title: Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules.
abstract: To determine the role of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) in the evaluation of incidentally diagnosed nonpalpable thyroid nodules (NP-TN), we compared the diagnostic yield of US-FNAB in NP-TN larger than 10 mm in diameter, with palpation-guided (P-FNAB) in palpable thyroid nodules (P-TN) in the same hospital setting. Of 108 consecutive patients with NP-TN (female/male: 97/11, age: 55.2 +/- 14.3, mean +/- SD), malignancy was identified in 8 patients (7 with thyroid papillary carcinoma, 4 of which had extrathyroidal spread, and 1 patient had metastasis of pulmonary adenocarcinoma). Male gender was associated with higher prevalence of malignancy (p = 0.09) while calcification and/or cystic degeneration of the nodule did not predict the cytological findings. Malignancy was identified in 16 of 151 consecutive patients with P-TN (female/male: 139/12, age: 44.1 +/- 9.5, mean +/- SD) indicating a similar rate of malignancy in both NP-TN and P-TN. In the P-TN group thyroid cancer was more common in males (p = 0.007), and the US properties of the nodule did not predict its cytological diagnosis. In conclusion, because similar rates of cancer are detected by FNAB in both NP-TN and P-TN, an FNAB is recommended for NP-TN larger than 10 mm.
authors.affiliation: Endocrine Institute, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: P
authors.initials: P
authors.lastname: Hagag
authors.forename: S
authors.initials: S
authors.lastname: Strauss
authors.forename: M
authors.initials: M
authors.lastname: Weiss
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000556:secondary; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009382:Neoplasms, Unknown Primary / Q000473:pathology; D010173:Palpation; D011446:Prospective Studies; D017678:Sex Distribution; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000556:secondary; D016606:Thyroid Nodule / Q000473:pathology*; D014465:Ultrasonics