Fine-Needle Aspiration Cytology
نویسنده
چکیده
The multidisciplinary team dealing with patients with thyroid nodules must include a pathologist. The aim is to make the correct diagnosis as soon as possible after presentation, to prevent surgery where it is not required, and to allow treatment to be planned when malignancy is diagnosed. The first investigation should now be fine-needle aspiration (FNA) cytology. With adequate specimens, the pathologist can give a relatively clear indication of the nature of the lesion. A diagnosis of benign disease indicates that the nodule need not be removed other than for local pressure effects or cosmetic reasons. This has reduced surgical intervention for thyroid nodules by up to 50%, and has increased the yield of cancers in surgical specimens from 10–15% up to 20–50% [1]. However, FNA is not yet the norm, and the proportion of patients having FNA varies in different centers. Recent studies from the USA and UK suggest that FNA is used as the initial procedure in only 52–84% of patients with thyroid nodules [2]. In dealing with the surgical specimen the pathologist should provide a definitive diagnosis and try to identify features that correlate with a more aggressive pattern of behavior. For example, distinguishing minimally from widely invasive follicular carcinoma and defining certain variants of papillary carcinoma. Pathology also contributes to the staging by defining the maximum dimension of the tumor, the presence or absence of extrathyroidal spread, the presence of ipsilateral or contralateral lymph node involvement, and sometimes the presence of metastases.
منابع مشابه
Diagnostic Accuracy of Frozen Section in Comparison With Fine Needle Aspiration Cytology in Thyroid Lesions – A Prospective Study
Background and Objectives: Thyroid gland because of its superficial location is amenable to direct physical examination. Clinical assessment of thyroid lesions by means of physical examination, thyroid scans and ultrasonography is not completely reliable. Fine needle aspiration cytology (FNAC) is the most cost-effective, safe and an initial diagnostic test in the pre-operative evaluation of thy...
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