Research Article
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Evaluation of Thyroid Fine Needle Aspiration Biopsy Results: A Single Center Experience

Year 2023, Volume: 7 Issue: 1, 34 - 38, 21.06.2023

Baris Karagün

https://doi.org/10.30565/medalanya.1191153

Abstract

Aim: It was aimed to examine the results of thyroid fine needle aspiration (FNA) biopsy performed in our clinic and to investigate its effectiveness.

Methods: In this study, the results of 101 patients who underwent thyroid FNAB in Tarsus State Hospital endocrinology clinic between December 2021 and July 2022 were retrospectively analyzed.

Results: Ultrasonographic features of thyroid nodules were classified according to EU-TIRADS, 51(50.5%) were in EU-TIRADS-3, 31 (30.7%) were in EU-TIRADS-4, 19(18.8%) were in EU-TIRADS-5. When we categorize cytology results according to Bethesda classification, 23 (22.8%) Bethesda I, 48 (47.5%) Bethesda II, 16 (15.8%) Bethesda III, 4(4%) Bethesda IV,10(9.9%) detected as Bethesda VI. Bethesda II was found in the EU-TIRADS-3 category with the highest frequency, while Bethesda VI was found in the EU-TIRADS-5 category with the highest frequency. The mean nodule diameter was found to be 20.48± 9.73mm.

Conclusion: Ultrasonographic findings of the nodules correlated with cytology results. The EU-TIRADS categorization has a good concordance with the Bethesda system. The coordinated use of the two classifications helps the clinician to avoid the risk of unnecessary invasive procedures.

Keywords

Byopsy Thyroid Nodule Ultrasonography

References

  • 1. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules: final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968;69(3):537-40. doi: 10.7326/0003-4819-69-3-537.
  • 2. Tunbridge WMG, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977;7(6):481-93. doi: 10.1111/j.1365-2265.1977.tb01340.x.
  • 3. Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest. 2009;39(8):699-706. doi: 10.1111/j.1365-2362.2009.02162.x.
  • 4. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 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. 2016;26(1):1-133. doi: 10.1089/thy.2015.0020.
  • 5. Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med. 2004 Oct 21;351(17):1764-71. doi: 10.1056/NEJMcp031436.
  • 6. Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L, et al. AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules–2016 update. Endocr Pr. 2016;22(5):622-39. doi: 10.4158/EP161208.GL.
  • 7. Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA, et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer. 2007;111(6):508-16. doi: 10.1002/cncr.23116.
  • 8. Mandel SJ. A 64-year-old woman with a thyroid nodule. Jama. 2004;292(21):2632-42. doi: 10.1001/jama.292.21.2632.
  • 9. Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2017;27(11):1341-1346. doi: 10.1089/thy.2017.0500.
  • 10. Ross DS. Overview of thyroid nodule formation. In: UpToDate, Cooper DS. (Ed), UpToDate, Waltham, MA. (Accessed on August 23, 2022.).
  • 11. Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin. 2012;96(2):329-49. doi: 10.1016/j.mcna.2012.02.002.
  • 12. Fisher SB, Perrier ND. The incidental thyroid nodule. CA Cancer J Clin. 2018;68(2):97-105. doi: 10.3322/caac.21447.
  • 13. Werk EE, Vernon BM, Gonzalez JJ, Ungaro PC, McCoy RC. Cancer in thyroid nodules: a community hospital survey. Arch Intern Med. 1984;144(3):474-6. PMID: 6703815
  • 14. Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, vd. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91(9):3411-7. doi: 10.1210/jc.2006-0690. Epub 2006 Jul 11.
  • 15. Erdem H, Yıldırım Ü, Özaydın İ, Doğan S, Aydın Y, Uzunlar AK, et al. Retrospective Comparison of Histopathologic Results of Thyroid Fine-Needle Aspiration Biopsies Konuralp Med J. 2012;4(2):27-30.
  • 16. Şengöz T, Çubuk R, Handan K, Arıbal E. Ultrasonography Guided Fine Needle Aspiration Biopsies On Thyroid Nodules. Duzce Med J. 2009;11(2):26-32.
  • 17. Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, vd. Benign and malignant thyroid nodules: US differentiation-multicenter retrospective study. Radiology. 2008;247(3):762-70. doi: 10.1148/radiol.2473070944.
  • 18. Yüksekkaya ZR, Çelikyay F, Bağcı P, Coşkunoğlu EZ. Ultrasonographic Features of Benign and Malignant Thyroid Nodules. F.Ü.Sağ.Bil.Tıp Derg. 2011: 25 (2): 77 - 82
  • 19. Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelstaedt CA. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J Ultrasound Med. 2003;22(10):1027-31. doi: 10.7863/jum.2003.22.10.1027.
  • 20. Kamran SC, Marqusee E, Kim MI, Frates MC, Ritner J, Peters H, vd. Thyroid Nodule Size and Prediction of Cancer. J Clin Endocrinol Metab. 2013;98(2):564-70. doi: 10.1210/jc.2012-2968.
  • 21. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytol. 2012;56(4):333-9. doi: 10.1159/000339959.
  • 22. Theoharis CG, Schofield KM, Hammers L, Udelsman R, Chhieng DC. The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution. Thyroid. 2009;19(11):1215-23. doi: 10.1089/thy.2009.0155.
  • 23. Myung SK, Lee CW, Lee J, Kim J, Kim HS. Risk factors for thyroid cancer: a hospital-based case-control study in Korean adults. Cancer Res Treat Off J Korean Cancer Assoc. 2017;49(1):70-8. doi: 10.4143/crt.2015.310.
  • 24. Khodamoradi F, Ghoncheh M, Mehri A, Hassanipour S, Salehiniya H. Incidence, mortality, and risk factors of thyroid cancer in the world: a review. World Cancer Res J. 2018;5(2):e1093.
  • 25. Haymart MR. Understanding the relationship between age and thyroid cancer. The oncologist. 2009;14(3):216-21. doi: 10.1634/theoncologist.2008-0194.
  • 26. Farahati J, Bucsky P, Parlowsky T, Mäder U, Reiners C. Characteristics of differentiated thyroid carcinoma in children and adolescents with respect to age, gender, and histology. Cancer. 1997;80(11):2156-62. doi: 10.1002/(sici)1097-0142(19971201)80:11<2156::aid-cncr16>3.0.co;2-y.

