Thyroid Cancer Detected by Ultrasound‐Guided Fine‐Needle Aspiration Biopsy

• Published in: World journal of surgery 1996-09, Vol.20 (7), p.848-853
• Main Authors: Yokozawa, Tamotsu, Fukata, Shuji, Kuma, Kanji, Matsuzuka, Fumio, Kobayashi, Akira, Hirai, Keisuke, Miyauchi, Akira, Sugawara, Masahiro
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Follicular - diagnostic imaging; Adenocarcinoma, Follicular - pathology; Adenocarcinoma, Follicular - surgery; Adult; Anaplasia; Benign Lesion; Biopsy, Needle; Calcinosis - complications; Calcinosis - pathology; Carcinoma; Carcinoma - diagnostic imaging; Carcinoma - pathology; Carcinoma - surgery; Carcinoma, Medullary - diagnostic imaging; Carcinoma, Medullary - pathology; Carcinoma, Medullary - surgery; Carcinoma, Papillary - diagnostic imaging; Carcinoma, Papillary - pathology; Carcinoma, Papillary - surgery; Female; Graves Disease - complications; Graves Disease - pathology; Humans; Male; Middle Aged; Palpation; Papillary Carcinoma; Thyroid Cancer; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroid Nodule - diagnostic imaging; Thyroid Nodule - pathology; Thyroid Nodule - surgery; Thyroidectomy; Thyroiditis; Thyroiditis, Autoimmune - complications; Thyroiditis, Autoimmune - pathology; Ultrasonography, Interventional
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s002689900129

A greater percentage of thyroid cancers can be detected by ultrasound‐guided fine‐needle aspiration biopsy (UG‐FNAB) than by ordinary FNAB. A group of 678 patients were selected sequentially as having been diagnosed with benign nodules by the conventional FNAB method. We reexamined these patients by UG‐FNAB and investigated the types of thyroid cancer that were missed by the conventional FNAB. Of the 678 patients diagnosed with benign nodules (using conventional FNAB), 571 (84.2%) demonstrated the same diagnosis when UG‐FNAB was used. The remaining 107 patients (15.8%) studied were suspected of having a malignancy after UG‐FNAB had been performed. Surgical specimen histology proved thyroid cancer in 99 of the 107 patients: 93 had papillary carcinoma, 4 had follicular carcinoma, 1 had medullary carcinoma and 1 had anaplastic carcinoma. Two drawbacks were noted when conventional FNAB was used: (1) cancer lesions difficult to palpate (n= 55) (e.g., small cancers with or without benign lesions or cancers associated with Hashimoto's thyroiditis or Graves’ disease); and (2) palpable cancers with insufficient cell material for analysis (n= 44) (e.g., cystic carcinoma and cancers with calcified lesions. UG‐FNAB is a powerful technique for detecting microcancers, cystic carcinomas, cancers associated with benign nodules, Hashimoto's thyroiditis, or coarse calcifications.