PURPOSE:
The purpose of this study was to determine whether core needle biopsy (CNB) provides different malignant risk and management plan between thyroid nodules with atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS) readings on previous fine-needle aspiration (FNA).
MATERIALS AND METHODS:
The Bethesda System for Reporting Thyroid Cytopathology was used for FNA and CNB readings. From October 2008 to July 2011, 600 consecutive core-needle biopsy results in 587 patients were retrospectively reviewed. Of them, 191 thyroid nodules of 191 patients (median age, 51.1 years; age range, 19-85 years) who previously had AUS (n=84)/ FLUS (n=107) FNA readings were enrolled in this study. Final diagnoses were determined on the basis of histology at surgery, concordant benign finding of two methods, and clinical course. We evaluated CNB readings for previous AUS and FLUS FNA readings to compare malignancy risk and management plans between two groups, and calculated diagnostic value of CNB.
RESULTS:
By CNB, surgical candidates (patients with the Bethesda 4-6) were significantly higher in AUS (36/51, 70.6%) than FLUS (16/91, 17.6%) (P < .001). Final malignancy result was higher in AUS (33/51, 65%) than FLUS (13/91, 14.3%) (P < .001) and final benign result was higher in FLUS (85.7%) than AUS (35%) (P < .001). CNB showed 0.5% of nondiagnostic rate. The accuracy, sensitivity, and specificity of CNB for malignancy in previous AUS/FLUS readings were 95.8%, 87%, and 100%, respectively.
CONCLUSION:
CNB demonstrated that patients with previous AUS FNA readings showed higher surgical candidates and malignancy risk. Further management guideline for patients with AUS readings should be different from those of FLUS.
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SS 07 TH-11.pdf
