title: Histologic follow-up of nondiagnostic thyroid fine needle aspirations: implications for adequacy criteria.
abstract: There is limited histologic follow-up for adequacy criteria in thyroid fine needle aspirations. We correlated the number of benign follicular cells in nondiagnostic aspirates (excluding atypical and Hurthle cells) and the results of histologic follow-up. A total of 170 cases with only benign follicular cells were reviewed. The sensitivity and specificity for 60 benign follicular cells was 97% and 42%. If the threshold for adequacy was lowered to 10 cells, the specificity of a benign diagnosis increased significantly (42% to 50%, P < 0.001) without a significant change in sensitivity (97% to 96%, P = 0.45). An additional 63 cases were diagnosed as adequate with three false negative cases. Lowering the threshold to 30 cells had no change in sensitivity (97%), increased specificity to 45% but this was not significant (P = 0.08). An additional 26 aspirates could be diagnosed as adequate without any false negative cases. Histologic follow-up suggests that the current criteria for adequacy can be lowered to improve specificity while retaining excellent sensitivity.
authors.affiliation: Department of Pathology, Baptist Hospital of Miami, Miami, Florida 33176, USA. andrewr@baptisthealth.net
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Renshaw
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000473:pathology; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002452:Cell Count / Q000592:standards; D005188:False Negative Reactions; D005500:Follow-Up Studies; D006801:Humans; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology