Use of fine-needle aspiration cytology and frozen section in the management of nodular goiters.
BACKGROUND
This study evaluates the role of frozen section (FS) in surgical decisions for nodular thyroid disease when a preoperative fine-needle aspiration cytology (FNAC) is available.


METHODS
The charts of 113 patients who underwent thyroidectomy for nodular goiter were reviewed. Each patient underwent FNAC, FS, or both. Results were compared with the final pathologic examination to evaluate their effectiveness in predicting malignancy.


RESULTS
The sensitivity and specificity of FNAC alone (49 patients) were 73% and 93.5%, respectively, and of FS (111 patients) 68% and 99%, respectively. The result of fine-needle aspiration cytology was: benign (n = 8), malignant (n = 13), indeterminate (n = 25), and nondiagnostic (n = 3). All cases diagnosed as benign on FNAC were benign on final pathology, but of the six FS performed in these cases, four were benign and two were suspect. Of the 13 FNAC that were interpreted as malignant, 11 and 10 proved to be malignant on final pathology and FS, respectively. The 25 indeterminate cases on FNAC were on final pathology benign (n = 21) and malignant (n = 4) and on frozen section were benign (n = 12), malignant (n = 2), and suspect (n = 11).


CONCLUSIONS
When results of FNAC are interpreted as benign or malignant, FS is of little value, because it does not change the extension of thyroidectomy. FS proved useful in determining the extent of thyroidectomy only when results of the FNAC were suspect or atypical.
Abboud
Bassam
B
Department of General and Endocrine Surgery, Hotel-Dieu de France Hospital, Faculty of Medecine, Saint-Joseph University; Beirut, Lebanon. dbabboud@yahoo.fr
Allam
Soha
S
Chacra
Lara Abou
LA
Ingea
Henri
H
Tohme
Cyril
C
Farah
Pierre
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002277:Carcinoma / Q000175:diagnosis; D005260:Female; D005629:Frozen Sections; D006044:Goiter, Nodular / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000175:diagnosis*; D013965:Thyroidectomy