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The impact of using defined criteria for adequacy of fine needle aspiration cytology of the thyroid in routine practice.
MedLine Citation:
PMID:  20091892     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The fine needle aspiration cytology (FNAC) of the thyroid is the predominant method of preoperative tissue diagnosis of thyroid lesions. The routine use of FNAC has reduced the rate of unnecessary surgery for thyroid nodules. However, there are overlaps in the existing criteria for defining adequacy in thyroid aspirates. In this study, we aimed to explore the reasons for high percentage of inadequate thyroid FNAC samples and to reevaluate those samples by applying clearly defined criteria suggested in the literature to reduce the proportion of inadequate aspirates. The results of 550 smears reported as inadequate FNAC samples are presented over a period of 15 years extending from 1986 to 2000 (18.8%). For the purpose of the study, only those patients with subsequent histological or cytological analysis were included (279). The original FNA samples were reviewed by two cytopathologists, unaware of the subsequent repeat cytology or histology results. Specific criteria for adequacy of specimens were used which include the presence of six or more groups of follicular cells, each having more than 10 discernable viable cells or 60 isolated viable follicular cells. Out of 279, 82 (29%) FNAC samples originally reported as inadequate met our criteria and were considered adequate on review. Of these 82 cases, subsequent surgical excision showed malignancy in 5 cases (6%), adenoma in 7 (9%), and benign hyperplasia and thyroiditis in 70 cases (85%). In addition, 16 (5%) cases were classified as cysts. The slide preparation error was noticed in 26 (14%) and the sampling error was observed in 160 (86%) cases. The use of well-defined criteria for adequacy is helpful because it improves the diagnostic efficiency of thyroid FNA and avoids unnecessary surgery for benign nonneoplastic thyroid lesions. However, since application of these criteria has also resulted in an increase in the false-negative diagnoses, they should be applied in the multidisciplinary context. Diagn. Cytopathol. 2011;39:81-86. © 2010 Wiley-Liss, Inc.
Authors:
Asma S Haider; Emad A Rakha; Christine Dunkley; Abed M Zaitoun
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diagnostic cytopathology     Volume:  39     ISSN:  1097-0339     ISO Abbreviation:  Diagn. Cytopathol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506895     Medline TA:  Diagn Cytopathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Wiley-Liss, Inc.
Affiliation:
Department of Cellular Pathology, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom.
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