title: Clinical relevance of non-palpable thyroid nodules as assessed by ultrasound-guided fine needle aspiration biopsy.
abstract: It is known from autopsy data that thyroid nodules are far more common than can be detected by palpation alone. With the wide use of modern non-invasive imaging many non-palpable thyroid nodules are discovered but the proper approach to these nodules is still debatable. In a retrospective study, we reviewed the data from 186 US-guided FNA biopsies (US-FNAB) performed between May 1995 and March 1997 at the Sapir Medical Center, Israel, a iodine-sufficient urban area. Sixty-one of the 186 US-FNAB of the thyroid were performed in non-palpable nodules. The mean size of these nodules was 2.4 +/- 1.0 cm (mean +/- SD) ranging from 1.1-5.5 cm. Description of the nodule consistency was available in 53 cases; 42/53 were solid and 11/53 were solid-cystic. FNAB was diagnostic in 46 patients and non-diagnostic in 15. Forty-three of the diagnostic cytology reports were benign, one revealed papillary carcinoma, one had suspicious findings and the third was suspicious for a follicular neoplasm. The last two patients were referred to surgery and a follicular adenoma was found in both. Among the 61 non-palpable thyroid nodules, only one was papillary carcinoma, a prevalence of 1.6%. The other two patients referred to surgery had benign lesions. We found a low prevalence of malignancy in relatively large non-palpable thyroid nodules.
authors.affiliation: Endocrine Unit, Sapir Medical Center Kfar Saba, ITel Aviv nabriskid@clalit.org.il
authors.forename: D
authors.initials: D
authors.lastname: Nabriski
authors.forename: R
authors.initials: R
authors.lastname: Ness-Abramof
authors.forename: T O
authors.initials: TO
authors.lastname: Brosh
authors.forename: O
authors.initials: O
authors.lastname: Konen
authors.forename: M S
authors.initials: MS
authors.lastname: Shapiro
authors.forename: L
authors.initials: L
authors.lastname: Shenkman
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013670:Sodium Pertechnetate Tc 99m; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D016606:Thyroid Nodule / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D018084:Ultrasonography, Interventional
chemical_list: D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m