title: Evaluation of cytopathological findings in thyroid nodules with macrocalcification: macrocalcification is not innocent as it seems.
abstract: OBJECTIVE
  Microcalcification is strongly correlated with papillary thyroid cancer. It is not clear whether macrocalcification is associated with malignancy. In this study, we aimed to assess the result of fine needle aspiration biopsies (FNAB) of thyroid nodules with macrocalcifications.
  
  
  METHODS
  We retrospectively evaluated 269 patients (907 nodules). Macrocalcifications were classified as eggshell and parenchymal macrocalcification. FNAB results were divided into four groups: benign, malignant, suspicious for malignancy, and non-diagnostic.
  
  
  RESULTS
  There were 79.9% female and 20.1% male and mean age was 56.9 years. Macrocalcification was detected in 46.3% nodules and 53.7% nodules had no macrocalcification. Parenchymal and eggshell macrocalcification were observed in 40.5% and 5.8% nodules, respectively. Cytologically, malignant and suspicious for malignancy rates were higher in nodules with macrocalcification compared to nodules without macrocalcification (p = 0.004 and p = 0.003, respectively). Benign and non-diagnostic cytology results were similar in two groups (p > 0.05). Nodules with eggshell calcification had higher rate of suspicious for malignancy and nodules with parenchymal macrocalcification had higher rates of malignant and suspicious for malignancy compared to those without macrocalcification (p = 0.01, p = 0.003 and p = 0.007, respectively).
  
  
  CONCLUSIONS
  Our findings suggest that macrocalcifications are not always benign and are not associated with increased nondiagnostic FNAB results. Macrocalcification, particularly the parenchymal type should be taken into consideration.
authors: Department of Endocrinology and Metabolism, Sakarya Training and Research Hospital, Sakarya University, Adapazari, Sakarya, Turkey.
authors: Dilek
authors: D
authors: Arpaci
authors: Department of Endocrinology and Metabolism, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.
authors: Didem
authors: D
authors: Ozdemir
authors: Department of Endocrinology and Metabolism, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.
authors: Neslihan
authors: N
authors: Cuhaci
authors: Department of Endocrinology and Metabolism, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.
authors: Ahmet
authors: A
authors: Dirikoc
authors: Department of Pathology, Ankara Ataturk Training and Research Hospital, Yıldırım Beyazit University, Ankara, Turkey.
authors: Aylin
authors: A
authors: Kilicyazgan
authors: Department of Pathology, Ankara Ataturk Training and Research Hospital, Yıldırım Beyazit University, Ankara, Turkey.
authors: Gulnur
authors: G
authors: Guler
authors: Department of Endocrinology and Metabolism, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.
authors: Reyhan
authors: R
authors: Ersoy
authors: Department of Endocrinology and Metabolism, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.
authors: Bekir
authors: B
authors: Cakir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D002114:Calcinosis / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006044:Goiter, Nodular / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult