Evidence-based criteria for adequacy in thyroid fine-needle aspiration.
To determine whether some thyroid fine-needle aspirates classified as nondiagnostic correlate with benign thyroid nodules and can be distinguished from other nondiagnostic aspirates, I reviewed (from a total of 1,581) 80 nondiagnostic cases, all of which were hypocellular and lacked colloid, and correlated the cytologic findings with the results of pathologic follow-up. Of the 80, 16 had carcinoma at follow-up and 64 were benign. The cellularity of the carcinoma cases ranged from 0 to 100 cells (mean, 20 cells), but every case with epithelial cells had Hürthle cell change or atypia suggestive of papillary carcinoma. The cellularity of the 64 benign cases ranged from 0 to 120 cells (mean, 40 cells), 17 of which had Hürthle cell change. There were 25 cases with at least 10 benign-appearing follicular cells without atypia or Hürthle cell change; all 25 cases were associated with benign follow-up. While these results need to be confirmed by others, the evidence suggests that a proportion of thyroid aspirates that do not meet traditional criteria for adequacy still may be associated strongly with a benign thyroid nodule and can be distinguished from other nondiagnostic aspirates.
Renshaw
Andrew A
AA
Department of Pathology, Baptist Hospital of Miami, FL 33176, USA.
D000230:Adenocarcinoma / Q000473:pathology*; D018249:Adenoma, Oxyphilic / Q000473:pathology*; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D013048:Specimen Handling / Q000379:methods; D013964:Thyroid Neoplasms / Q000473:pathology*; D016606:Thyroid Nodule / Q000473:pathology*