PURPOSE: The purpose of this study was to evaluate the diagnostic role of core needle biopsy (CNB) in sonographically suspicious thyroid nodules with initially benign cytologic results by histopathologic analysis using CNB or surgical specimens.
MATERIALS AND METHODS: Between October 2008 and July 2011, 88 consecutive patients with 88 focal thyroid nodules underwent ultrasound (US)-guided CNB for initially benign cytologic results with suspicious US features at our institution. 85 patients were finally included in the study based on histopathological reading after surgery (n = 28), and concordant benign reading of FNA and CNB (n = 57). We evaluated the risk of malignancy, diagnostic performance of CNB, and histopathologic findings in sonographically suspicious thyroid nodules with initially benign cytologic results.
RESULTS: Of the 85 thyroid nodules, 28 (32.9%) were histologically upgraded on CNB specimens including 1 atypia of undetermined significance (AUS), 7 follicular neoplasm, 1 suspicious for malignancy, and 19 malignancy. Of them, 27 (31.8%) were finally confirmed as malignancy and one as follicular adenoma at surgery. Pathologic results of 27 malignant nodules included 21 papillary thyroid carcinomas (PTCs), 5 follicular thyroid carcinomas, and 1 hurthle cell carcinoma. All PTCs were conducted from CNB readings of AUS, suspicious for malignancy, and malignancy. Follicular thyroid carcinomas and hurthle cell carcinoma were conducted from CNB readings of suspicious for follicular neoplasm or follicular neoplasm. On the histopathologic analysis, CNB specimens revealed severe fibrosis (96.4%) and hemosiderin (21.4%), calcification (17.9%), granulation tissue (12.5%), and thyroiditis (12.5%) in benign nodules with suspicious US features.
CONCLUSION: CNB has an excellent diagnostic performance for sonographically suspicious thyroid nodules with initially benign cytologic results. More confident diagnosis may be possible by histologic understanding of these nodules.
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SS 07 TH-12.pdf
