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Research Article
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The evaluation of fine needle aspiration biopsy results in differentiating between benign and malignant thyroid nodules

Year 2024, Volume: 9 Issue: 3, 85 - 89, 25.10.2024

Mustafa Reşorlu , Yusuf Haydar Ertekin , Şenay Bengin Ertem , Fatih Kamış , Hasan Hüseyin Balkir , İbrahim Gül

https://doi.org/10.22391/fppc.1532726

Abstract

Introduction: Thyroid fine-needle aspiration biopsy (FNAB) has begun playing an important role in the evaluation of thyroid nodules, in addition to physical examination and imaging techniques. The purpose of this study was to evaluate the results of patients who underwent thyroid FNAB together with their demographic data, imaging findings, and follow-up compliance.
Methods: Patients who underwent thyroid FNAB procedures in our hospital’s interventional radiology unit between January 2022 and May 2024 were evaluated retrospectively. Data were retrieved from patient records. Cytological results were classified as malignant, atypia of undetermined significance, benign, and non-diagnostic material.
Results: Two hundred twelve solid nodules were detected in the patients who underwent biopsy, and 59 mixed nodules with a cystic component. Non-diagnostic material was reported in 51 cases at cytological examination, benign cytology in 150, atypia of undetermined significance in 53, and malignant material in 17. The incidence of non-diagnostic results was significantly higher in hypoechoic nodules and low-volume nodules.
Conclusions: Thyroid FNAB is a valuable diagnostic tool due to its ease of application and provision of useful information in benign-malignant differentiation. Once it becomes capable of application by primary physicians and local state hospitals in Türkiye it will reduce delayed diagnoses, unnecessary surgical procedures, and economic burdens on social security institutions.

Keywords

Thyroid Nodule Fine-Needle Biopsy Ultrasonography

Ethical Statement

Ethical approval was obtained from the Çanakkale Onsekiz Mart University Rectorate Graduate Education Institute Ethics Committee Scientific Research and Publication Ethics Commission with the decision numbered 11/14 dated 25.07.2024.

