Issue N# 1 - 2003
Results of fine needle aspiration biopsy, frozen section diagnosis, and definitive histologic results in thyroid pathology (163 cases).
Authors : P. Boutin, A. Bozorg Grayeli, C. Terrada, E. Rondini-Gilli, I. Mosnier, N. Julien, D. Bouccara, O. Groussard, B. Bok, O. Sterkers (Paris)
Ref. : Rev Laryngol Otol Rhinol. 2003;124,1:59-63.
Article published in french
Downloadable PDF document french
Introduction: in thyroid diseases, the place of fine needle aspiration biopsy still continues to be discussed: the sensibility and specificity vary greatly in the literature. Frozen section diagnosis is necessary to form a diagnostic strategy. The objective of this study was compare the results of fine needle aspiration biopsy, frozen section diagnosis, and definitive histologic results in a population of 163 patients and to draw conclusions about treatment. Materiel and method: from 1994 to 1999, 163 patients (132 females and, 31 males) undergoing thyroid surgery were included in this retrospective study, after a standard preoperative work-up. Those with a single palpable nodule and hypofixation on scintigraphy underwent fine needle aspiration before surgery. These results were compared with the definitive histologic results. Results: a loboisthmectomy was performed in 88 cases (54 %), a subtotal thyroidectomy in 34 cases (21 %), and a total thyroidectomy in 41 cases (25 %). In the latter group, an associated neck dissection was performed in 18 cases (11 %); a frozen section diagnosis was obtained in all cases of thyroid nodules. This study demonstrated a single nodule in 97 cases (60 %), multiple nodules in 27 cases (17 %), multinodular goitre in 34 cases (21 %), and 5 Basedow diseases (3 %). Sixty-two cases (38 %) of thyroid nodules underwent fine needle aspiration before surgery. In 25 cases (15 %), definitive pathology showed a malignant lesion. The frozen section diagnosis had a sensitivity of 73 % and a specificity of 99 %, and the fine needle aspiration biopsy had a sensitivity of 40 % and a specificity of 100 %. Conclusion: the authors propose fine needle aspiration biopsy in the following cases: a single palpable nodule and hypofixation on scintigraphy or a surgical contra indication; and direct surgery in symptomatic thyroid disease or if there are one or several full nodules > 2 cm. In near future, these indications will be modified with the increasing reliability of fine needle aspiration biopsy.
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