+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Overcoming the limitations of fine needle aspiration biopsy: detection of lateral neck node metastasis in papillary thyroid carcinoma



Overcoming the limitations of fine needle aspiration biopsy: detection of lateral neck node metastasis in papillary thyroid carcinoma



Yonsei Medical Journal 56(1): 182-188



Ultrasound (US) and US-guided fine needle aspiration biopsies (FNAB) are considered the modalities of choice for assessing lymph nodes suspected of containing metastases, but the sensitivity of FNAB varies and is specific to the operator. We analyzed the risk of FNAB providing false negative results of lateral neck node metastasis, and evaluated diagnostic accuracy of FNAB, in patients with papillary thyroid cancer. FNAB was performed in 242 patients suspected of having lateral neck node metastasis on preoperative imaging. Thyroglobulin in the fine-needle aspirate washout (FNA wash-out Tg) and computed tomography enhancement (Hounsfield units) were measured. Patients with negative results on FNAB were examined by intraoperative frozen section. The false negative and true negative groups were compared. Of the 242 patients, 130 were confirmed as having lateral neck node metastases. In 74 patients, the metastasis was identified by FNAB. False positive results were observed in 2 patients (0.8%) and false negatives in 58 (44.6%). Risk analysis showed that patient age <45 years (p=0.006), tumor size >1 cm (p=0.008) and elevated FNA wash-out Tg (p=0.004) were significantly associated with false negative results on FNAB. The accuracy of FNAB increased significantly when combined with FNA wash-out Tg (p=0.003). To reduce the false negative rate of FNAB, patient age (<45 years), tumor size (>1 cm) and FNA wash-out Tg (>34.8 ng/mL) should be considered in preoperative planning. Accuracy may be improved by combining the results of FNAB and FNA wash-out Tg.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058485326

Download citation: RISBibTeXText

PMID: 25510763

DOI: 10.3349/ymj.2015.56.1.182


Related references

Prediction of occult central lymph node metastasis in papillary thyroid carcinoma by preoperative BRAF analysis using fine-needle aspiration biopsy: a prospective study. Journal of Clinical Endocrinology and Metabolism 97(11): 3996-4003, 2012

Fine-needle aspiration for the diagnosis of lymph node metastasis in papillary thyroid carcinoma. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 54(1): 23-27, 2019

Cutaneous Implantation Metastasis of Papillary Thyroid Carcinoma Following Fine Needle Aspiration Biopsy. Annals of Dermatology 29(1): 123-125, 2017

Papillary thyroid carcinoma metastasis most probably due to fine needle aspiration biopsy. A case report. Acta Dermatovenerologica Alpina Pannonica et Adriatica 15(4): 169-172, 2006

Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer. World Journal of Surgery 29(4): 483-485, 2005

BRAF v600e mutation combined with thyroglobulin and fine-needle aspiration in diagnosis of lymph node metastasis of papillary thyroid carcinoma. Pathology Research and Practice 214(11): 1892-1897, 2018

Parapharyngeal metastasis from papillary thyroid carcinoma: a case diagnosed by thyroglobulin measurement in peroral fine-needle aspiration of a cystic metastatic lymph node. Journal of Laryngology and Otology 119(2): 155-157, 2005

Comparison of the diagnostic performances of ultrasonography, CT and fine needle aspiration cytology for the prediction of lymph node metastasis in patients with lymph node dissection of papillary thyroid carcinoma: A retrospective cohort study. International Journal of Surgery 51: 145-150, 2018

Utility of BRAF mutation detection in fine-needle aspiration biopsy samples read as "suspicious for papillary thyroid carcinoma". Head and Neck 37(12): 1788-1793, 2015

Pancreatic metastasis of papillary thyroid carcinoma preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report with review of literatures. Clinical Journal of Gastroenterology 11(6): 521-529, 2018

Measurement of fine-needle aspiration thyroglobulin levels increases the detection of metastatic papillary thyroid carcinoma in cystic neck lesions. Cancer Cytopathology 122(7): 521-526, 2014

Needle tract implantation of papillary thyroid carcinoma after fine-needle aspiration biopsy. World Journal of Surgery 29(12): 1544-1549, 2005

Fine needle aspiration biopsy in papillary carcinoma of the thyroid. Archives D'anatomie et de Cytologie Pathologiques 30(1): 25-32, 1982

Needle track seeding of papillary thyroid carcinoma from fine needle aspiration biopsy. A case report. Acta Cytologica 46(3): 591-595, 2002

Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy. Endocrine 42(2): 399-403, 2012