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Fine-Needle Aspiration Biopsy of the Thyroid: The Problem of Suspicious Cytologic Findings

HOSSEIN GHARIB, M. D.; JOHN R. GOELLNER, M.D.; ALAN R. ZINSMEISTER, Ph.D.; CLIVE S. GRANT, M.D.; and JON A. VAN HEERDEN, M.B.,Ch.B.
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▸Requests for reprints should be addressed to Hossein Gharib, M.D.; Mayo Clinic; Rochester, MN 55905.


Rochester, Minnesota


© 1984 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1984;101(1):25-28. doi:10.7326/0003-4819-101-1-25
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Cases in which thyroid nodules yielded suspicious cytologic findings on fine-needle aspiration biopsy were prospectively studied during a 3-year period. Of 1970 patients, 333 (17%) had suspicious cytologic findings; from this group, the cases of 253 patients were studied. The cytologic diagnoses were 96 (38%) Hürthle cell neoplasms, 84 (33%) follicular cell neoplasms, and 73 (29%) nonspecific diagnoses. A thyroid scan was obtained in 123 of 203 (61%) patients with a solitary nodule, and the nodules were hypofunctional in 102 (83%). Malignant lesions were found in 60 (24%) of the 253 patients. Our findings are consistent with reports that 20% of patients who have a fine-needle aspiration biopsy will have suspicious cytologic findings and that of these, 20% may have a malignant lesion. Thyroid scanning will not distinguish between benign and malignant thyroid lesions that are suspicious on cytologic examination. Surgical excision of all suspicious lesions seems reasonable.

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