References

  • 1. Erkinuresin T, Demirci H. Diagnostic accuracy of fine needle aspiration cytology of thyroid nodules. Diagnosis (Berl). 2020;7(1):61-66. https://doi.org/10.1515/dx-2019-0039
  • 2. Liebeskind A, Sikora AG, Komisar A, et al. Rates of malignancy in incidentally discovered thyroid nodules evaluated with sonography and fine-needle aspiration. J Ultrasound Med 2005;24:629-34. https://doi.org/10.7863/jum.2005.24.5.629
  • 3. Kelly NP, Um JC, DeJong S, et al. Specimen adequacy and diagnostic specificity of ultrasound-guided fine needle aspirations of nonpalpable thyroid nodules. Diagn Cytopathol 2006;34:188-90. https://doi.org/10.1002/dc.20392
  • 4. Jack GA, Sternberg SB, Aronson MD, et al. Nondiagnostic fine-needle aspiration biopsy of thyroid nodules: outcomes and determinants. Thyroid 2020; 30(7):992-8. https://doi.org/10.1089/thy.2019.0140
  • 5. Pinchot Sn, Al Wagih H, Schaefer S, et al. Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg. 2009;144(7):649-55. https://doi.org/10.1001/archsurg.2009.116
  • 6. Sahin S, Çavuşoğlu T, Kubat M, et al. The evaluation of patients diagnosed with atypia of unidentified significance after a fine needle aspiration biopsy of the thyroid. Kırıkkale Uni J Med Fac 2020;22(3): 322-8. https://doi.org/10.24938/kutfd.670331
  • 7. Baloch ZW, Hendreen S, Gupta PK, et al. Interinstitutional review of thyroid fine-needle aspirations: impact on clinical management of thyroid nodules. Diagn Cytopathol. 2001;25(4):231-4. https://doi.org/10.1002/dc.2044
  • 8. Burguera B, Gharib H. Thyroid incidentalomas. Prevalence, diagnosis, significance, and management. Endocrinol Metab Clin North Am 2000; 29(1): 187-203. https://doi.org/10.1016/S0889-8529(05)70123-7
  • 9. Braga M, Cavalcanti TC, Collaco LM, Graf H. Efficacy of ultrasound-guided fine-needle aspiration biopsy in the diagnosis of complex thyroid nodules. J Clin Endocrinol Metab 2001;86:4089-91. https://doi.org/10.1210/jcem.86.9.7824
  • 10. Yerci Ö, Filiz G, Özuysal S, Ertürk E. Evaluation of the fine needle aspiration biopsies of the thyroid (1676 Cases). Turk J Ecopathol 1997; 3:14-8.
  • 11. Kang KW, Kim SK, Kang HS, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18Ffluorodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab. 2003;88(9):4100-4. https://doi.org/10.1210/jc.2003-030465
  • 12. Bongiovanni M, Spitale A, Faquin WC, et al. The Bethesda system for reporting thyroid cytopathology: a meta‐analysis. Acta Cytol. 2012;56(4):333‐9. https://doi.org/10.1159/000339959
  • 13. Imamoglu C, Imamoglu FG, Dizen H, et al. Ultrasound guided fine needle aspiration cytology in thyroid nodules: cytohistologic correlation. Med J Mugla Sitki Kocman Uni 2015; 2(3), 7-11.
  • 14. Hall TL, Layfield LJ, Phlippe A, Rosenthal DL. Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer 1989; 63:718-25. https://doi.org/10.1002/1097-0142(19890215)63:4%3C718::AID-CNCR2820630420%3E3.0.CO;2-N
  • 15. Inan G, Sert S, Bircan S, et al. The comparison of fine needle aspiration biopsy and histopathology results in thyroid lesions. Med J Suleyman Demirel Uni 2006; 13(4): 27-31.
  • 16. Haugen BR, Alexander EK, Bible KC, et al. 2015 2016 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid nodules and differentiated thyroid cancer. Thyroid 26(1):1‐133. https://doi.org/10.1089/thy.2015.0020
  • 17. VanderLaan PA, Marqusee E, Krane JF. Clinical outcome for atypia of undetermined significance in thyroid fine-needle aspirations: should repeated fna be the preferred initial approach? Am J Clin Pathol 2011;135(5):770-5. https://doi.org/10.1309/AJCP4P2GCCDNHFMY
  • 18. İyidir ÖT, Özkan Ç, Altınova AE, et al. Ultrasonographic and fine needle aspiration biopsy characteristics of patients operated for nodular goitre. Gazi Med J 2014; 25(1).
  • 19. Renshaw AA, Gould EW. Characteristics of false-negative thyroid fine-needle aspirates. Acta Cytologica, 2018, 62.1: 12-18. https://doi.org/10.1159/000481722
  • 20. Gumus M, Cay N, Algin O, et al. Comparison of 21 and 27 gauge needles for determining sample adequacy in the aspiration biopsy of thyroid nodules. Diagn Interv Radiol 2012; 18:102-5. https://doi.org/10.4261/1305-3825.DIR.4340-11.1
  • 21. Zhang L, Liu Y, Tan X, Liu X, Zhang H, Qian L. Comparison of Different-gauge needles for fine-needle aspiration biopsy of thyroid nodules. J Ultrasound Med. 2018;37(7):1713-6. https://doi.org/10.1002/jum.14521
  • 22. Gurel FS. Fine-needle aspiration biopsy for diagnosis of nodular thyroid disease. Med J Adnan Menderes Univ 2001;2(1): 21-6.

