The Value of FNABs in the Management of Thyroid Lesions

• Published in: Otolaryngology-head and neck surgery Vol. 139; no. 2_suppl; p. P46
• Main Authors: Mijovic, (presenter), Tamara, Payne, Richard J, Rochon, Louise, Black, Martin J, Hier, Michael P, Gologan, Olga E, Young, Jonathan
• Format: Journal Article
• Language: English
• Published: England 01.08.2008
• ISSN: 1097-6817
• DOI: 10.1016/j.otohns.2008.05.150

Objective Determine the value of fine-needle aspiration biopsies (FNAB), and stratify the risk of malignancy within the indeterminate FNAB diagnostic category at our institution. Methods The preoperative FNABs of 115 consecutive patients who underwent thyroidectomy at a teaching hospital between 2005 and 2007 were reviewed and categorized into 4 groups: negative for malignancy, positive or suspicious for malignancy, indeterminate, and nondiagnostic. The final histopathological diagnosis was then compared with the FNAB result. FNABs reported as follicular or Hurthle cell lesions were considered indeterminate diagnoses, and malignancy rates were calculated within this category. Results The FNAB results were as follows: 17% negative for malignancy, 35% positive or suspicious for malignancy, 40% indeterminate, and 8% nondiagnostic. The sensitivity of FNAB in detecting thyroid malignancy was 83%, specificity 92% and accuracy 85%. There were 9 discrepant cases giving a false negative rate of 17% and a false positive rate of 8%. Overall, 52% of the indeterminate cases were carcinomas, with a malignancy rate of 48% for the follicular lesions and 62% for the Hurthle cell lesions. When cytological atypia was present, the rate of malignancy increased to 75% and 83% for the follicular and Hurthle cell lesions, respectively. Conclusions Our study confirms that FNAB is an accurate and helpful method for the evaluation of thyroid nodules with results directly correlating with management. Moreover, surgery should be strongly considered for FNABs categorized as indeterminate cases, especially in the presence of cytological atypia. Due to the high false negative rate, benign FNABs require close follow-up and periodic rebiopsies.