Journal List > Korean J Cytopathol > v.19(2) > 1006518

Korean J Cytopathol. 2008 Sep;19(2):144-151. Korean.
Published online September 30, 2008.  https://doi.org/10.3338/kjc.2008.19.2.144
Copyright © 2008 The Korean Society for Cytopathology
Correlation and Accuracy Between Fine Needle Aspiration Cytology of Thyroid Lesions and Histopathologic Diagnosis -Analysis of 322 Histopathologically Confirmed Cases -
Jaseung Koo, M.D., Woo-Hee Jung, M.D., Seokwoo Yang, M.D. and SoonWon Hong, M.D.
Department of Pathology, Yonsei University Health System, Yongdong Severance Hospital, Seoul, Korea.
Received July 09, 2008; Accepted August 25, 2008.

Abstract

Fine needle aspiration (FNA) cytology is the decisive test in the preoperative diagnostics of thyroid nodules. Here we share our institutional experience about thyroid aspiration and give suggestions for suspicious cytology results. Three hundred twenty-two cases in 270 patients (mean age 47.4 years, 243 women and 27 men) who underwent thyroidectomy were reviewed. Among the 322 cases, the FNA diagnosis of "positive for malignancy" was 87 cases (27.0%), "suggestive of malignancy" 30 cases (9.3%), "suspicious for malignancy" 61 cases (18.9%), "negative for malignancy" 102 cases (31.7%), and "unsatisfactory smear" 42 cases (13.0%). Eighty seven cases (100%) out of "positive for malignancy", 29 cases (96.7%) out of "suggestive of malignancy", and 39 cases (64.0%) out of "suspicious for malignancy" were papillary carcinoma (148 cases, 95.5%), or follicular carcinoma (2 cases, 1.3%), or metastatic carcinoma (1 case, 0.6%). Seventeen patients who had only negative or unsatisfactory cytology underwent thyroidectomy and nine cases (52.9%) were papillary carcinoma. We suggest that: the cytology diagnosis of "suggestive of malignancy" could be regarded as "positive for malignancy", the cytology diagnosis of "suspicious of malignancy" should be carefully correlated with clinico-radiologic manifestation, and even a negative or unsatisfactory smear should be carefully followed up.

Keywords: Thyroid; Fine needle aspiration cytology

Figures


Fig. 1
A suspicious case in cytologic smear. This case shows high cellularity(A), and nuclear clearing, grooves and rare pseudoinclusion(B)(Papanicolaou stain). This case represents similar nuclear feature of papillary carcinoma(C)(H&E). The immunohistochemical stains reveal weak positive reaction to cytokeratin 19, and negative reaction to galectin-3. Therefore, the diagnosis of this case is cellular adenomatous hyperplasia(Immunohistochemical stain; D: CK19; E: galectin-3).
Click for larger image

Tables


Table 1
FNA cytologic diagnosis and corresponding histologic findings after thyroid surgery
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Table 2
Case review of histologically non-tumor cases with suspicious cytology
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