title: [Diagnosis of metastases in patients with papillary thyroid cancer by the measurement of thyroglobulin in fine needle aspirate].
abstract: The widespread use of neck ultrasonography (US) during the follow-up of patients with papillary thyroid carcinoma (PTC) has led to the discovery of small cervical lymph nodes (LN). Although US has a high sensitivity for diagnosing LN, fine needle aspiration biopsy (FNA) and measurement of thyroglobulin in fine needle aspirates (FNA-Tg) have proven to be invaluable tools. The aim of this study is to determine the sensitivity of the combined use of neck US, FNA biopsy and FNA-Tg for diagnosis of cervical lymph nodes. We have studied 32 patients with 44 LN detected by US, 19 classified as inflammatory and 25 as suspicious. 15 of those 25 suspicious LN had high FNA-Tg (13 of the 15 had positive cytology and 2 indeterminate). All of these 15 LN (11 patients) were proven to be PTC metastasis by histopathology. All 19 inflammatory LN and those 10/25 suspicious LN, had cytology negative for malignancy and undetectable FNA-Tg. We conclude that fine needle aspiration biopsy and FNA-Tg combined with neck US are essential for detecting positive cervical lymph nodes due to its high sensitivity and specificity and it should be considered the standard for investigating locally recurrent disease in patients with PTC.
authors.affiliation: Disciplina de Endocrinologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo. rosapaula@uol.com.br
authors.forename: Rosa Paula M
authors.initials: RP
authors.lastname: Biscolla
authors.forename: Elza S
authors.initials: ES
authors.lastname: Ikejiri
authors.forename: Maria Conceição
authors.initials: MC
authors.lastname: Mamone
authors.forename: Cláudia C D
authors.initials: CC
authors.lastname: Nakabashi
authors.forename: Victor P
authors.initials: VP
authors.lastname: Andrade
authors.forename: Teresa S
authors.initials: TS
authors.lastname: Kasamatsu
authors.forename: Felipe
authors.initials: F
authors.lastname: Crispim
authors.forename: Maria Izabel
authors.initials: MI
authors.lastname: Chiamolera
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Andreoni
authors.forename: Cleber P
authors.initials: CP
authors.lastname: Camacho
authors.forename: Flávio C
authors.initials: FC
authors.lastname: Hojaij
authors.forename: José Gilberto H
authors.initials: JG
authors.lastname: Vieira
authors.forename: Reinaldo P
authors.initials: RP
authors.lastname: Furlanetto
authors.forename: Rui M B
authors.initials: RM
authors.lastname: Maciel
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D013954:Thyroglobulin / Q000032:analysis* / Q000097:blood; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000628:therapy; D013965:Thyroidectomy; D014463:Ultrasonography; D051598:Whole Body Imaging
chemical_list: D014408:Biomarkers, Tumor; D013954:Thyroglobulin