Correlation of fine needle aspiration cytology and frozen section biopsies in the diagnosis of thyroid nodules.
Open Access
- 1 December 1997
- journal article
- research article
- Published by BMJ in Journal of Clinical Pathology
- Vol. 50 (12), 1005-1009
- https://doi.org/10.1136/jcp.50.12.1005
Abstract
AIMS: To evaluate the correlation of fine needle aspiration (FNA) cytology and frozen section biopsy in the diagnosis of thyroid nodules. METHODS: The medical records of 662 patients who underwent FNA cytology of the thyroid and thyroid surgery were analysed. Frozen section biopsies were taken from 586 of the 662 patients. The diagnostic correlations of FNA cytology, frozen section, and both FNA cytology and frozen section with definitive histological assessment were evaluated. RESULTS: Among the 662 patients who received FNA cytology, there were 356 cases (53.8%) diagnosed as benign, 114 cases (17.2%) as malignant, 148 cases (22.4%) as indeterminate, and 44 cases (6.6%) as unsatisfactory. The positive predictive value for the detection of malignancy by FNA cytology was 92.1% and the negative predictive value was 95.2%. The incidence of malignancy in the indeterminate cytological diagnosis was 23%. The diagnosis from frozen sections was benign in 445 cases (75.9%), malignant in 134 cases (22.9%), and deferred in 7 cases (1.2%). By frozen section, the positive and negative predictive values were 97% and 95.5%, respectively. Diagnostic accuracy up to 98% was achieved when FNA cytology and frozen section diagnoses were in agreement. No false positives were observed when FNA cytology and frozen sections were both positive for malignancy. When FNA cytology and frozen section diagnoses were discordant, frozen section showed a higher accuracy (78.9%) than FNA cytology (21.1%). In the face of an indeterminate or unsatisfactory cytological diagnosis, the diagnostic accuracy of frozen sections reached 92.6%. CONCLUSIONS: The results confirm that FNA cytology is a useful tool in the initial evaluation of thyroid nodules. Intraoperative frozen section is a valuable procedure to confirm the cytological diagnosis and identify malignancy in patients with indeterminate or unsatisfactory cytological diagnosis. With reliance on frozen sections as an intraoperative guide of thyroid surgery, the possibility of unnecessary extensive surgery and the need for the second operation are considerably lower.Keywords
This publication has 18 references indexed in Scilit:
- Prevalence of goiter in Taiwanese adults: a preliminary study.1995
- Intraoperative decision making during thyroid surgery based on the results of preoperative needle biopsy and frozen section.1990
- FINE NEEDLE ASPIRATION CYTOLOGY OF THYROID-GLAND DISEASES1990
- Sources of diagnostic error in fine needle aspiration of the thyroidCancer, 1989
- FINE NEEDLE ASPIRATION CYTOLOGIC DIAGNOSIS OF THE SOLITARY COLD THYROID-NODULE - COMPARISON WITH ULTRASONOGRAPHY, RADIONUCLIDE PERFUSION STUDY AND XERORADIOGRAPHY1989
- CLINICOPATHOLOGIC MANAGEMENT OF TUMORS OF THE THYROID-GLAND IN AN ENDEMIC GOITER AREA - COMBINED USE OF PREOPERATIVE FINE NEEDLE ASPIRATION BIOPSY AND INTRAOPERATIVE FROZEN SECTION1989
- ACCURACY AND SIGNIFICANCE OF FINE-NEEDLE ASPIRATION AND FROZEN SECTION IN DETERMINING THE EXTENT OF THYROID RESECTION1987
- Diagnostic accuracy of fine-needle aspiration biopsy versus frozen section in solitary thyroid nodulesThe American Journal of Surgery, 1986
- The role of fine needle aspiration in the management of the thyroid noduleThe Laryngoscope, 1985
- The diagnosis of malignant follicular neoplasms of the thyroid by needle biopsyCancer, 1985