Usefulness of repeated fine-needle cytology in the follow-up of non-operated thyroid nodules.
OBJECTIVE
The usefulness of repeated fine-needle cytology (FNC) in thyroid nodules with benign cytology remains unknown. We analyzed the relevance of repeated FNC to detect suspicious or malignant (S/M) cytologies and carcinomas.


METHODS
A retrospective study (1983-2004) was conducted in our endocrinology department.


METHODS
We reviewed the reports of 895 adequate FNC performed in 298 patients (298 nodules) during a mean follow-up of 5 years. We compared the nodules with at least one suspicious or malignant FNC (S/M nodules) with nodules with repeatedly benign (RB) FNC (RB nodules).


RESULTS
Among the nodules with initial benign cytology, we found 35 nodules with one or more later suspicious or malignant results. The interval between the first FNC and the first S/M FNC was 2.9 years. The probability for a nodule to have a repeated benign FNC decreases with time and with the number of FNC. We did not find any clinical or ultrasonographic characteristics related to an S/M cytology. Seven cancers were detected by the second or the third FNC with S/M results. The proportion of cancers among S/M nodules was similar when S/M cytology appears during the first, the second, or the third FNC.


CONCLUSIONS
We suggest to repeat FNC up to three adequate samples in the follow-up of thyroid nodules so as not to miss the presence of malignant neoplasm.
Illouz
Frédéric
F
Département d'Endocrinologie, CHU d'Angers, Angers, France. frillouz@chu-angers.fr
Rodien
Patrice
P
Saint-André
Jean Paul
JP
Triau
Stéphane
S
Laboureau-Soares
Sandrine
S
Dubois
Séverine
S
Vielle
Bruno
B
Hamy
Antoine
A
Antoine
Hamy
H
Rohmer
Vincent
V
D000328:Adult; D044963:Biopsy, Fine-Needle; D003581:Cytodiagnosis / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology*