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Optimal timing for a repeat fine-needle aspiration biopsy of thyroid nodule following an initial nondiagnostic fine-needle aspiration - 18/04/17

Doi : 10.1016/j.amjsurg.2016.04.010 
Ahmed Deniwar, M.D. a, AbdulRahman Y. Hammad, M.D. a, Daniah Bu Ali, M.D. a, Nuha Alsaleh, M.D. a, Maha Lahlouh, M.D. a, Andrew B. Sholl, M.D. b, Krzysztof Moroz, M.D. b, Rizwan Aslam, D.O. c, Tina Thethi, M.D. d, Emad Kandil, M.D., F.A.C.S., F.A.C.E. a,
a Division of Endocrine and Oncological Surgery, Department of Surgery, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA 
b Department of Pathology & Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA 
c Department of Otolaryngology, Tulane University School of Medicine, New Orleans, LA, USA 
d Division of Endocrinology, Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA 

Corresponding author. Tel.: +1-504-988-7407; fax: +1-504-988-4762.

Abstract

Background

In the case of a nondiagnostic thyroid fine-needle aspiration (FNA) biopsy result, recent guidelines from the Bethesda system recommend repeat thyroid FNA after 3 months to prevent false-positive results. We aimed to examine our institutional data to determine whether the 3-month period affects the diagnostic yield of repeat biopsies.

Methods

A retrospective review of patient records over a 5-year period at our institution was performed. Patients who required repeat FNA due to nondiagnostic results were included. The time between the FNA biopsies, adequacy of the FNA specimens, as well as the surgical pathology diagnosis were analyzed.

Results

We identified 317 patients who required a repeat FNA. Of these, 96 (30.3%) patients had repeat FNAs less than 3 months after initial biopsy, while 221 (69.7%) patients had repeat FNAs in greater than 3 months. One hundred five patients were referred to our clinic with an initial nondiagnostic biopsy from an outside institution. Repeat FNA was nondiagnostic in 35 patients (11.04%) in the total study population. There was no difference in satisfactory diagnostic yield between repeat FNAs performed greater than 3 months (201 patients, 90.95%) or less than 3 months (81 patients, 84.38%) after the initial biopsy (P = .117). Of the 35 patients with repeat nondiagnostic biopsy, 17 patients underwent diagnostic lobectomy and 3 (17.6%) patients were found to have malignant disease.

Conclusions

Early (<3 months) repeat FNA does not affect diagnostic yield of the subsequent sample. Patients with suspicious thyroid nodules could therefore receive a repeat FNA as soon as needed, rather than waiting 3 months. The shortened biopsy interval would alleviate stress on patients with benign nodules and expedite surgical intervention in patients with malignancy.

El texto completo de este artículo está disponible en PDF.

Highlights

Repeating nondiagnostic thyroid FNA within 3 months was proposed.
No significant difference was found between FNA repeated within or after 3 months.
Short interval will alleviate stress and expedite intervention for malignancy.

El texto completo de este artículo está disponible en PDF.

Keywords : Fine-needle aspiration, Repeat FNA, Thyroid nodule, Bethesda criteria, Bethesda recommendations, Thyroid cancer


Esquema


 The authors have no financial interest in companies or other entities that have an interest in the information included in the contribution.
 The authors declare no conflicts of interest.


© 2016  Publicado por Elsevier Masson SAS.
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Vol 213 - N° 2

P. 433-437 - février 2017 Regresar al número
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