Document Detail

False-negative Results with the Bethesda System of Reporting Thyroid Cytopathology: Predictors of Malignancy in Thyroid Nodules Classified as Benign by Cytopathologic Evaluation.
MedLine Citation:
PMID:  25105404     Owner:  NLM     Status:  In-Data-Review    
The benign category of the Bethesda System for reporting thyroid cytopathology (BSRTC) predicts an incidence of malignancy from zero to three per cent. However, recent series report higher rates of malignancy ranging from eight to 14 per cent. Surgery is often performed for reasons other than their fine needle aspiration biopsy (FNAB) such as symptoms, nodule enlargement, or worrisome imaging. We hypothesized that an analysis of patients who underwent thyroidectomy despite a benign FNAB would identify predictors of malignancy, an area not currently addressed by American Thyroid Association guidelines. We performed a retrospective analysis of patients with benign FNAB results who underwent thyroidectomy from October 2007 to October 2012. Data collected included symptoms, imaging findings, FNAB results, and operative and histopathology results, all of which were obtained by chart review. Findings were compared between patients with and without a diagnosis of malignancy. Statistical significance was set as P < 0.05. Of 3839 FNABs, 2838 were benign. Of these, 180 underwent surgery for indications other than the FNAB category. Twenty-four (13.4%) malignancies were identified: 12 (6.7%) incidental microcarcinomas and 12 (6.7%) significant cancers (papillary greater than 1.0 cm, any nonpapillary histology). No patient's symptoms or signs reached significance as a predictor of malignancy. Suspicious ultrasound appearance was significantly associated with an underlying carcinoma (P = 0.004). The false-negative result with benign FNAB is higher in surgical series than suggested by the BSRTC. Patients with tolerable symptoms may be observed in the face of a benign FNAB. Additionally, despite a benign FNAB, recommendations for closer follow-up or surgical intervention are warranted if the ultrasound appearance is suspicious.
Bryan K Richmond; Rudy Judhan; Benny Chong; Adam Ubert; Zachary AbuRahma; William Mangano; Stephanie Thompson
Related Documents :
16761964 - What is the biological basis of pattern formation of skin lesions?
19465814 - Arcing injuries in a fatal electrocution.
11775764 - Neurotic excoriations.
19825094 - Prevention of work-related skin diseases: teledermatology as an alternative approach in...
8285834 - Osseous metaplasia in benign colorectal polyps.
15770974 - Fdg-pet in a case of multiple bone metastases of gastric cancer.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  80     ISSN:  1555-9823     ISO Abbreviation:  Am Surg     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-08-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  811-6     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Systematic Review: Surgery for Patients with Metastatic Melanoma during Active Treatment with Ipilim...
Next Document:  Parathyroid hormone levels predict posttotal thyroidectomy hypoparathyroidism.