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The role of ultrasound in thyroid nodules with a cytology reading of "suspicious for papillary thyroid carcinoma".

 Jin Young Kwak  ;  Eun-Kyung Kim  ;  Min Jung Kim  ;  Soon Won Hong  ;  Seon Hyeong Choi  ;  Eun Ju Son  ;  Ki Keun Oh  ;  Cheong Soo Park  ;  Woung Youn Chung  ;  Ki Whang Kim 
 Thyroid, Vol.18(5) : 517-522, 2008 
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BACKGROUND: Irrespective of ultrasound (US) features, surgery is usually recommended for patients who have a fine-needle aspiration biopsy (FNAB) read as suspicious for papillary carcinoma (PTC). The aim of the present study was to evaluate the role of US in the management of thyroid nodules with a FNAB reading suspicious for PTC. METHODS: Between August 2002 and May 2006, 303 patients who had thyroid nodules with a FNAB reading suspicious for PTC underwent surgery. The sonographic findings in the patients were classified as suspicious for malignancy or probably benign based on the US reading. The US readings and final pathological diagnoses of thyroid nodules were analyzed in these patients. RESULTS: The malignancy rate was 84.2% in patients with a FNAB specimen suspicious for PTC. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the US were 96.4%, 74.5%, 92.7%, 94.9%, and 80.9%, respectively, in nodules read as suspicious for PTC on FNAB. Whereas 243 (96.4%) lesions were found to be malignant at surgery, in the 252 lesions that had ultrasound findings suspicious for malignancy, only 13 (25.5%) lesions were malignant out of the 51 that had US readings of probably benign (p < 0.05). CONCLUSIONS: The probability of malignancy is much lower in thyroid nodules with benign US findings even if the FNAB is read as suspicious for PTC. Therefore, US may be useful in planning the extent of surgery in patients with a FNAB reading of suspicious for PTC. As thyroid malignancy occurs in approximately 26% of patients with cytology readings suspicious for PTC and benign-appearing US, the US reading alone is not sufficient to determine the need for surgery. The US and FNAB are complementary to each other and should be useful when providing informed consent before thyroid surgery.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
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, Ki Whang(김기황)
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
Park, Cheong Soo(박정수)
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Oh, Ki Keun(오기근)
Chung, Woung Youn(정웅윤)
Hong, Soon Won(홍순원) ORCID logo https://orcid.org/0000-0002-0324-2414
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