Cystic thyroid nodules. The dilemma of malignant lesions

Abstract

In contrast to opinions expressed even less than 10 years ago, present sentiment and publications endorse the general technique of fine-needle aspiration (FNA) for the diagnosis of thyroid nodules. 1,2 Following verification that both aspirationist and cytopathologist have achieved a high degree of accuracy and reliability, the results of FNA usually form the principal basis on which thyroid nodules are managed. Recent publications have focused on identifying and further refining the inadequacies of FNA. 3,4 De los Santos et al5 have correctly pointed out a potential problem with the technique, that of establishing a firm diagnosis on thyroid nodules that are at least partially cystic. In contradistinction to nonbloody simple breast cysts that are virtually always benign, the possibility of a partially cystic thyroid malignancy is clearly a real concern. See also p 1422. This retrospective study of 221 surgically resected thyroid nodules demonstrated that nearly one third were cystic,