title: Interinstitutional review of thyroid fine-needle aspirations: impact on clinical management of thyroid nodules.
abstract: Routine interinstitution pathology consultation can result in change in pathologic diagnosis in up to 10% of patients. In this study, we compared the outside cytopathologic diagnosis of thyroid fine-needle aspiration (FNA) specimens with the in-house diagnosis at the University of Pennsylvania Medical Center over an 18-mo period and its effect on patient management. One hundred ten (60%) diagnostic disagreements were identified among 183 patients. In 16 cases, the diagnosis was changed from benign to malignant, and in 12, the diagnosis was reversed from neoplastic/malignant to benign. Histologic follow-up was available in 109 cases; the overall accuracy of outside diagnosis was 73%, and that of inside diagnosis was 85%. In conclusion, we strongly recommend interinstitution cytology consultation on referred thyroid FNA cases, since our data showed a significant change in diagnosis, thus affecting patient management.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Z W
authors.initials: ZW
authors.lastname: Baloch
authors.forename: S
authors.initials: S
authors.lastname: Hendreen
authors.forename: P K
authors.initials: PK
authors.lastname: Gupta
authors.forename: V A
authors.initials: VA
authors.lastname: LiVolsi
authors.forename: S J
authors.initials: SJ
authors.lastname: Mandel
authors.forename: R
authors.initials: R
authors.lastname: Weber
authors.forename: D
authors.initials: D
authors.lastname: Fraker
mesh_terms: D001707:Biopsy, Needle / Q000379:methods; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006801:Humans; D011446:Prospective Studies; D012017:Referral and Consultation; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000628:therapy; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*