Does fine needle aspiration from a different nodule other than the dominant nodule provide additional benefit in thyroid diseases with nodules?

Year 2021, Volume: 4 Issue: 5, 680 - 685, 05.09.2021

Hasret Cengiz , Taner Demirci , Ayhan Aydın , Ceyhun Varım

https://doi.org/10.32322/jhsm.950773

Abstract

Objectives: The incidence of thyroid nodules has increased significantly and malignancy detected in 5-15% of them. While biopsy is recommended for all nodules larger than 1 cm in multinodular goiter, this is practically not possible in many patients. In addition, the relationship between nodule size and malignancy is not clear. We aimed to examine the value of additional biopsy from a nondominant nodule in terms of changing treatment and follow-up decisions and the relationship between nodule size and malignancy risk.
Material and Method: Patients (n=2,541) with thyroid nodules who applied to our clinic for various indications and performed fine needle aspiration between January 1, 2016 and March 1, 2021 were included in the study. Some of our patients with multinodular goiter were biopsied from a second additional nodule. Cytologic evaluations reported according to the Bethesta system. Pathology reports of the operated patients were scanned retrospectivelly.
Results: Fine needle aspiration biopsy was performed from a total of 3382 nodules of 2541 patients. The average age of our patient group was 56 (46-65) and 79% of them were women. When a comparison was made between nodule size and malignancy rate; the highest malignancy rate was detected in nodules between 1-2 cm (61,8%). Finally, a diagnosis of Bethesta-4,-5,-6 was reached in only 7 (0.9%) of 823 patients who underwent additional biopsy from nondominant nodule.
Conclusion: The value of an additional biopsy from a second nodule in terms of changing follow-up is very low and not significant and most of the cancers arise from nodules between 1-2 cm. According to our study, the assumptions that the malignancy risk increases as the nodule size or nodule count increase were not found to be correct.

Keywords

Thyroid nodule, Fine Needle Aspiration Biopsy, Thyroid Cancer

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