Repeated fine-needle aspiration cytology for the diagnosis and follow-up of thyroid nodules

• Main Authors: Agnaldo José Graciano, Carlos Takahiro Chone, Carlos Augusto Fischer, Giuliano Stefanello Bublitz, Ana Jacinta de Aquino Peixoto
• Format: Article
• Language: English
• Published: Elsevier 2014-10-01
• Series: Brazilian Journal of Otorhinolaryngology
• Subjects: Glândula tireoide; Neoplasias da glândula tireoide; Biópsia por agulha fina; Neoplasias de cabeça e pescoço
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942014000500422&lng=en&tlng=en

INTRODUCTION: The recently-proposed Bethesda reporting system has offered clinical recommendations for each category of reported thyroid cytology, including repeated fine-needle aspiration (FNA) for non-diagnostic and atypia/follicular lesions of undetermined significance, but there are no sound indications for repeated examination after an initial benign exam. OBJECTIVE: To investigate the clinical validity of repeated FNA in the management of patients with thyroid nodules. METHOD: The present study evaluated 412 consecutive patients who had repeated aspiration biopsies of thyroid nodules after an initial non-diagnostic, atypia/follicular lesion of undetermined significance, or benign cytology. RESULTS: The majority of patients were female (93.5%) ranging from 13 to 83 years. Non-diagnostic cytology was the most common indication for a repeated examination in 237 patients (57.5%), followed by benign (36.8%), and A/FLUS (5.6%) cytology. A repeated examination altered the initial diagnosis in 70.5% and 78.3% of the non-diagnostic and A/FLUS patients, respectively, whereas only 28.9% of patients with a benign cytology presented with a different diagnosis on a sequential FNA. CONCLUSIONS: Repeat FNA is a valuable procedure in cases with initial non-diagnostic or A/FLUS cytology, but its routine use for patients with an initial benign examination appears to not increase the expected likelihood of a malignant finding.