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The fine-needle aspiration biopsy efficacy of small thyroid nodules in the area of recently normalized iodine supply

Dorota Sowiska-Klencka¹, Boena Popowicz¹, Andrzej Lewiski², Stanisaw Sporny³ and Mariusz Klencki¹

¹ Department of Morphometry of Endocrine Glands, Chair of Endocrinology and Metabolic Diseases² Clinic of Endocrinology and Metabolic Diseases, Chair of Endocrinology and Metabolic Diseases³ Department of Dental Patomorphology, Chair of Patomorphology, Medical University of Lodz, Sterlinga Street No 5, 91-425 Lodz, Poland

(Correspondence should be addressed to D Sowiska-Klencka; Email: dsk{at}tyreo.am.lodz.pl)

Objective: To evaluate the incidence of focal lesions in the thyroid in the area of recently normalized iodine supply as well as to compare the efficacy of fine-needle aspiration biopsy (FNAB) of small (infracentimetric) and large thyroid lesions in this area.

Methods: The outcomes of 13 646 ultrasound (US) examinations, 13 437 US-guided FNABs of the thyroid and 1694 results of post-operative histopathological examinations were analysed.

Results: Infracentimetric nodules (INs 10 mm) were revealed by US examinations in 43.5% of patients; in the majority of the cases (82.2%) INs were multiple. The percentage of revealed carcinomas by aspiration of INs is similar to that observed when large nodules (LNs >10 mm) are examined cytologically. However, the efficiency of preoperative diagnosis of INs is lower than LNs with respect to both US selection of lesions for FNAB and the percentage of false negative results of FNAB (29.8 vs 5.4%, P<0.001). In post-operative histopathological examination, extrathyroidal extension of thyroid cancers was observed in nearly 30% of microcarcinomas.

Conclusions: In endemic or post-endemic areas, the efficiency of FNAB is lower in the case of small lesions than larger ones. In spite of this, the percentage of cytologically revealed carcinomas among small lesions is not lower than larger ones. Thus, it is particularly indicated to follow up small thyroid lesions with repeated US examinations in such areas.

This article has been cited by other articles:

				B. Popowicz, M. Klencki, A. Lewinski, and D. Slowinska-Klencka The usefulness of sonographic features in selection of thyroid nodules for biopsy in relation to the nodule's size Eur. J. Endocrinol., July 1, 2009; 161(1): 103 - 111. [Abstract] [Full Text] [PDF]