Tiroid İnce İğne Aspirasyon Biyopsi Sonuçlarının Değerlendirilmesi: Tek Merkez Deneyimi

Year 2023, Volume: 7 Issue: 1, 34 - 38, 21.06.2023

Baris Karagün

https://doi.org/10.30565/medalanya.1191153

Abstract

Amaç: Kliniğimizde yapılan tiroid ince iğne aspirasyon biyopsi (İİAB) sonuçlarımızı inceleyip etkinliğini araştırmak amaçlandı.

Yöntem: Bu çalışmada Aralık 2021 -Temmuz 2022 tarihleri arasında Tarsus Devlet Hastanesi Endokrinoloji Kliniğinde tiroid İİAB yapılan 101 hastanın sonuçları retrospektif olarak incelendi.

Bulgular: Tiroid nodüllerinin ultrasonografik özelikleri EU-TIRADS’a göre sınıflandırıldığında 51(50.5%)’i EU-TIRADS-3, 31 (30.7%)’i EU-TIRADS-4, 19(18.8%)’u EU-TIRADS-5 kategorisindeydi. Sitoloji sonuçlarını Bethesda sınıflamasına göre kategorize ettiğimizde ise 23 (22.8%)’ü Bethesda I, 48 (47.5%)’i Bethesda II, 16(15.8%)’sı Bethesda III, 4(4%)’ü Bethesda IV, 10(9.9%)’si Bethesda VI olarak tespit edildi. Bethesda II en yüksek frekans ile EU-TIRADS-3 kategoride saptanırken Bethesda VI ise en yüksek frekans ile EU-TIRADS-5 kategoride yer aldı. Ortalama nodul çapı 20.48± 9.73 mm olarak bulundu.

Sonuç: Nodüllerin ultrasonografik bulguları sitoloji sonuçları ile korelasyon göstermiştir. EU-TIRADS sınıflandırması, Bethesda sistemi ile iyi bir uyum içindedir. İki sınıflamanın koordineli kullanılması, klinisyene gereksiz invaziv prosedür riskinden kaçınmak için yardımcı olmaktadır.

