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The efficacy FNAB of small thyroid nodules in the area of recently normalized iodine supply

D Slowinska-Klencka, Dept. of Morphometry of Endocrine Glands, Medical University of Lodz, Lodz, 91-495, Poland
B Popowicz, Dept. of Morphometry of Endocrine Glands, Medical University of Lodz, Lodz, Poland
A Lewinski, Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
S Sporny, Dept. Dental Patomorphology, Medical University of Lodz, Lodz, Poland
M Klencki, Dept. of Morphometry of Endocrine Glands, Medical University of Lodz, Lodz, Poland

Correspondence: Dorota Slowinska-Klencka, Email: dsk{at}tyreo.am.lodz.pl

Abstract

Objective: to evaluate the incidence of focal lesions in the thyroid in the area of recently normalized iodine supply as well as to compare the efficacy of fine-needle aspiration biopsy (FNAB) of small (infracentimetric) and large thyroid lesions in such an area.

Methods: outcomes of 13646 ultrasound (US) examinations, 13437 US-guided FNABs of the thyroid, and 1694 results of postoperative histopathological examinations were analyzed.

Results: Infracentimetric nodules (INs - 10mm) were revealed by US in 43.5% of patients; in majority of cases (82.2%) INs were multiple. The percentage of revealed carcinomas by aspiration of INs is similar to that observed when large nodules (LNs - >10mm) are examined cytologically. However, the efficiency of preoperative diagnostics of INs is lower than LNs in respect to both US selection of lesions for FNAB and percentage of false negative results of FNAB (29.8% vs. 5.4%, p<0.001). In postoperative histopathological examination extrathyroidal extension of thyroid cancers was observed in near 30% of microcarcinomas.

Conclusions: In endemic or post-endemic areas the efficiency of FNAB is lower in case of small lesions than in larger ones. In spite of this, the percentage of cytologically revealed carcinomas among small lesions is not lower than among larger ones. Thus, it is particularly indicated to follow up small thyroid lesions by repeated US examination in such areas.