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Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules

 Choi, Yoon Seong  ;  Hong, Soon Won  ;  Kwak, Jin Young  ;  Moon, Hee Jung  ;  Kim, Eun-Kyung 
 ANNALS OF SURGICAL ONCOLOGY, Vol.19(7) : 2304-2309, 2012 
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Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; Carcinoma, Papillary/diagnostic imaging* ; Carcinoma, Papillary/pathology* ; Carcinoma, Papillary/surgery ; Cytodiagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; 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
Fine Needle Aspiration ; Thyroid Nodule ; Cytologic Diagnosis ; Follicular Neoplasm ; American Thyroid Association
BACKGROUND: The purpose of this study was to investigate the clinical and ultrasonographic (US) findings affecting the nondiagnostic cytology and malignancy rate in thyroid nodules with nondiagnostic cytology upon a second ultrasound-guided fine needle aspiration (US-FNA). MATERIALS AND METHODS: A total of 1124 nodules in 1081 patients (M:F=111:970; mean age, 48.5 years) with 2 or more US-FNAs were included. Clinical and US features were compared between the nodules with nondiagnostic results and diagnostic results from their second FNA using univariate and multivariate analyses. The malignancy rate was analyzed in terms of nondiagnostic cytology. RESULTS: Among 458 nondiagnostic results of the initial FNA, 94 nodules (20.5%) still had nondiagnostic results on the second FNA. Having cystic portion>50% (odds ratio [OR]=2.845, P=.0001), nondiagnostic cytology of the first FNA (OR=2.813, P<.0001), a nodule size≤5 mm (OR=1.742, P=.0331), or hypoechogenicity (OR=1.512, P=.0404) were factors significantly affecting the incidence of nondiagnostic results in the second US-FNA based on multivariate analysis. The malignancy rate was 11.4% in the nodules with nondiagnostic results in the first FNA and 3.2% in the nodules with serial nondiagnostic results in both the first and second FNAs. CONCLUSIONS: The high probability of nondiagnostic results from a second FNA should be considered if a nodule shows cystic portion greater than 50%, nondiagnostic cytology on the first FNA, a nodule size≤5 mm, or hypoechogenicity. The malignancy rate of thyroid nodules with 2 consecutive nondiagnostic results was 3.2%.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
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
Choi, Yoon Seong(최윤성)
Hong, Soon Won(홍순원) ORCID logo https://orcid.org/0000-0002-0324-2414
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