title: Ultrasound-guided fine-needle capillary biopsy of thyroid nodules, coupled with on-site cytologic review, improves results.
abstract: Fine-needle aspiration biopsy represents the most reliable test for cytologic evaluation of thyroid nodules. However, inadequate samples may occur leading to a repetition of the procedure with the consequence of patients' discomfort and poor compliance. In this paper, we present results from biopsy of thyroid nodules obtained by combining: (1) ultrasound (US) guidance, (2) no-aspiration technique, and (3) on-site review of specimens. A total of 465 nodules were biopsied in 307 patients. Solitary nodules and multinodular goiter were present in 36.8% and 63.1% of patients, respectively. After collection, each sample was smeared in duplicates, one of which was stained with hematoxylin and checked on-site by a cytopathologist. In cases of inadequate smears, biopsies were immediately repeated. All slides were then processed for final cytologic results, which were reported as benign in 427 nodules (91.8%), malignant in 12 nodules (2.5%), with follicular proliferation or suspicious for malignancy in 23 nodules (4.9%). Inadequate final cytology was reported in 3 nodules (0.6%). No statistically significant relationship was found between nodule size and adequacy of specimens. We conclude that the combination of US guidance, capillary collection with no-aspiration technique, and on-site review of slides, characterizes an advantageous method for thyroid nodule fine-needle biopsy.
authors.affiliation: Department of Internal Medicine and Biomedical Sciences, School of Endocrinology, University of Parma, Parma, Italy. ceresini@unipr.it
authors.forename: G
authors.initials: G
authors.lastname: Ceresini
authors.forename: L
authors.initials: L
authors.lastname: Corcione
authors.forename: S
authors.initials: S
authors.lastname: Morganti
authors.forename: B
authors.initials: B
authors.lastname: Milli
authors.forename: L
authors.initials: L
authors.lastname: Bertone
authors.forename: R
authors.initials: R
authors.lastname: Prampolini
authors.forename: S
authors.initials: S
authors.lastname: Petrazzoli
authors.forename: M
authors.initials: M
authors.lastname: Saccani
authors.forename: G P
authors.initials: GP
authors.lastname: Ceda
authors.forename: G
authors.initials: G
authors.lastname: Valenti
mesh_terms: D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D008875:Middle Aged; D011441:Propylthiouracil / Q000627:therapeutic use; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology*; D013974:Thyroxine / Q000627:therapeutic use; D014463:Ultrasonography / Q000379:methods
chemical_list: D008713:Methimazole; D011441:Propylthiouracil; D013974:Thyroxine