Fine-Needle Aspiration Versus Frozen Section in the Evaluation of Malignant Thyroid Nodules in Patients With the Diagnosis of Suspicious for Malignancy or Malignancy by Fine-Needle Aspiration.
Context.--The Bethesda System for Reporting Thyroid Cytopathology recommends against the use of intraoperative frozen section (FS) during lobectomy of a thyroid nodule with a fine-needle aspiration (FNA) diagnosis of malignant. Bethesda recommendations for FS in the FNA category of suspicious for ma...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 141; no. 5; pp. 684 - 690 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
May2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122740820&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122740820 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: May2017 vid: 141 iid: 5 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 122740820 122740820 122740820 10.5858/arpa.2016-0305-OA 122740820 ppf: 684 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Fine-Needle Aspiration Versus Frozen Section in the Evaluation of Malignant Thyroid Nodules in Patients With the Diagnosis of Suspicious for Malignancy or Malignancy by Fine-Needle Aspiration. aug: au: Qin Ye Woo, Jennifer S. Qunzi Zhao Ping Wang Pintong Huang Lirong Chen Xin Li Kanlun Xu Ying Yong (Sung-Eun) Yang, Stephanie Jianyu Rao affil: Department of Pathology, Second Affiliate Hospital, Zhejiang University, Hangzhou, China sug: subj: Biopsy, Needle Frozen Sections Thyroid Neoplasms Diagnosis Thyroid Gland Pathology China Intraoperative Care False Negative Results Preoperative Care Thyroidectomy Comparative Studies Retrospective Design Data Analysis Software Fisher's Exact Test Child Adolescence Adult Middle Age Aged Aged, 80 and Over Female Male Human Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: Context.--The Bethesda System for Reporting Thyroid Cytopathology recommends against the use of intraoperative frozen section (FS) during lobectomy of a thyroid nodule with a fine-needle aspiration (FNA) diagnosis of malignant. Bethesda recommendations for FS in the FNA category of suspicious for malignancy (SFM) is less welldefined. In some institutions in China, FS examination is performed during lobectomy even for FNA-proven malignant cases. Objective.--To compare the efficacy of FNA versus FS in the evaluation of malignant thyroid lesions. Design.--A 3-year retrospective analysis from a single institution was performed on cases with an FNA diagnosis of SFM or malignant with subsequent FS examination during thyroidectomy. The results of FNA and FS findings were compared to the final thyroidectomy pathology. Results.--A total of 5832 thyroidectomy procedures were performed: 1265 cases had FNA and FS results available. Fine-needle aspiration gave a diagnosis of SFM to 306 cases and a diagnosis of malignant to 821 cases. Of the SFM cases, 10.5% (32 of 306) had benign/indeterminate, 4.6% (14 of 306) suspicious, and 84.9% (260 of 306) malignant FS results. Final pathology showed 56.3% (18 of 32), 64.3% (9 of 14), and 100% (260 of 260) malignancy rates, respectively. For the malignant FNA group, 10.0% (82 of 821) had benign/indeterminate, 4.4% (36 of 821) suspicious, and 85.6% (703 of 821) malignant FS results. The final pathology showed 96.4% (79 of 82), 97.2% (35 of 36), and 99.9% (702 of 703) malignancy rates, respectively. Conclusions.--Frozen section should not be performed for the malignant FNA category because FS evaluation may result in 10% falsely negative findings. Performing FS for SFM may be better justified; however, more than half of FS cases read as benign in this category had malignant final pathology. Therefore, caution should be taken for FS results even in the SFM group. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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