Abstract
Objective: Although fine needle aspiration cytology (FNAC) is the most reliable, safe and accurate method for the clinical management of abnormal thyroid nodules, 5%-15% of cases lead to indeterminate diagnoses and surgery is the recommended practice for them as they may be malignant. Nevertheless, the majority of cases with indeterminate cytology are benign, so the risk of unnecessary surgery is significant. In our study we combined FNAC and scintigraphy in order to reduce the number of inappropriate surgeries. Subjects and Methods: From 219 patients with thyroid fine needle aspiration cytology 33(9 males and 24 females) aged 18-73 years, had indeterminate FNAC diagnoses and were referred for scintigraphy. Surgery was performed in all cases. The results of FNAC, scintigraphy and histology were collected and compared. Results: From 33 cases with indeterminate cytology 32 had a benign histological diagnosis and only one was malignant (follicular Ca). That case had a positive scan. All cases with negative thyroid scans (29/33) were benign. False positive scans were 3, whereas one scan was true positive with final diagnosis follicular carcinoma. Conclusion: This study showed that combining the FNAC with the thyroid scintigraphy in cases of thyroid nodules with indeterminate cytology it is possible to reduce the number of inappropriate surgeries from 32 to 3.
Highlights
Thyroid nodules are not a rare problem and it is well known that most of them are a result of a benign disease process, it is clinically important to exclude malignancy.Thyroid nodules are usually asymptomatic and found on physical examination or incidentally with the use of sensitive imaging techniques
Objective: fine needle aspiration cytology (FNAC) is the most reliable, safe and accurate method for the clinical management of abnormal thyroid nodules, 5%-15% of cases lead to indeterminate diagnoses and surgery is the recommended practice for them as they may be malignant
This study showed that combining the FNAC with the thyroid scintigraphy in cases of thyroid nodules with indeterminate cytology it is possible to reduce the number of inappropriate surgeries from 32 to 3
Summary
Thirty three patients that fell into an indeterminate category after FNAC, were selected for the current study. All were patients with single nodules more than 1cm in size. Twenty four patients were females and 9 were. The selected cases had recommendations for FNAC based on experts opinion, mainly suspicious sonographic and/or clinical features. The thyroid scans were obtained after intravenous administration of 100MBq of technetium99m pertechnetate (99mTcO4-) and they were imaged on a dual-head Siemens gamma camera (E- Cam, Siemens Electronics, Erlangen, Germany) 20 and 60 minutes later. All scans were obtained in the anterior position. Final histological diagnoses were evaluated by three experienced pathologists after surgery in all 33 patients. The results of FNAC, scintigraphy and histology were compared
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
