Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis
ABSTRACT Objective Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. Subjects and methods Three hundred twenty-eight consecutive patient...
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Brazilian Society of Endocrinology and Metabolism
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| Series: | Archives of Endocrinology and Metabolism |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972016000400367&lng=en&tlng=en |
| _version_ | 1811203153725489152 |
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| author | Ana Patrícia de Cristo Heloísa Folgierini Goldstein Carlo Sasso Faccin Ana Luiza Maia Marcia Silveira Graudenz |
| author_facet | Ana Patrícia de Cristo Heloísa Folgierini Goldstein Carlo Sasso Faccin Ana Luiza Maia Marcia Silveira Graudenz |
| author_sort | Ana Patrícia de Cristo |
| collection | DOAJ |
| description | ABSTRACT Objective Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. Subjects and methods Three hundred twenty-eight consecutive patients underwent US-FNA, cytology and cell block evaluation. Six slides were prepared for each patient and stained by Papanicolaou and Giemsa techniques. The residual hemorrhagic aspirate in the syringe and needle was fixed in 10% formalin and paraffin-embedded (cell block). The histological sections were examined as a complementary diagnostic tool to US-FNA. Results The study population comprised 89% females and the mean age was 57.4 ± 13.7 years. The mean nodule size was 2.3 ± 1.2 cm. US-FNA cytological results were as follows: Bethesda I, 17.1% (n = 56); Bethesda II, 61.6% (n = 202); Bethesda III, 9.5% (n = 31); Bethesda IV, 5.8% (n = 19); Bethesda V, 2.4% (n = 8), and Bethesda VI, 3.6% (n = 12). Cell blocks were obtained in 100% of cases and were considered diagnostic in 89.6%. Combined cytological and cell block (cyto-cell block) results were as follows: unsatisfactory, 4.3% (n = 14); benign, 72.6% (n = 238); indeterminate, 11.3% (n = 37); follicular lesion, 5.8% (n = 19); suspicious for malignancy, 2.4% (n = 8), and malignant, 3.6% (n = 12). The sensitivity and specificity for cyto-cell block was 100% and 90%, respectively, and the accuracy was 94%. Cyto-cell block analysis reduced the rate of unsatisfactory samples (p < 0.001). Conclusions The cyto-cell block interpretation improved the efficiency of US-FNA. This simple, fast and low-cost technique should be used as an adjunctive test in thyroid nodule evaluation. Arch Endocrinol Metab. 2016;60(4):367-73 |
| first_indexed | 2024-04-12T02:50:56Z |
| format | Article |
| id | doaj.art-95adfb0cf3434fd894023eac3687b384 |
| institution | Directory Open Access Journal |
| issn | 2359-4292 |
| language | English |
| last_indexed | 2024-04-12T02:50:56Z |
| publisher | Brazilian Society of Endocrinology and Metabolism |
| record_format | Article |
| series | Archives of Endocrinology and Metabolism |
| spelling | doaj.art-95adfb0cf3434fd894023eac3687b3842022-12-22T03:51:00ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-429260436737310.1590/2359-3997000000180S2359-39972016000400367Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysisAna Patrícia de CristoHeloísa Folgierini GoldsteinCarlo Sasso FaccinAna Luiza MaiaMarcia Silveira GraudenzABSTRACT Objective Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. Subjects and methods Three hundred twenty-eight consecutive patients underwent US-FNA, cytology and cell block evaluation. Six slides were prepared for each patient and stained by Papanicolaou and Giemsa techniques. The residual hemorrhagic aspirate in the syringe and needle was fixed in 10% formalin and paraffin-embedded (cell block). The histological sections were examined as a complementary diagnostic tool to US-FNA. Results The study population comprised 89% females and the mean age was 57.4 ± 13.7 years. The mean nodule size was 2.3 ± 1.2 cm. US-FNA cytological results were as follows: Bethesda I, 17.1% (n = 56); Bethesda II, 61.6% (n = 202); Bethesda III, 9.5% (n = 31); Bethesda IV, 5.8% (n = 19); Bethesda V, 2.4% (n = 8), and Bethesda VI, 3.6% (n = 12). Cell blocks were obtained in 100% of cases and were considered diagnostic in 89.6%. Combined cytological and cell block (cyto-cell block) results were as follows: unsatisfactory, 4.3% (n = 14); benign, 72.6% (n = 238); indeterminate, 11.3% (n = 37); follicular lesion, 5.8% (n = 19); suspicious for malignancy, 2.4% (n = 8), and malignant, 3.6% (n = 12). The sensitivity and specificity for cyto-cell block was 100% and 90%, respectively, and the accuracy was 94%. Cyto-cell block analysis reduced the rate of unsatisfactory samples (p < 0.001). Conclusions The cyto-cell block interpretation improved the efficiency of US-FNA. This simple, fast and low-cost technique should be used as an adjunctive test in thyroid nodule evaluation. Arch Endocrinol Metab. 2016;60(4):367-73http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972016000400367&lng=en&tlng=enUltrasound-guided fine-needle aspiration (US-FNA)cell blockthyroid nodulethyroid cancer |
| spellingShingle | Ana Patrícia de Cristo Heloísa Folgierini Goldstein Carlo Sasso Faccin Ana Luiza Maia Marcia Silveira Graudenz Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis Archives of Endocrinology and Metabolism Ultrasound-guided fine-needle aspiration (US-FNA) cell block thyroid nodule thyroid cancer |
| title | Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis |
| title_full | Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis |
| title_fullStr | Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis |
| title_full_unstemmed | Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis |
| title_short | Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis |
| title_sort | increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine us fna analysis |
| topic | Ultrasound-guided fine-needle aspiration (US-FNA) cell block thyroid nodule thyroid cancer |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972016000400367&lng=en&tlng=en |
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