title: Low false-negative rate of cytology in thyroid nodules >or= 4 cm.
abstract: OBJECTIVE
  To report the results of cytology and histology obtained for a series of systematically resected thyroid nodules >or= 4 cm.
  
  
  METHODS
  A group of 151 patients with thyroid nodules >or= 4 cm was submitted to surgery despite the cytology result.
  
  
  RESULTS
  Malignancy was confirmed histologically in 22.5% of the patients. Excluding cases of insufficient material, cytology was benign in only 3/31 carcinomas (90.3% sensitivity). The frequency of malignancy was 35% among nodules with indeterminate cytology (follicular neoplasm), and there was a predominance (77%) of papillary carcinoma. The negative predictive value of benign cytology was 96.4%.
  
  
  CONCLUSIONS
  The false-negative rate of cytology in thyroid nodules >or= 4 cm does not justify systematic resection of these nodules in asymptomatic patients with benign cytology.
authors.affiliation: Programa de Pós-graduação, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brasil. pedrorosario@globo.com
authors.forename: Pedro Weslley
authors.initials: PW
authors.lastname: Rosario
authors.forename: Daniela Santos
authors.initials: DS
authors.lastname: Salles
authors.forename: Breno
authors.initials: B
authors.lastname: Bessa
authors.forename: Saulo
authors.initials: S
authors.lastname: Purisch
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000453:epidemiology / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000473:pathology*; D002648:Child; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology*; D019564:Unnecessary Procedures; D055815:Young Adult