Several situations of thyroid fine-needle aspiration needle biopsy results and some suggestions

Feb 11, 2022

Thyroid fine needle aspiration biopsy results are very important for the choice of thyroid nodule treatment. It can reduce the amount of thyroid surgery by nearly 50%, and the detection rate of thyroid cancer has increased from 15% to 50%. False-negative FNA biopsy has high specificity and sensitivity. If UGFNA is used, the false-negative rate is only 1% to 2%, and repeated FNA biopsy will further reduce the false-negative rate. Regarding how to minimize the false negative rate of FNA biopsy, the guidelines recommend: ① use UGFNA biopsy; ② perform multi-point puncture sampling for nodules; ③ for benign nodules, consider repeating UGFNA for follow-up; ④ for multinodular goiter , the nodule to be tested can be selected first according to the findings of ultrasonography; ⑤ For cystic lesions, UGFNA biopsy should be performed in the solid area, and cyst fluid should be extracted for cytological examination; ⑥ At least 6 ultrathin cell smears should be prepared; ⑦ The Pap staining technique is used for immediate wet fixation. A false positive is when the FNA biopsy results are malignant but not found in the postoperative specimen. The false positive rate reported in the literature is 1% to 7.7%. Common reasons for false-positive results are overlapping cytological features, degenerative changes, poor specimens, or inexperience of the cytopathologist.

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