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Combined Ultrasound and Needle Aspiration Cytology in the Assessment and Management of Hypofunctioning Thyroid Nodule

PAUL G. WALFISH, M.D., F.R.C.P.(C), F.A.C.P.; ELIZUR HAZANI, M.D.; HARRY T. G. STRAWBRIDGE, M.D., F.R.C.P.(Edin), F.R.C.P.(C); MURRAY MISKIN, M.D., F.R.C.P.(C); and IRVING B. ROSEN, M.D., F.R.C.S.(C), F.A.C.S.
[+] Article and Author Information

Grant support: by Department of Medicine and Research Institute Funds, Mount Sinai Hospital, Toronto. Dr. E. Hazani was supported by an Endocrine Division and Thyroid Research Laboratory Research Fellowship, Mount Sinai Hospital, Toronto.

This paper was presented in part on 15 September 1976 at the 52nd Annual Meeting of the American Thyroid Association, Toronto, as well as on 1 October 1976 at the Conference on Radiation-Associated Thyroid Carcinoma, Chicago.

▸Requests for reprints should be addressed to P. G. Walfish, M.D.; c/o Endocrine Division and Clinical Investigation Centre, Suite 640, Mount Sinai Hospital, 600 University Ave.; Toronto, Canada ON M5G 1X5.


Toronto, Canada


Ann Intern Med. 1977;87(3):270-274. doi:10.7326/0003-4819-87-3-270_1
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We evaluated the efficacy of combining B-scan bistable and gray-scale ultrasound with needle aspiration cytology in assessing and managing solitary hypofunctioning solid and cystic nodules. Of the 150 cases surveyed, 90 had surgical follow-up histology for comparison to preoperative aspiration cytology results. Overall neoplasm rate in these 90 cases was 66%, increasing to 93% if colloid nodules were included. Adequate material for cytology preoperatively was obtained in 83 (92%). In cases with adequate preoperative needle aspiration cytology, there were 66 solid and 17 cystic or mixed lesions. Overall accuracy for differentiating benign from malignant nodules for solid lesions was 63 of 66 (95%), compared to 15 of 17 (88%) for predominantly cystic or mixed lesions. Of the 17 cases of proven carcinoma, correct preoperative cytology diagnosis for malignancy was obtained in 12 (71%). Malignancy was most often correctly diagnosed for solid papillary and metastatic cancer lesions. No false-positives were noted and atypical adenomas and Hürthle-cell adenomas have been correctly diagnosed. The simplicity and safety of these diagnostic procedures justify their use for "selective" surgery and particularly for those cases that have been initially assigned to conservative, nonsurgical therapy.

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