Diagnostic pitfalls in thyroid fine-needle aspiration: a review of 394 cases.
To determine the diagnostic pitfalls of thyroid fine-needle aspiration (FNA), we reviewed 394 thyroid aspirates obtained between January 1986 and December 1990. Surgical follow-up was available for 150 aspirations. The cytologic diagnoses were categorized into four groups: benign, 57; indeterminate, 51; malignant, 33; and nondiagnostic specimen, nine. There were three false negative diagnoses (3%), which upon review were judged to be inadequate specimens. Three false positive diagnoses (7%) were identified: in the first two cases, follicular adenomas were mistaken for papillary carcinoma; in the third case, atypical Hürthle cells were mistaken for a Hürthle cell carcinoma. Our results showed a sensitivity of 93% and a specificity of 91% for the detection of malignancy. If indeterminate cases were considered positive, the specificity decreased to 50%, while the sensitivity increased to 97%. We conclude that: 1) certain follicular adenomas may display cytologic features mimicking papillary carcinoma; 2) as in follicular neoplasms, aspirates of Hürthle cell adenomas cannot be differentiated from Hürthle cell carcinomas; 3) with adequate sampling, false negative results can be markedly reduced.
Caraway
N P
NP
Department of Pathology, University of Texas, M. D. Anderson Cancer Center, Houston 77030.
Sneige
N
N
Samaan
N A
NA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D003581:Cytodiagnosis / Q000592:standards; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000175:diagnosis* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology