Timing of Repeat Thyroid Fine-Needle Aspiration in the Management of Thyroid Nodules

2011 ◽  
Vol 55 (6) ◽  
pp. 544-548 ◽  
Author(s):  
Remmi S. Singh ◽  
Helen H. Wang
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Thyroid Fine Needle Aspiration

scholarly journals Managing Thyroid Nodules in Qatar During the COVID19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A841-A842
Author(s):  
Zaina Alamer ◽  
Gowri Karuppasamy ◽  
Arwa Alsaud ◽  
Tania Jaber ◽  
Hanan Farghaly ◽  
...  
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Fine Needle Aspiration ◽  
Medical Staff ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Morbidity And Mortality ◽  
American Thyroid Association ◽  
Fine Needle ◽  
Thyroid Fine Needle Aspiration

Abstract Background: The Coronavirus disease 2019 (COVID-19) pandemic impacted health care systems in all countries, including Qatar. Hamad Medical Corporation (HMC); In compliance with recommendations, suspended all non-urgent procedures, including thyroid fine needle aspiration biopsies (FNAB). Thyroid nodules are second most common cause of referral to HMC endocrine clinic. FNABs are gold standard to differentiate benign from malignant nodules.1- 2 Methods: Our approach includes a teleconsultation to obtain patient’s history and risk factors. Reviewing neck ultrasound (US), obtaining a calcitonin level if indicated, considering comorbidities associated with a high risk of COVID-19 morbidity and mortality.3 Results: We developed a pathway triaging thyroid (FNAB) to:1-Urgent: patients at higher risk of aggressive thyroid malignancy. Benefits of early detection and treatment outweigh the risk of COVID-19 exposure.4 FNAB should not be delayed.2-Semi-urgent: patients at low risk for COVID-19 and high suspicion thyroid nodules, but no evidence that early detection improves survival2, FNAB may be delayed up to 12 months.3-Non-urgent: patients with asymptomatic nodules that have low or intermediate suspicion US pattern.2 Also, includes nodules with ATA high suspicion US pattern in pregnant women and patients at high risk for COVID-19. The risks outweigh the benefits. FNAB should be delayed until outbreak is controlled.4 When urgent FNAB is indicated, safety of patients and medical staff needs to be addressed.5 We recommend testing patient for COVID-19 before FNAB, utilizing US guidance with rapid on-site adequacy evaluation in all cases. Cervical lymph node FNAB with TG washout should be done if indicated. The patient should wear a mask. All medical staff involved should wear personal protective equipment (PPE). The operator should wear N95 mask and face shield. The patient should be informed about cytopathology results via telemedicine. Conclusion: Triaging thyroid (FNAB) during the COVID-19 pandemic should be based on nodule characteristics and risk of COVID-19 morbidity and mortality. Our group recommends deferring FNAB for asymptomatic patients.4FNAB should not be delayed in selected patients who benefit from early detection and intervention. Table1: Triage of Thyroid fine needle aspiration biopsies (FNAB). ATA: American thyroid association. US: ultrasound.

scholarly journals Impact of Molecular Testing in the Diagnosis of Thyroid Fine Needle Aspiration Cytology: Data from Mainland China

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Hui-qin Guo ◽  
Huan Zhao ◽  
Zhi-hui Zhang ◽  
Yan-li Zhu ◽  
Ting Xiao ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Molecular Testing ◽  
Benign Lesions ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Thyroid Fine Needle Aspiration ◽  
Needle Aspiration Cytology

Background. The molecular work-up of thyroid nodules from fine needle aspiration samples has given clinicians a new level of diagnostic information. The aim of the present study was to evaluate the utility of molecular analysis in thyroid fine needle aspiration samples from a Chinese population.Methods. Specimens were collected from thyroid nodules by fine needle aspiration. Cytology diagnosis and genes analysis were performed and correlated with histology outcome.Results. A total of 83 patients with thyroid nodules were enrolled, including 20 benign lesions and 63 papillary carcinomas. BRAF and RAS mutations and RET/PTC gene rearrangements were found in 65.1%, 0%, and 1.6% of papillary carcinomas, respectively. No gene alterations were found in benign lesions. The combination of BRAF testing and cytology improved the accuracy of cytology from 69.9% to 89.2%(P<0.05). Moreover, BRAF testing confirmed 82.4% of papillary carcinomas with suspicious cytology and identified 33.3% of papillary carcinomas with atypia cytology.Conclusions. Of the three candidate markers, BRAF testing showed diagnostic utility in fine needle aspiration. Combining BRAF testing with cytology improves the accuracy of fine needle biopsy. Those who have positive BRAF and malignant or suspicious malignant cytology can undergo thyroidectomy without a frozen section.

Diagnostic value of the candidate microRNAs in thyroid fine-needle aspiration biopsy (FNAB) samples

2020 ◽  
Vol 41 (2) ◽  
Author(s):  
Mohammad-Reza Mahmoudian-Sani ◽  
Maryam Amrollahi-Sharifabadi ◽  
Abdolmajid Taheri ◽  
Seyed Masih Hosseini ◽  
Kamran Tahmasebi ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Thyroid Tumor ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Thyroid Fine Needle Aspiration ◽  
Needle Aspiration Biopsy ◽  
Benign Thyroid

AbstractBackgroundThyroid cancer (TC) is known to be the most common endocrine malignancy with an incidence rate which has increased by 2.3-fold over the past 30 years. Approximately, 30% of the thyroid fine-needle aspiration biopsy (FNAB) outcomes are indecisive. Moreover, researchers recognized multiple differentially expressed microRNAs (miRNAs) as candidate diagnostic markers for thyroid nodules. The purpose of this study was to identify thyroid tumor-associated miRNAs in FNAB with the capacity to be developed as unique biomarkers.Materials and methodsAccording to the study design, a quantitative real time reverse transcription polymerase chain reaction (qRT-PCR) was applied to evaluate the expression levels of nine miRNAs (Let7, miR-34a, miR-146b, miR-221, miR-151, miR-155, miR-181b, miR-222 and miR-375) among 224 FNA samples as the training set.ResultsThe findings of this study revealed that miR-181b and miR-146b are the best predictors to diagnose benign thyroid FNA samples from malignant samples. However, the remaining miRNAs were co-expressed and had no significant effect on the predictor model. On the other hand, sensitivity and specificity of miR-181b and miR-146b were reported at 83.0%–83.0% and 83.0%–66.0%, respectively.ConclusionsAccording to the results of this study, miR-146b and miR-181b might be considered as adjunct markers contributing to thyroid FNAB in tumor types. In addition, miR-146b and miR-181b were recognized as biomarkers for discriminating benign thyroid nodules from malignant ones. It is suggested that further prospective clinical trials be conducted to evaluate the accuracy of such findings in a larger cohort and determine the clinical uses.

scholarly journals Can We Improve Thyroid Fine-needle Aspiration Cytology Adequacy in a Low-volume Thyroid Center?

2017 ◽  
Vol 13 (01) ◽  
pp. 21
Author(s):  
Mohamed Shaaban ◽  
Mario Metry ◽  
Sebastian Aspinall ◽  
◽  
◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Single Operator ◽  
Thyroid Fine Needle Aspiration ◽  
Low Volume ◽  
Needle Aspiration Cytology

Introduction: Thyroid cancer is the most common endocrine malignancy, and has shown an increase in incidence in recent decades. Fine-needle aspiration cytology (FNAC) is the mainstay of assessment of thyroid nodules and diagnosis of malignancy. Several reports have suggested that ultrasound (US)-guided FNAC has many advantages over palpation-guided biopsy. Methods: Comparison of results of thyroid nodule FNACs in a low volume thyroid center (Northumbria Health Care NHS Foundation Trust) performed by a diverse group of clinicians and radiologists involved in the management of thyroid nodules over 18 months, between October 2008 and April 2010, identified retrospectively from pathology records, with the results of surgeon-performed US (SUS) -guided FNACs performed by a single operator (SRA) recorded prospectively over 17 months between July 2013 and November 2014. Results: The study included 185 FNA, with 104 FNAC being undertaken between October 2008 and April 2010 compared to 81 FNAC between July 2013 and November 2014. There was a statistically significant reduction of non-diagnostic rates in the second period: 23/81 (28%) versus 51/104 (49%) (Fisher’s exact, p=0.0063), non-neoplastic (Thy2) scores remained comparable: 28/81 (35%) versus 32/104 (31%), there were more Thy3 results: 21/81 (26%) versus 15/104 (14%), while the proportion of neoplastic results in the SUS-FNAC group increased: 8/81 (10%) versus 6/104 (6%). Also, time to diagnostic FNAC was significantly shorter in the SUS-FNAC group: 24.2 ± 4.5 versus 54.9 ± 11.4 days (p=0.01, unpaired t-test). Conclusion: SUS-guided FNAC for thyroid nodules is a safe and simple technique. This study demonstrates that it leads to improved patient care by reducing inadequacy rate and time to diagnosis in a low-volume thyroid center.