Tiroit nodüllerinde benign-malign ayrımında ince iğne aspirasyon biyopsi sonuçlarının değerlendirilmesi

Year 2024, Volume: 9 Issue: 3, 85 - 89, 25.10.2024

Mustafa Reşorlu , Yusuf Haydar Ertekin , Şenay Bengin Ertem , Fatih Kamış , Hasan Hüseyin Balkir , İbrahim Gül

https://doi.org/10.22391/fppc.1532726

Abstract

Giriş: Tiroit ince iğne aspirasyon biyopsisi (İİAB), fizik muayene ve görüntüleme tekniklerine ek olarak tiroit nodüllerinin değerlendirilmesinde önemli bir rol oynamaya başlamıştır. Bu çalışmanın amacı, tiroit İİAB uygulanan hastaların demografik verileri, görüntüleme bulguları ve takip uyumları ile sonuçlarını değerlendirmektir.
Yöntem: Ocak 2022 ile Mayıs 2024 tarihleri arasında hastanemizin girişimsel radyoloji ünitesinde tiroit İİAB uygulanan hastalar retrospektif olarak değerlendirildi. Veriler hasta kayıtlarından elde edildi. Sitolojik sonuçlar malign, önemi belirsiz atipi, benign ve tanısal olmayan materyal olarak sınıflandırıldı.
Bulgular: Biyopsi uygulanan hastalarda 212 solid nodül ve kistik bileşenli 59 mikst nodül tespit edildi. Sitolojik incelemede 51 olguda tanısal olmayan materyal, 150 olguda iyi huylu sitoloji, 53 olguda önemi belirsiz atipi ve 17 olguda kötü huylu materyal rapor edildi. Tanısal olmayan sonuçların görülme sıklığı hipoekoik nodüllerde ve düşük hacimli nodüllerde anlamlı olarak daha yüksekti.
Sonuç: Tiroit İİAB, uygulama kolaylığı ve iyi huylu-kötü huylu ayrımında yararlı bilgi sağlaması nedeniyle değerli bir tanı aracıdır. Türkiye'deki birincil hekimler ve yerel devlet hastaneleri tarafından uygulanabilir hale geldiğinde gecikmiş tanıları, gereksiz cerrahi prosedürleri ve sosyal güvenlik kurumlarındaki ekonomik yükleri azaltacaktır.

Keywords

Tiroit Nodülü İnce İğne Biyopsisi Ultrasonografi

Ethical Statement

Çanakkale Onsekiz Mart Üniversitesi Rektörlüğü Lisansüstü Eğitim Enstitüsü Etik Kurulu Bilimsel Araştırma ve Yayın Etiği Komisyonunun 25.07.2024 tarih ve 11/14 sayılı kararı ile etik onam almıştır.

References

  • 1. Erkinuresin T, Demirci H. Diagnostic accuracy of fine needle aspiration cytology of thyroid nodules. Diagnosis (Berl). 2020;7(1):61-66. https://doi.org/10.1515/dx-2019-0039
  • 2. Liebeskind A, Sikora AG, Komisar A, et al. Rates of malignancy in incidentally discovered thyroid nodules evaluated with sonography and fine-needle aspiration. J Ultrasound Med 2005;24:629-34. https://doi.org/10.7863/jum.2005.24.5.629
  • 3. Kelly NP, Um JC, DeJong S, et al. Specimen adequacy and diagnostic specificity of ultrasound-guided fine needle aspirations of nonpalpable thyroid nodules. Diagn Cytopathol 2006;34:188-90. https://doi.org/10.1002/dc.20392
  • 4. Jack GA, Sternberg SB, Aronson MD, et al. Nondiagnostic fine-needle aspiration biopsy of thyroid nodules: outcomes and determinants. Thyroid 2020; 30(7):992-8. https://doi.org/10.1089/thy.2019.0140
  • 5. Pinchot Sn, Al Wagih H, Schaefer S, et al. Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg. 2009;144(7):649-55. https://doi.org/10.1001/archsurg.2009.116
  • 6. Sahin S, Çavuşoğlu T, Kubat M, et al. The evaluation of patients diagnosed with atypia of unidentified significance after a fine needle aspiration biopsy of the thyroid. Kırıkkale Uni J Med Fac 2020;22(3): 322-8. https://doi.org/10.24938/kutfd.670331
  • 7. Baloch ZW, Hendreen S, Gupta PK, et al. Interinstitutional review of thyroid fine-needle aspirations: impact on clinical management of thyroid nodules. Diagn Cytopathol. 2001;25(4):231-4. https://doi.org/10.1002/dc.2044
  • 8. Burguera B, Gharib H. Thyroid incidentalomas. Prevalence, diagnosis, significance, and management. Endocrinol Metab Clin North Am 2000; 29(1): 187-203. https://doi.org/10.1016/S0889-8529(05)70123-7
  • 9. Braga M, Cavalcanti TC, Collaco LM, Graf H. Efficacy of ultrasound-guided fine-needle aspiration biopsy in the diagnosis of complex thyroid nodules. J Clin Endocrinol Metab 2001;86:4089-91. https://doi.org/10.1210/jcem.86.9.7824
  • 10. Yerci Ö, Filiz G, Özuysal S, Ertürk E. Evaluation of the fine needle aspiration biopsies of the thyroid (1676 Cases). Turk J Ecopathol 1997; 3:14-8.
  • 11. Kang KW, Kim SK, Kang HS, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18Ffluorodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab. 2003;88(9):4100-4. https://doi.org/10.1210/jc.2003-030465
  • 12. Bongiovanni M, Spitale A, Faquin WC, et al. The Bethesda system for reporting thyroid cytopathology: a meta‐analysis. Acta Cytol. 2012;56(4):333‐9. https://doi.org/10.1159/000339959
  • 13. Imamoglu C, Imamoglu FG, Dizen H, et al. Ultrasound guided fine needle aspiration cytology in thyroid nodules: cytohistologic correlation. Med J Mugla Sitki Kocman Uni 2015; 2(3), 7-11.
  • 14. Hall TL, Layfield LJ, Phlippe A, Rosenthal DL. Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer 1989; 63:718-25. https://doi.org/10.1002/1097-0142(19890215)63:4%3C718::AID-CNCR2820630420%3E3.0.CO;2-N
  • 15. Inan G, Sert S, Bircan S, et al. The comparison of fine needle aspiration biopsy and histopathology results in thyroid lesions. Med J Suleyman Demirel Uni 2006; 13(4): 27-31.
  • 16. Haugen BR, Alexander EK, Bible KC, et al. 2015 2016 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid nodules and differentiated thyroid cancer. Thyroid 26(1):1‐133. https://doi.org/10.1089/thy.2015.0020
  • 17. VanderLaan PA, Marqusee E, Krane JF. Clinical outcome for atypia of undetermined significance in thyroid fine-needle aspirations: should repeated fna be the preferred initial approach? Am J Clin Pathol 2011;135(5):770-5. https://doi.org/10.1309/AJCP4P2GCCDNHFMY
  • 18. İyidir ÖT, Özkan Ç, Altınova AE, et al. Ultrasonographic and fine needle aspiration biopsy characteristics of patients operated for nodular goitre. Gazi Med J 2014; 25(1).
  • 19. Renshaw AA, Gould EW. Characteristics of false-negative thyroid fine-needle aspirates. Acta Cytologica, 2018, 62.1: 12-18. https://doi.org/10.1159/000481722
  • 20. Gumus M, Cay N, Algin O, et al. Comparison of 21 and 27 gauge needles for determining sample adequacy in the aspiration biopsy of thyroid nodules. Diagn Interv Radiol 2012; 18:102-5. https://doi.org/10.4261/1305-3825.DIR.4340-11.1
  • 21. Zhang L, Liu Y, Tan X, Liu X, Zhang H, Qian L. Comparison of Different-gauge needles for fine-needle aspiration biopsy of thyroid nodules. J Ultrasound Med. 2018;37(7):1713-6. https://doi.org/10.1002/jum.14521
  • 22. Gurel FS. Fine-needle aspiration biopsy for diagnosis of nodular thyroid disease. Med J Adnan Menderes Univ 2001;2(1): 21-6.
There are 22 citations in total.