Keywords

Biyopsi Tiroid nodülü Ultrasonografi

References

  • 1. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules: final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968;69(3):537-40. doi: 10.7326/0003-4819-69-3-537.
  • 2. Tunbridge WMG, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977;7(6):481-93. doi: 10.1111/j.1365-2265.1977.tb01340.x.
  • 3. Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest. 2009;39(8):699-706. doi: 10.1111/j.1365-2362.2009.02162.x.
  • 4. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 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. 2016;26(1):1-133. doi: 10.1089/thy.2015.0020.
  • 5. Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med. 2004 Oct 21;351(17):1764-71. doi: 10.1056/NEJMcp031436.
  • 6. Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L, et al. AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules–2016 update. Endocr Pr. 2016;22(5):622-39. doi: 10.4158/EP161208.GL.
  • 7. Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA, et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer. 2007;111(6):508-16. doi: 10.1002/cncr.23116.
  • 8. Mandel SJ. A 64-year-old woman with a thyroid nodule. Jama. 2004;292(21):2632-42. doi: 10.1001/jama.292.21.2632.
  • 9. Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2017;27(11):1341-1346. doi: 10.1089/thy.2017.0500.
  • 10. Ross DS. Overview of thyroid nodule formation. In: UpToDate, Cooper DS. (Ed), UpToDate, Waltham, MA. (Accessed on August 23, 2022.).
  • 11. Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin. 2012;96(2):329-49. doi: 10.1016/j.mcna.2012.02.002.
  • 12. Fisher SB, Perrier ND. The incidental thyroid nodule. CA Cancer J Clin. 2018;68(2):97-105. doi: 10.3322/caac.21447.
  • 13. Werk EE, Vernon BM, Gonzalez JJ, Ungaro PC, McCoy RC. Cancer in thyroid nodules: a community hospital survey. Arch Intern Med. 1984;144(3):474-6. PMID: 6703815
  • 14. Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, vd. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91(9):3411-7. doi: 10.1210/jc.2006-0690. Epub 2006 Jul 11.
  • 15. Erdem H, Yıldırım Ü, Özaydın İ, Doğan S, Aydın Y, Uzunlar AK, et al. Retrospective Comparison of Histopathologic Results of Thyroid Fine-Needle Aspiration Biopsies Konuralp Med J. 2012;4(2):27-30.
  • 16. Şengöz T, Çubuk R, Handan K, Arıbal E. Ultrasonography Guided Fine Needle Aspiration Biopsies On Thyroid Nodules. Duzce Med J. 2009;11(2):26-32.
  • 17. Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, vd. Benign and malignant thyroid nodules: US differentiation-multicenter retrospective study. Radiology. 2008;247(3):762-70. doi: 10.1148/radiol.2473070944.
  • 18. Yüksekkaya ZR, Çelikyay F, Bağcı P, Coşkunoğlu EZ. Ultrasonographic Features of Benign and Malignant Thyroid Nodules. F.Ü.Sağ.Bil.Tıp Derg. 2011: 25 (2): 77 - 82
  • 19. Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelstaedt CA. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J Ultrasound Med. 2003;22(10):1027-31. doi: 10.7863/jum.2003.22.10.1027.
  • 20. Kamran SC, Marqusee E, Kim MI, Frates MC, Ritner J, Peters H, vd. Thyroid Nodule Size and Prediction of Cancer. J Clin Endocrinol Metab. 2013;98(2):564-70. doi: 10.1210/jc.2012-2968.
  • 21. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytol. 2012;56(4):333-9. doi: 10.1159/000339959.
  • 22. Theoharis CG, Schofield KM, Hammers L, Udelsman R, Chhieng DC. The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution. Thyroid. 2009;19(11):1215-23. doi: 10.1089/thy.2009.0155.
  • 23. Myung SK, Lee CW, Lee J, Kim J, Kim HS. Risk factors for thyroid cancer: a hospital-based case-control study in Korean adults. Cancer Res Treat Off J Korean Cancer Assoc. 2017;49(1):70-8. doi: 10.4143/crt.2015.310.
  • 24. Khodamoradi F, Ghoncheh M, Mehri A, Hassanipour S, Salehiniya H. Incidence, mortality, and risk factors of thyroid cancer in the world: a review. World Cancer Res J. 2018;5(2):e1093.
  • 25. Haymart MR. Understanding the relationship between age and thyroid cancer. The oncologist. 2009;14(3):216-21. doi: 10.1634/theoncologist.2008-0194.
  • 26. Farahati J, Bucsky P, Parlowsky T, Mäder U, Reiners C. Characteristics of differentiated thyroid carcinoma in children and adolescents with respect to age, gender, and histology. Cancer. 1997;80(11):2156-62. doi: 10.1002/(sici)1097-0142(19971201)80:11<2156::aid-cncr16>3.0.co;2-y.
There are 26 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Baris Karagün 0000-0002-4011-4622

Early Pub Date May 28, 2023
Publication Date June 21, 2023
Submission Date October 18, 2022
Acceptance Date February 24, 2023
Published in Issue Year 2023 Volume: 7 Issue: 1

Cite

Vancouver Karagün B. Evaluation of Thyroid Fine Needle Aspiration Biopsy Results: A Single Center Experience. Acta Med. Alanya. 2023;7(1):34-8.

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