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The combined role of ultrasound and frozen section in surgical management of thyroid nodules read as suspicious for papillary thyroid carcinoma on fine needle aspiration biopsy: a retrospective study

Authors
 Hee Jung Moon  ;  Jin Young Kwak  ;  Eun-Kyung Kim  ;  Min Jung Kim  ;  Cheong Soo Park  ;  Woung Youn Chung  ;  Eun Ju Son 
Citation
 WORLD JOURNAL OF SURGERY, Vol.33(5) : 950-957, 2009 
Journal Title
 WORLD JOURNAL OF SURGERY 
ISSN
 0364-2313 
Issue Date
2009
MeSH
Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle/methods ; Carcinoma, Papillary/diagnostic imaging* ; Carcinoma, Papillary/pathology* ; Carcinoma, Papillary/surgery ; Diagnosis, Differential ; Female ; Frozen Sections/methods ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology* ; Thyroid Nodule/surgery ; Ultrasonography ; Young Adult
Keywords
Papillary Thyroid Carcinoma ; Thyroid Nodule ; Papillary Carcinoma ; Thyroid Malignancy ; Follicular Adenoma
Abstract
BACKGROUND: The purpose of this study was to evaluate the combined role of ultrasound (US) and frozen section (FS) in the surgical management of thyroid nodules that are suspicious for papillary thyroid carcinoma (PTC) on US-guided fine-needle aspiration biopsy (US-FNAB). METHODS: Between 2006 and 2008, 217 patients with thyroid nodules classified as suspicious for PTC on US-FNAB underwent intraoperative FS and surgery. A thyroid nodule with any suspicious US findings of marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, or taller than wider in shape was defined as positive and that without was defined as negative. FSs were classified as malignant, indeterminate, defer, and benign. We compared the results of US groupings, FS, and final histopathologic diagnosis. RESULTS: Twenty-one (52.5%) of 40 patients with a negative US revealed malignancy. In contrast, 168 (94.9%) of 177 patients with a positive US had malignancy. Fourteen (50%) of 28 patients with benign pathology on FS had malignancy, and 166 (97.6%) of 170 patients with malignancy on FS proved malignancy on histopathology. Of 40 patients with negative US, 13 (92.9%) of 14 with malignancy on FS proved malignancy. CONCLUSIONS: The malignancy rate of thyroid nodules read as "suspicious for PTC" on US-FNAB was 87.1%. When a thyroid nodule with "suspicious for PTC" on US-FNAB has suspicious malignant US features, FS may be unnecessary due to a very high risk of malignancy (94.9%). In contrast, when a thyroid nodule read as "suspicious for PTC" on US-FNAB has no suspicious malignant US features, FS can help surgeons determine the extent of surgery.
Full Text
http://link.springer.com/article/10.1007%2Fs00268-009-9984-7
DOI
10.1007/s00268-009-9984-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Park, Cheong Soo(박정수)
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Chung, Woong Youn(정웅윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103759
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