title: [Fine-needle aspiration (FNA) of the thyroid gland : Analysis of discrepancies between cytological and histological diagnoses].
abstract: BACKGROUND
  Diagnostic problems of thyroid cytology are frequently discussed, but relevance and causes of discrepant cytological and histological diagnoses are rarely studied in detail.
  
  
  OBJECTIVE
  Investigation of causes and relevance of discrepant diagnoses.
  
  
  METHODS
  The analysis includes 297 patients who had thyroid resection after prior fine needle aspiration (FNA) and is based on the cytological and histological reports. In special cases, cytological and histological specimens were re-examined.
  
  
  RESULTS
  Malignant tumors were found in 45 patients (15.1 %). In 5 patients the cytological diagnosis was "false negative". Three of these 5 tumors were papillary carcinomas (PTC) of ≤10 mm, one an obviously nonmalignant papillary proliferation of the thyroidal epithelium and one a malignant lymphoma complicating autoimmune thyreoiditis (AIT). In 11 of the 35 patients with a FNA diagnosis "suspicious of malignancy" or "malignant," 1 AIT, 4 goiter nodules, and 6 adenomas were diagnosed histologically. However, since distinct nuclear atypia was found in three of five false positive diagnoses, there still remains doubt in their benignity.
  
  
  CONCLUSIONS
  Carcinomas of ≤10 mm incidentally detected in the resected thyroid tissue may not be relevant to the patient and do not reduce the high negative predictive value of FNA. The final diagnosis on the resected tissue should include the cytological findings. Discrepant findings should be commented in the report to the clinician.
authors.affiliation: Institut für Pathologie, Universitätsspital, Himmelrainweg 24, 4450, Basel, Sissach, Schweiz. pdalquen@sunrise.ch.
authors.forename: P
authors.initials: P
authors.lastname: Dalquen
authors.affiliation: Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Rashed
authors.affiliation: Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Hinsch
authors.affiliation: Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Issa
authors.affiliation: Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Clauditz
authors.affiliation: Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Luebke
authors.affiliation: Pathologisches Institut, Katholisches Marienkrankenhaus, Hamburg, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Lüttges
authors.affiliation: Pathologisches Institut, Katholisches Marienkrankenhaus, Hamburg, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Saeger
authors.affiliation: Nuklearmedizin Spitalerhof, Hamburg, Deutschland.
authors.forename: K H
authors.initials: KH
authors.lastname: Bohuslavizki
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D005188:False Negative Reactions; D005189:False Positive Reactions; D006044:Goiter, Nodular / Q000473:pathology; D006801:Humans; D008223:Lymphoma / Q000473:pathology; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000473:pathology*; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000473:pathology*; D013965:Thyroidectomy; D013967:Thyroiditis, Autoimmune / Q000473:pathology
keywords: Carcinoma; Diagnostic discrepancies; Histology; Sources of error; Thyroid cytology