scholarly journals Acute thyroid swelling after fine needle aspiration—a case report of a rare complication and a systematic review

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tiantong Zhu ◽  
Ye Yang ◽  
Hao Ju ◽  
Ying Huang
Keyword(s):  
Thyroid Gland ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Rare Complication ◽  
Needle Aspiration ◽  
Case Presentation ◽  
Fine Needle ◽  
Thyroid Fine Needle Aspiration ◽  
Thyroid Swelling ◽  
New Hypothesis

Abstract Background Thyroid fine needle aspiration (FNA) is the procedure of choice in the management of thyroid nodules. Acute thyroid swelling after FNA is a rare complication and is reported in a finite number of literatures. To the best of our knowledge, only seven reported cases exist in literatures. This study describes an addition case with an acute thyroid swelling after FNA, as well as puts forward a new hypothesis of this phenomenon. Case presentation The case is presented of a 30-year-old female with an acute thyroid swelling after FNA, with funicular hypoechoic lesions in thyroid gland. The size of thyroid was 1.5-fold enlarged in the unilateral thyroid gland. No complains of pain or other discomforts with her and no signs of hemorrhage were found along the passage of the fine needle. The episode was recovered spontaneously. Conclusions An acute thyroid swelling is a rare complication of FNA. A hypothesis of anaphylactic reaction was suggested in our study. Physicians should pay more attention of this phenomenon and more information is needed to support our hypothesis.

Retrospective Analysis of Cancer-Specific Gene Expression Panel for Thyroid Fine Needle Aspiration Specimens.

2021 ◽  
Author(s):  
Yongchun Wang ◽  
Brittany Avin McKelvey ◽  
Zhiyang Liu ◽  
Lisa Rooper ◽  
Leslie M. Cope ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Thyroid Tumors ◽  
Fine Needle ◽  
Thyroid Fine Needle Aspiration ◽  
Isoform Expression ◽  
Benign Nodules ◽  
Gene Isoform

Abstract Background: While molecular testing is a promising strategy for preoperative assessment of cytologically indeterminate thyroid nodules, thyroid fine needle aspiration biopsy (FNA) presents unique challenges for molecular assays, including contaminating peripheral blood mononuclear cells (PBMC) and variable numbers of evaluable epithelial thyroid cells. Moreover, the newly recognized entity, noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), has added an additional challenge to the currently available molecular diagnostic platforms. New diagnostic tools are still needed to correctly distinguish benign and malignant thyroid nodules preoperatively.Methods: Twenty-two transcript splice variants from 12 genes we previously identified as discriminating benign from malignant thyroid nodules were characterized in 80 frozen thyroid tumors from 8 histological subtypes. Isoforms detectable in PBMC were excluded, and the 5 most discriminating isoforms were further validated by real-time quantitative PCR (qPCR) on intraoperative FNA samples from 59 malignant tumors, 55 benign nodules, and 23 NIFTP samples. The qPCR threshold cycle values for each transcript were normalized to the thyrocyte-specific thyroid peroxidase isoform 1 (TPO1) and z-transformed. Receiver operating characteristic (ROC) analyses of the composite transcript scores were used to evaluate classification of thyroid FNAs by the 5-gene isoform expression panel.Results: A molecular signature was developed by combining expression levels of specific isoforms of CDH3, FNDC4, HMGA2, KLK7, and PLAG1. FNAs containing at least 12-36 thyrocytes were sufficient for this assay. The 5-gene composite score achieved an area under the ROC curve (AUC) of 0.86 for distinguishing malignant from benign nodules, with a specificity of 91%, sensitivity of 75%, negative predictive value of 91% and positive predictive value of 74%.Conclusion: Our newly developed 5-gene isoform expression panel distinguishes benign from malignant thyroid tumors and, may help distinguish benign from malignant thyroid nodules in the context of the new NIFTP subtype.

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