Discordance Between Cytologic Results in Multiple Thyroid Nodules Within the Same Patient

作者：Levenson Jonathan N; Santaella Idalia; Wachtel Mitchell S; Levenson David I^*

来源：Acta Cytologica, 2010, 54(5): 673-678.

DOI：10.1159/000325231

• aspiration biopsy, fine-needle
• discordance
• thyroid neoplasms

Objective
To examine the frequency of discordant cytologic results between multiple thyroid nodules biopsied in the same patient.
Study Design
In a retrospective chart review of 441 consecutive patients, 326 (73.9%) had 2 or more nodules with colloid and/or thyroid cells recovered. Cytology was classified as (A) colloid only, (B) benign colloid nodule with or without degeneration, (C) Hashimoto's, or (D) follicular or Hurthle cell neoplasm, hyperplasia or suspicious for malignanty. Discordance was defined as having at least 2 different categories in the same patient. Twenty-four pre-determined factors were analyzed, including demographics, laboratory values and ultrasound characteristics.
Results
The results, by category, were A, 164 (18.4%); B, 575 (64.6%); C, 131 (14.7%); and D, 20 (2.2%). Overall, 126 of 326 (38.7%) patients bad at least 1 discordant grouping between their nodules. Of 326 patients, 165 had 2, 94 had 3, 48 had 4, 14 had 5, and Shad 6 nodules biopsied, of which 48 (29.1%), 39 (41.5%), 29 (60.4%), 8 (57.1%) and 2 (40.0%), respectively, showed diagnostic discordances (p=0.0007).
Conclusion
The high rate (38.7%) of discordance between biopsies of multiple nodules in the same patient support a recommendations to biopsy till nodules that otherwise meet criteria for biopsy, as opposed to only the largest one (Acta Cytol 2010;54:673-678)

• 出版日期2010-10