DIAGNOSTIC PITFALLS IN THYROID FINE-NEEDLE ASPIRATION - A REVIEW OF 394 CASES

被引:152
作者
CARAWAY, NP
SNEIGE, N
SAMAAN, NA
机构
[1] Departments of Pathology, Section of Cytopathology
[2] Section of Endocrinology, The University of Texas, M D. Anderson Cancer Center, Houston, Texas
关键词
THYROID; CYTOLOGY; REVIEW; FOLLICULAR NEOPLASMS; PAPILLARY CARCINOMA; FALSE POSITIVE DIAGNOSIS; FALSE NEGATIVE DIAGNOSIS;
D O I
10.1002/dc.2840090320
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
To determine the diagnostic pitfalls of thyroid fine-needle aspiration (FNA), we reviewed 394 thyroid aspirates obtained between January 1986 and December 1990. Surgical follow-up was available for 150 aspirations. The cytologic diagnoses were categorized into four groups: benign, 57; indeterminate, 51; malignant, 33; and nondiagnostic specimen, nine. There were three false negative diagnoses (3%), which upon review were judged to be inadequate specimens. Three false positive diagnoses (7%) were identified: in the first two cases, follicular adenomas were mistaken for papillary carcinoma; in the third case, atypical Hurthle cells were mistaken for a Hurthle cell carcinoma. Our results showed a sensitivity of 93% and a specificity of 91% for the detection of malignancy. If indeterminate cases were considered positive, the specificity decreased to 50%, while the sensitivity increased to 97%. We conclude that: 1) certain follicular adenomas may display cytologic features mimicking papillary carcinoma; 2) as in follicular neoplasms, aspirates of Hurthle cell adenomas cannot be differentiated from Hurthle cell carcinomas; 3) with adequate sampling, false negative results can be markedly reduced.
引用
收藏
页码:345 / 350
页数:6
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