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The evaluation of thyroid nodules: is routine use of frozen-section examination necessary following preoperative fine-needle aspiration biopsy?

Year 2003, Volume: 11 Issue: 3, 80 - 84, 10.06.2003

Abstract

Objectives: We evaluated the role of fine-needle aspiration biopsy as a single parameter in determining the extent of thyroidectomy and the necessity of routine use of frozen-section examination in patients with nodular thyroid disease.Patients and Methods: We reviewed 67 patients 40 females, 27 males; mean age 44 years; range 17 to 78 years who undervvent thyroidectomy for nodular thyroid disease. Preoperative fine-needle aspiration biopsy and intraoperative frozen-section examination were per- formed in 46 patients and 40 patients, respectively. The results were compared with histopathologic diagnoses.Results: Histopathologically, 25 patients 37.3% had malignant and 42 patients 62.7% had benign disease. The sensitivity, specificity, and diagnostic accuracy were 50%, 95%, and 77% for fine-needle aspiration biopsy, and 100%, 87%, and 91% for frozen-section examination, respectively.Conclusion: İn view of lower sensitivity and accuracy rates for fine-needle aspiration biopsy, the routine use of frozen-section examination seems to be necessary especially in cases with highly suggestive clinical findings of malignancy.

References

  • Keller MP, Crabbe MM, Norwood SH. Accuracy and significance of fine-needle aspiration and frozen sec- tion in determining the extent of thyroid resection. Surgery 1987;101:632-5.
  • Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 1993;118:282-9.
  • Hamberger B, Gharib H, Melton LJ 3rd, Goellner JR, Zinsmeister AR. Fine-needle aspiration biopsy of thy- roid nodules. Impact on thyroid practice and cost of care. Am J Med 1982;73:381-4.
  • Richards ML, Chisholm R, Bruder JM, Strodel WE. Is thyroid frozen section too much for too little? Am J Surg 2002;184:510-4.
  • Mandell DL, Genden EM, Mechanick JI, Bergman DA, Biller HF, Urken ML. Diagnostic accuracy of fine-nee- dle aspiration and frozen section in nodular thyroid disease. Otolaryngol Head Neck Surg 2001;124:531-6.
  • Baloch ZW, Sack MJ, Yu GH, LiVolsi VA, Gupta PK. Fine- needle aspiration of thyroid: an institutional experience. T h y roid 1998;8:565-9.
  • Caraci P, Aversa S, Mussa A, Pancani G, Ondolo C, Conticello S. Role of fine-needle aspiration biopsy and frozen-section evaluation in the surgical management of thyroid nodules. Br J Surg 2002;89:797-801.
  • Irish JC, van Nostrand AW, Asa SL, Gullane P, Rotstein L. Accuracy of pathologic diagnosis in thyroid lesions. Arch Otolaryngol Head Neck Surg 1992;118:918-22.
  • Davoudi MM, Yeh KA, Wei JP. Utility of fine-needle aspiration cytology and frozen-section examination in the operative management of thyroid nodules. Am Surg 1997;63:1084-9.
  • Lee TI, Yang HJ, Lin SY, Lee MT, Lin HD, Braverman LE, et al. The accuracy of fine-needle aspiration biopsy and f rozen section in patients with thyroid cancer. Thyro i d 2 0 0 2 ; 1 2 : 6 1 9 - 2 6 .
  • Rosen Y, Rosenblatt P, Saltzman E. Intraoperative pathologic diagnosis of thyroid neoplasms. Report on experience with 504 specimens. Cancer 1990;66:2001-6.
  • Boyd LA, Earnhardt RC, Dunn JT, Frierson HF, Hanks JB. Preoperative evaluation and predictive value of fine-needle aspiration and frozen section of thyroid nodules. J Am Coll Surg 1998;187:494-502.
  • McHenry CR, Raeburn C, Strickland T, Marty JJ. The utility of routine frozen-section examination for intra- operative diagnosis of thyroid cancer. Am J Surg 1996; 172:658-61.

Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?

Year 2003, Volume: 11 Issue: 3, 80 - 84, 10.06.2003

Abstract

Amaç : Ameliyat öncesi ince iğne aspirasyon biyopsisi İİAB sonuçlarını tek parametre olarak kullanarak tiroidektominin geniflliğine karar verilip verilemeyeceği vefrozen section incelemesinin her olguda rutin olarakgerekip gerekmediği arafltırıldı.Hastalar ve Yöntemler: Çalıflmaya nodüler tiroit tanısıyla tiroidektomi ameliyatı yapılan ve ameliyat öncesinde ince iğne aspirasyonu n=46 ve/veya ameliyat sırasında frozen section n=40 sonuçlarına ulaflılabilen 67 hasta alındı. İki yöntemin sonuçlarıyla patolojik inceleme sonuçları karflılafltırıldı.Bulgular: Histopatolojik sonuçlar 25 olguda %37.3 malign, 42 olguda %62.7 benign bulundu. İnce iğne aspirasyon biyopsisinin duyarlılığı %50, özgüllüğü %95, tanısal doğruluk oranı %77; frozen sectionincelemesinin duyarlılığı %100, özgüllüğü %87, tanısal doğruluğu %91 bulundu.Sonuç: Bulgularımız, İİAB’nin düflük duyarlılık ve tanısal doğruluk değerleri nedeniyle, klinik malignensi parametrelerinin dikkatle değerlendirilmesi ile birlikte rutinfrozen section incelemesinin gerekli olduğunu gösterm e k t e d i r

