Value of repeated fine needle aspiration cytology in patients with nodular goiter.
OBJECTIVE
To assess the value of reaspiration cytology in benign nodular thyroid disease.


METHODS
We prospectively studied 400 patients (365 women, 35 men) aged 46 years (18-89) with nodular thyroid disease and initial benign fine needle aspiration cytology (FNAC). Reaspiration of the same nodule was performed in a median follow-up time of 14 months (6-18).


RESULTS
Repeat FNAC was benign in 346 patients (86.5%), insufficient for diagnosis in 42 (10.5%), suspicious in 16 (2.5%) and malignant in 2 (0.5%). All diagnostic changes to suspicious malignant cytology took place in patients with solitary nodules. Surgery confirmed thyroid cancer in the 2 patients with malignant cytology, in 5 of 10 patients with suspicious cytology and in none of 39 patients with benign cytology who underwent surgery for other reasons. Clinical changes (size increase or local symptoms) were not related to changes in cytologic diagnosis after a second aspiration, nor with the results of the biopsy.


CONCLUSIONS
Repeat aspiration cytology of thyroid nodules may correct initial false negative results because of cytologic misdiagnosis, occurring in 1.75% of patients, whereas clinical changes did not contribute to diagnosis change. Repeat aspiration cytology is recommended in all patients with nodular goiter.
Menéndez Torre
Edelmiro
E
Unidad de Patología Tiroidea, Hospital de Navarra y Hospital Virgen del Camino, Servicio Navarro de Salud, Pamplona, Spain.
Pineda Arribas
Javier
J
Martínez de Esteban
Juan Pablo
JP
López Carballo
María Teresa
MT
de Miguel
Concepción
C
Salvador
Pilar
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results