine Needle Aspiration Biopsy in the Management of Thyroid NodulesThe Endocrinologist, 1991
- False‐negative errors in fine‐needle aspiration biopsy of dominant thyroid nodules: A prospective follow‐up studyWorld Journal of Surgery, 1986