References

  • Keller MP, Crabbe MM, Norwood SH. Accuracy and significance of fine-needle aspiration and frozen sec- tion in determining the extent of thyroid resection. Surgery 1987;101:632-5.
  • Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 1993;118:282-9.
  • Hamberger B, Gharib H, Melton LJ 3rd, Goellner JR, Zinsmeister AR. Fine-needle aspiration biopsy of thy- roid nodules. Impact on thyroid practice and cost of care. Am J Med 1982;73:381-4.
  • Richards ML, Chisholm R, Bruder JM, Strodel WE. Is thyroid frozen section too much for too little? Am J Surg 2002;184:510-4.
  • Mandell DL, Genden EM, Mechanick JI, Bergman DA, Biller HF, Urken ML. Diagnostic accuracy of fine-nee- dle aspiration and frozen section in nodular thyroid disease. Otolaryngol Head Neck Surg 2001;124:531-6.
  • Baloch ZW, Sack MJ, Yu GH, LiVolsi VA, Gupta PK. Fine- needle aspiration of thyroid: an institutional experience. T h y roid 1998;8:565-9.
  • Caraci P, Aversa S, Mussa A, Pancani G, Ondolo C, Conticello S. Role of fine-needle aspiration biopsy and frozen-section evaluation in the surgical management of thyroid nodules. Br J Surg 2002;89:797-801.
  • Irish JC, van Nostrand AW, Asa SL, Gullane P, Rotstein L. Accuracy of pathologic diagnosis in thyroid lesions. Arch Otolaryngol Head Neck Surg 1992;118:918-22.
  • Davoudi MM, Yeh KA, Wei JP. Utility of fine-needle aspiration cytology and frozen-section examination in the operative management of thyroid nodules. Am Surg 1997;63:1084-9.
  • Lee TI, Yang HJ, Lin SY, Lee MT, Lin HD, Braverman LE, et al. The accuracy of fine-needle aspiration biopsy and f rozen section in patients with thyroid cancer. Thyro i d 2 0 0 2 ; 1 2 : 6 1 9 - 2 6 .
  • Rosen Y, Rosenblatt P, Saltzman E. Intraoperative pathologic diagnosis of thyroid neoplasms. Report on experience with 504 specimens. Cancer 1990;66:2001-6.
  • Boyd LA, Earnhardt RC, Dunn JT, Frierson HF, Hanks JB. Preoperative evaluation and predictive value of fine-needle aspiration and frozen section of thyroid nodules. J Am Coll Surg 1998;187:494-502.
  • McHenry CR, Raeburn C, Strickland T, Marty JJ. The utility of routine frozen-section examination for intra- operative diagnosis of thyroid cancer. Am J Surg 1996; 172:658-61.
There are 13 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Levent Saydam This is me

Mahmut Tayyar Kalcıoğlu This is me

Ahmet Kızılay This is me

Mete Kaan Bozkurt This is me

Publication Date June 10, 2003
Published in Issue Year 2003 Volume: 11 Issue: 3

Cite

APA Saydam, L., Kalcıoğlu, M. T., Kızılay, A., Bozkurt, M. K. (2003). Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?. The Turkish Journal of Ear Nose and Throat, 11(3), 80-84.
AMA Saydam L, Kalcıoğlu MT, Kızılay A, Bozkurt MK. Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?. Tr-ENT. June 2003;11(3):80-84.
Chicago Saydam, Levent, Mahmut Tayyar Kalcıoğlu, Ahmet Kızılay, and Mete Kaan Bozkurt. “Tiroit nodüllerinin değerlendirilmesi: İnce iğne Aspirasyon Biyopsisinden Sonra Frozen Section Incelemesi Gerekli Mi?”. The Turkish Journal of Ear Nose and Throat 11, no. 3 (June 2003): 80-84.
EndNote Saydam L, Kalcıoğlu MT, Kızılay A, Bozkurt MK (June 1, 2003) Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?. The Turkish Journal of Ear Nose and Throat 11 3 80–84.
IEEE L. Saydam, M. T. Kalcıoğlu, A. Kızılay, and M. K. Bozkurt, “Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?”, Tr-ENT, vol. 11, no. 3, pp. 80–84, 2003.
ISNAD Saydam, Levent et al. “Tiroit nodüllerinin değerlendirilmesi: İnce iğne Aspirasyon Biyopsisinden Sonra Frozen Section Incelemesi Gerekli Mi?”. The Turkish Journal of Ear Nose and Throat 11/3 (June 2003), 80-84.
JAMA Saydam L, Kalcıoğlu MT, Kızılay A, Bozkurt MK. Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?. Tr-ENT. 2003;11:80–84.
MLA Saydam, Levent et al. “Tiroit nodüllerinin değerlendirilmesi: İnce iğne Aspirasyon Biyopsisinden Sonra Frozen Section Incelemesi Gerekli Mi?”. The Turkish Journal of Ear Nose and Throat, vol. 11, no. 3, 2003, pp. 80-84.
Vancouver Saydam L, Kalcıoğlu MT, Kızılay A, Bozkurt MK. Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?. Tr-ENT. 2003;11(3):80-4.