Details

Primary Language English
Subjects Endocrinology, Radiology and Organ Imaging, Family Medicine
Journal Section Original Research
Authors

Mustafa Reşorlu 0000-0002-2941-8879

Yusuf Haydar Ertekin 0000-0002-2016-9159

Şenay Bengin Ertem 0000-0002-7237-6061

Fatih Kamış 0000-0003-2913-6166

Hasan Hüseyin Balkir 0009-0003-4869-1920

İbrahim Gül 0009-0008-9289-916X

Publication Date October 25, 2024
Submission Date August 13, 2024
Acceptance Date October 2, 2024
Published in Issue Year 2024 Volume: 9 Issue: 3

Cite

APA Reşorlu, M., Ertekin, Y. H., Ertem, Ş. B., … Kamış, F. (2024). The evaluation of fine needle aspiration biopsy results in differentiating between benign and malignant thyroid nodules. Family Practice and Palliative Care, 9(3), 85-89. https://doi.org/10.22391/fppc.1532726
AMA Reşorlu M, Ertekin YH, Ertem ŞB, Kamış F, Balkir HH, Gül İ. The evaluation of fine needle aspiration biopsy results in differentiating between benign and malignant thyroid nodules. Fam Pract Palliat Care. October 2024;9(3):85-89. doi:10.22391/fppc.1532726
Chicago Reşorlu, Mustafa, Yusuf Haydar Ertekin, Şenay Bengin Ertem, Fatih Kamış, Hasan Hüseyin Balkir, and İbrahim Gül. “The Evaluation of Fine Needle Aspiration Biopsy Results in Differentiating Between Benign and Malignant Thyroid Nodules”. Family Practice and Palliative Care 9, no. 3 (October 2024): 85-89. https://doi.org/10.22391/fppc.1532726.
EndNote Reşorlu M, Ertekin YH, Ertem ŞB, Kamış F, Balkir HH, Gül İ (October 1, 2024) The evaluation of fine needle aspiration biopsy results in differentiating between benign and malignant thyroid nodules. Family Practice and Palliative Care 9 3 85–89.
IEEE M. Reşorlu, Y. H. Ertekin, Ş. B. Ertem, F. Kamış, H. H. Balkir, and İ. Gül, “The evaluation of fine needle aspiration biopsy results in differentiating between benign and malignant thyroid nodules”, Fam Pract Palliat Care, vol. 9, no. 3, pp. 85–89, 2024, doi: 10.22391/fppc.1532726.
ISNAD Reşorlu, Mustafa et al. “The Evaluation of Fine Needle Aspiration Biopsy Results in Differentiating Between Benign and Malignant Thyroid Nodules”. Family Practice and Palliative Care 9/3 (October2024), 85-89. https://doi.org/10.22391/fppc.1532726.
JAMA Reşorlu M, Ertekin YH, Ertem ŞB, Kamış F, Balkir HH, Gül İ. The evaluation of fine needle aspiration biopsy results in differentiating between benign and malignant thyroid nodules. Fam Pract Palliat Care. 2024;9:85–89.
MLA Reşorlu, Mustafa et al. “The Evaluation of Fine Needle Aspiration Biopsy Results in Differentiating Between Benign and Malignant Thyroid Nodules”. Family Practice and Palliative Care, vol. 9, no. 3, 2024, pp. 85-89, doi:10.22391/fppc.1532726.
Vancouver Reşorlu M, Ertekin YH, Ertem ŞB, Kamış F, Balkir HH, Gül İ. The evaluation of fine needle aspiration biopsy results in differentiating between benign and malignant thyroid nodules. Fam Pract Palliat Care. 2024;9(3):85-9.
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Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505