Fine needle aspiration cytology for parotid neoplasms: risk of malignancy through inconclusive results and lower grade tumors

Ultrasonography-guided fine-needle aspiration biopsy is the common choice for diagnosis of the suspected thyroid nodule. An algorithm(s) that finds the malignant potential of a nodule preoperatively, to overcome unnecessary diagnostic methods, does not exist. The objective of the study was to correlate thyroid nodule sizes measured by ultrasonography and risk of malignancy assessed by cytologic and histologic examinations. Data regarding fine-needle aspiration cytology and the results of histologic examinations of surgical specimens of 260 nodules were collected and analyzed. The macro or multiple calcifications, the complex echo pattern, and posterior region homogeneity were considered suspicious in ultrasonography. Bethesda system for classification of thyroid nodules was used for cytopathology. Histopathology performed as per the 2004 World Health Organization classification system. The benefit score analysis was performed for determination of clinical usefulness. Twenty-eight of 49 malignant nodules and 46 of 68 malignant nodules detected through ultrasound following fine-needle aspiration cytopathology and histopathology were <2 cm in size. A correlation was found for malignancy rate detected by ultrasonography-guided fine-needle aspiration cytology and those of the surgical specimen ( r = 0.945, P = .015, R 2 = 0.894). Ultrasonography-guided fine-needle aspiration cytology had 0.994 sensitivities, 0.721 accuracies, and 0.08 to 0.945 diagnostic confidence for the detection of malignant nodules. Nodule size less than 2 mm ( P = .011) was associated with the malignancy potential of thyroid nodules. Ultrasonography-guided fine-needle aspiration cytology had 19 (7%) results as a false negative and 1 (1%) results were false positive. Ultrasound-guided fine-needle aspiration cytopathology reported oversize of thyroid nodule than original but can predict the risk of malignancy. Level of Evidence: III.

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O31: CORRELATION BETWEEN THYROID FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) SCORES AND CANCER INCIDENCE ON FINAL HISTOPATHOLOGY – A MULTI-CENTRE RETROSPECTIVE ANALYSIS

British Journal of Surgery ◽

10.1093/bjs/znab117.031 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

O Iwegbulem ◽

Z Razzaq ◽

F Crowley ◽

M Majeed ◽

D Cagney ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Risk Of Malignancy ◽

Bethesda System ◽

Needle Aspiration Cytology ◽

The Bethesda System

Abstract Introduction Fine Needle Aspiration Cytology (FNAC) is the best diagnostic tool for evaluating thyroid nodules pre-operatively. The Bethesda System for Reporting Thyroid Cyto-pathology (TBSRTC) in America and THY classification in Europe are standardized reporting systems for thyroid FNAC specimens using six categories. As compared to the first edition in 2009, a second edition of TBSRTC published in 2017 has revised risk of malignancy (ROM) for these categories, with focus on atypia of unknown significance (Thy3A) upgraded to 10-30% from previously 5-15%, and suspicion for follicular neoplasm (Thy3F) 25-40% from previous 15-30%. Method A three-year audit of thyroid surgeries performed in two high volume thyroid institutions from January 2016 to September 2019, was performed retrospectively. The FNAs were performed by thyroid specialist radiologists with a cytopathology technician in attendance for rapid on-site evaluation and reported as per TBSRTC and Thy classification, by a Consultant Cyto-pathologist from a single institution. Result A total of 702 patients were examined. There were 552 patients who had corresponding FNAC prior to surgery (mean age 53.6 years, females 79%). The rates of malignancy were, Thy1: 9.3%, Thy2: 4.6%, Thy3A: 10.8%, Thy3F: 28.7%, Thy4: 82.3% and Thy5: 100%. The main types of thyroid malignancy were Papillary (73.6%), Follicular (14.1%), Medullary (4%), Anaplastic (4.7%) and others (3.6%). Conclusion Pre-operative diagnosis of thyroid nodules using TBSRTC was comparable and the criteria helped avoid misinterpretation of results. Our results were comparable with the risk of malignancy in 2009 edition of TBSRTC, as compared to the 2017 revision. Take-home message Pre-operative diagnosis of thyroid nodules using The Bethesda System for Reporting Thyroid Cyto-pathology (TBSRTC) was comparable and the criteria helped avoid misinterpretation of results. Our results were comparable with the risk of malignancy in 2009 edition of TBSRTC, as compared to the 2017 revision.

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Re: Use of fine-needle aspiration cytology in the diagnosis of parotid neoplasms

ANZ Journal of Surgery ◽

10.1111/ans.13263 ◽

2015 ◽

Vol 85 (11) ◽

pp. 892-892 ◽

Cited By ~ 2

Author(s):

Arosha Weerasinghe ◽

Francis Yi Xing Lai ◽

Monica May Jun Foong

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Parotid Neoplasms ◽

Needle Aspiration Cytology

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Percutaneous ultrasound-guided fine needle aspiration cytology of pulmonary lesions: a single centre experience

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587791 ◽

2016 ◽

Vol 37 (S 01) ◽

Author(s):

A Pecorelli ◽

R Nani ◽

R Agazzi ◽

S Sironi

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Single Centre ◽

Aspiration Cytology ◽

Fine Needle ◽

Pulmonary Lesions ◽

Single Centre Experience ◽

Needle Aspiration Cytology

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Role of fine needle aspiration cytology in the preoperative diagnosis of malignancy in parotid and submandibular gland neoplasm

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v19i2.17634 ◽

2014 ◽

Vol 19 (2) ◽

pp. 110-118

Author(s):

Mohammad Amzad Hossain ◽

Md Zahedul Alam ◽

Md Rojibul Haque ◽

Md Nazmul Haque ◽

KM Nurul Alam ◽

...

Keyword(s):

Submandibular Gland ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

False Negative ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Medical College ◽

Preoperative Diagnostic ◽

Needle Aspiration Cytology

Objective: To evaluate the role of Fine Needle Aspiration Cytology in the preoperative diagnosis of malignancy in parotid and submandibular gland neoplasm. Methods: This cross sectional study on 50 cases was conducted in the Department of Otolaryngology and Head-Neck Surgery of Sir Salimullah Medical College Mitford Hospital and Dhaka Medical College Hospital from January2009 to June 2010. Results: Fine needle aspiration cytology findings of our all 50 cases were compared with postoperative histopathological reports. Out of the 50 cases, in 36(72%) cases of benign neoplasm and 7(14%) cases of malignant neoplasm, pre-operative FNAC findings and post operative histopathological findings were same. In 7 cases, FNAC and post operative histopathological findings did not matched. These were 2 (4%) false positive and 5 (10%) false negative result.In our study sensitivity of FNAC for reporting malignancy was 58.33%, specificity to rule out malignancy was 94.73% and overall accuracy in detecting malignant tumour was 86%. Positive predictive value and negative value were 77.77% and 87.80% respectively. It can be concluded that fine needle aspiration cytology is a safe, cheap and useful preoperative diagnostic tool in the diagnosis of malignancy in parotid and submandibular gland, but as fine needle aspiration cytology partly depends on operator skill, it may give false negative and false positive result. Conclusion: FNAC is a useful preoperative diagnostic tool for malignant parotid and submandibular glands with high specificity and sensitivity. DOI: http://dx.doi.org/10.3329/bjo.v19i2.17634 Bangladesh J Otorhinolaryngol 2013; 19(2): 110-118

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