Reliability of fine needle aspiration biopsy in large thyroid nodules

Özet

Objective: Fine needle aspiration biopsy provides one of the most important data that determines the treatmentalgorithm of thyroid nodules. Nevertheless, the reliability of fine needle aspiration biopsy is controversial in largenodules. The aim of this study was to evaluate the adequacy of fine needle aspiration biopsy in thyroid nodulesthat are four cm or greater.Material and Methods: We retrospectively examined 219 patients files who underwent thyroidectomy for thyroidnodules that were greater than four centimeter between May 2007 and December 2012. Seventy-four patients withhyperthyroidism, and 18 patients without preoperative fine needle aspiration cytology were excluded from thestudy. Histopathologic results after thyroidectomy were compared with preoperative cytology results, and sensitivityand specificity rates were calculated.Results: False-negativity, sensitivity and specificity rates of fine needle aspiration biopsy of thyroid nodules werefound to be 9.7%, 55.5%, and 85%, respectively. Within any nodule of the 127 patients, 28 (22.0%) had thyroid cancer.However, when only nodules of at least 4 cm were evaluated, thyroid cancer was detected in 22 (17.3%) patients.Conclusion: In this study, fine needle aspiration biopsy of large thyroid nodules was found to have a high falsenegativity rate. The limitations of fine-needle aspiration biopsy should be taken into consideration in treatmentplanning of thyroid nodules larger than four centimeters.