HOME BROWSE TOPICS PRESENTERS SESSIONS
American Head & Neck Society
Translational Research Meeting

April 21-22, 2015

AHNS Annual Meeting
April 22-23, 2015 during the
Combined Otolaryngology Spring Meetings


Tips on Using this Site
Locate an abstract by entering any author's surname into the search box. You may also search by keyword or program ID number.

Broaden your search by typing only a few letters of a keyword; however, do not append the wildcard “*” to a search string.

Type too small? In most browsers, press Control “+” to enlarge type size. Reset by pressing Control “0”.

Results. To view an abstract, click on a title within results. Presenters’ names are underlined among the list of authors.
Accuracy & Predictive Value Of Thyroid Nodule Fna: The Need For Institutional Introspection

Presentation: S016
Topic: Endocrine Surgery
Type: COSM
Date: Thursday, April 23, 2015
Session: 8:00 AM - 9:00 AM Scientific Session #4
Authors: Marcus J Magister, BS, Irina Chaikhoutdinov, MD, Brian Saunders, MD, David Goldenberg, MD
Institution(s): Penn State Hershey Medical Center
imipramin zulassung billigogol.site imipramin 25 mg

OBJECTIVES/ BACKGROUND

The Bethesda system for reporting thyroid cytopathology has helped standardize the way thyroid nodules (TN) are classified.  The test characteristics of fine needle aspiration (FNA) biopsies of larger nodules are a source of controversy.  The objective of this study is to assess the accuracy and predictive value of pre-operative FNA biopsies preformed on thyroid nodules as compared to their final pathology.

MATERIALS and METHODS

Two hundred and fifty eight patients (268 primary nodules) were retrospectively identified. All underwent a pre-operative FNA followed by surgical excision between 2011 and 2013 at the Penn State Hershey Medical Center.  All FNA results were reviewed by the Department of Pathology and assigned a Bethesda classification of class I-VI.  FNA vs. final pathology comparisons were made based on Bethesda classification to determine the negative (NPV) and positive predictive values (PPV) of benign (class-II) and malignant (class-VI) TN, respectively.  Additionally, the rate of malignancy in indeterminate thyroid nodules (class-III-V) was also assessed.  All results were stratified by nodule size into groups of <2.0cm, 2-3cm, and ≥3cm.

RESULTS

The 258 patients were comprised of 202 females and 66 males; the mean age was 50 years old (σ=15).  Primary nodule size ranged from 0.4cm to 8.8cm with a mean of 2.06cm (σ=1.41cm).  Our data included 9 class-I, 59 class-II, 42 class-III, 70 class-IV, 23 class-V, and 66 class-VI TN.  Comparison of all class-II nodules to their final pathologies revealed a NPV of 93%.  Likewise, comparison of all class-VI nodules to their final pathologies revealed a PPV of 98%.  When stratified by size however, class-II nodules <2cm were 4.7 times more likely to show malignant changes on final pathology as compared to class-II nodules ≥2cm (14% vs. 3%).  Class-VI nodules showed no such pattern when stratified by size. Results from our subset analyses revealed rates of malignancy of 31%, 20%, and 83% for class-III, IV, and V nodules, respectively.  When these indeterminate nodules were stratified by size, class-III nodules <2cm were 2.2 times more likely to have malignant changes on final pathology as compared to nodules ≥2cm (40% vs. 18%).  Additionally, the rates of malignancy of the largest TN (≥3cm) did not significantly differ from those expected based on their Bethesda classification.

CONCLUSIONS

At our institution, we found class-II and III nodules <2cm have higher rates of malignancy than previously assumed.  Our data also did not find an increase in the false-negative rate with larger nodules (≥3cm), as suggested in some prior reports.  Therefore, thyroidectomy based solely on nodule size without prior FNA should be viewed with caution.

lansoprazol 30 mg dosis lansoprazol pantoprazol lansoprazol stada 15 mg
atarax constipation atarax vanedannende atarax with alcohol
imipramin zulassung imipramin uses imipramin 25 mg



JAMA Network Logo