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== Fine Needle Aspiration ==
== Fine Needle Aspiration ==
* [[Fine needle aspiration]] (FNA) should otherwise be the first step in the evaluation of a thyroid nodule, and its use has halved the number of patients undergoing surgery. It costs ~ $350 (1995) dollars, compared with $400 for an [[ultrasound]], and $600 for a scan. The results are usually reported as [[benign]], [[malignant]] or indeterminate (suspicious).   
* [[Fine needle aspiration]] (FNA) should otherwise be the first step in the evaluation of a thyroid nodule. The results are usually reported as [[benign]], [[malignant]] or indeterminate (suspicious).   
* Most results (~ 70 - 80%) do not reveal malignancy (however ~ 11% are indeterminate, and ~11% are inadequate).
* Most results (~ 70 - 80%) do not reveal malignancy (however ~ 11% are indeterminate, and ~11% are inadequate).
*:* These patients can be followed clinically with [[ultrasound]] and repeat FNA in 6 months to 1 year.  The rate of false negatives is ~ 1-6% and results from sampling errors or inadequate specimens (repeat biopsy is adequate in 50% of these cases).  
*:* These patients can be followed clinically with [[ultrasound]] and repeat FNA in 6 months to 1 year.  The rate of false negatives is ~ 1-6% and results from sampling errors or inadequate specimens (repeat biopsy is adequate in 50% of these cases).  

Latest revision as of 14:29, 19 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Fine Needle Aspiration

  • Fine needle aspiration (FNA) should otherwise be the first step in the evaluation of a thyroid nodule. The results are usually reported as benign, malignant or indeterminate (suspicious).
  • Most results (~ 70 - 80%) do not reveal malignancy (however ~ 11% are indeterminate, and ~11% are inadequate).
    • These patients can be followed clinically with ultrasound and repeat FNA in 6 months to 1 year. The rate of false negatives is ~ 1-6% and results from sampling errors or inadequate specimens (repeat biopsy is adequate in 50% of these cases).
    • Hashimoto’s thyroiditis is the most common cause of the 4-6% false positive rate.
    • ~ 20% of indeterminate biopsies turn out to be malignant (usually follicular cancer).

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