title: A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy.
abstract: OBJECTIVE
  The most commonly used diagnostic method for the preoperative diagnosis of thyroid nodules is ultrasound-guided fine-needle aspiration biopsy (FNA), which often yields non-diagnostic or non-definitive results and seldom produces definite malignant diagnoses. To improve upon the malignancy-specific sensitivity, we tested core needle biopsies (CNBs) of thyroid lesions taken from surgical specimens.
  
  
  METHODS
  52 consecutive patients with malignant or malignant-suspicious thyroid nodules were referred to Tampere University Hospital between May 2010 and December 2011. Preoperative FNAs were categorised as follicular neoplasm (48%), suspicion for malignancy (46%) or malignancy (6%). Intraoperative FNA and CNB samples were acquired from surgical specimens removed during surgery. The results of the needle biopsies were compared with the final pathological diagnosis.
  
  
  RESULTS
  CNBs had a high definitive sensitivity for malignancy (61%, CI 41% to 78%) whereas the definitive sensitivity for malignancy of FNAs was significantly lower (22%, CI 10% to 42%). CNB was not beneficial in the diagnosis of follicular thyroid lesions. When all suspected follicular tumours were excluded, the definitive sensitivity of CNB rose to 70% (CI 48% to 86%).
  
  
  CONCLUSIONS
  CNB may be beneficial for the diagnosis of papillary thyroid carcinoma and other non-follicular thyroid lesions. CNB may be considered as an additional diagnostic procedure in cases with FNA suspicious for malignancy.
authors.affiliation: Department of Surgery, Tampere University Hospital, , Tampere, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Hakala
authors.forename: I
authors.initials: I
authors.lastname: Kholová
authors.forename: J
authors.initials: J
authors.lastname: Sand
authors.forename: R
authors.initials: R
authors.lastname: Saaristo
authors.forename: P
authors.initials: P
authors.lastname: Kellokumpu-Lehtinen
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000592:standards*; D062005:Biopsy, Large-Core Needle / Q000592:standards*; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary; D005260:Female; D005387:Finland; D006785:Hospitals, University; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
keywords: CYTOLOGY; HEAD AND NECK CANCER; HISTOPATHOLOGY; THYROID; THYROID CANCER