Malignancy Rate and Reliability of Cytology in Operated Giant Thyroid Nodules

Year 2019, , 622 - 627, 30.09.2019

Berna Evranos Öğmen , Birgül Genç Şefika Burçak Polat

https://doi.org/10.17098/amj.624545

Abstract

Objectives: The main determinants of surgery
decision for thyroid nodules are cytology and ultrasonography. It is still
debated in the literature if the giant nodules should be routinely operated
despite benign cytology reports. This study aimed to determine the malignancy
rate in operated giant nodules and calculate the false negativity of cytology
in that group.

Materials and Methods We enrolled 675 patients with giant
nodules who were followed in our clinics between the dates of June 2015 and
April 2019. We evaluated the malignancy rates and other hormonal and
demographic parameters of 226 patients who underwent an operation and had
histopathology result, retrospectively

Results: According to the
histopathology results; 37 (14.40%) of the giant nodules were malignant whereas
220 (85.60%) were benign. There was no statistically significant difference
between malign and benign groups regarding preoperative ultrasonographic
features, nodule size and demographic properties. TSH was higher in the
malignant group. False negativity of the cytology was calculated as 11.65%.

Conclusion: Decision of surgery
should be based on ultrasonography findings and FNAC in giant thyroid nodules.
Routine surgery is not recommended. Repeated biopsies and sampling the
different parts of the nodule during a biopsy can decrease the false negative
results.

Keywords

Giant nodüle, cytology, malignancy rate

Opere Dev Tiroid Nodüllerinde Malignite Oranı ve Sitolojinin Güvenilirliği

Abstract

Amaç: Tiroid nodüllerinde operasyon
kararının en önemli belirleyicisi ultrason özellikleri ile birlikte altın
standart olarak kabul edilen sitolojidir. Dev nodüller sitoloji benignse takip
mi edilmeli yoksa sitoloji sonucundan bağımsız olarak opere mi edilmeli henüz
netleştirilmemiştir. Bu çalışmanın amacı opere olmuş dev nodüllerde malignite
ve İİAB'ın yanlış negatiflik oranlarını belirlemektir.

Materyal ve Metot: Bu çalışmaya
Haziran 2015- Nisan 2019 tarihleri arasında ≥ 4 cm çaplı nodülü olan 675 hasta
dahil edilmiştir. Bu hastaların 226 'sı opere edilmiş ve verileri retrospektif
olarak incelenmiştir.

Bulgular: Histopatolojik incelemede
bu nodüllerin 37'si (14.40%) malign, 220’si (85.60%) benigndi. Benign ve malign
nodüllerin ultrasonografik özellikleri ve nodül çapları arasında anlamlı
farklılık saptanmadı. İki grup demografik özellikler açısından benzer
bulunurken, TSH düzeyi malign nodüllerde daha yüksekti. Sitolojinin yanlış
negatiflik oranı dev nodüller için %11.65’di.

Sonuç: Sonuç olarak dev nodüllerde
cerrahi kararı verirken sitoloji ve ultrason özellikleri ve bası semptomu
varlığı veya kozmetik problem varlığı göz önünde bulundurulmalıdır. Sitolojide
yanlış negatiflik oranı küçük nodüllerden yüksek olabilir bu nedenle takipte
ultrason ve gerektiğinde tekrarlayan biyopsi yapmak gerekir. Bu bulgular rutin
cerrahi önermek için yeterli değildir.

Keywords

Dev nodül, sitoloji, malignite oranı

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