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Ultrasound scan-guided core sampling for diagnosis versus freehand FNAC of the thyroid gland

Lookup NU author(s): Pallavi Mehrotra, Dr Sarah Johnson, Dr David Richardson, Richard Bliss, Professor Thomas Lennard


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Background and Aim: Freehand fine needle aspiration cytology (FNAC) is an obligatory investigation of the thyroid nodule. Between 5.0-43.1% of FNAC samples are reported as being initially unsatisfactory. In our unit, thyroid freehand FNAs are performed with a small needle (21 or 23G). Non-dominant nodules as part of multinodular goitres, difficult to palpate nodules or nodules with previously unsatisfactory freehand FNACs are sampled under ultrasound scan (USS) guidance with the larger 20G cuffing core sampling technique. We aimed to compare the satisfactory sampling rate and safety of the two different methods. Patients and Methods: Cytology forms were reviewed for 262 freehand FNACs and USS-guided core samples, performed in our unit over a two-year interval (1 July 1999 to 30 June 2001). Results: Ultrasound-guided core samples for cytology were unsatisfactory (AC0-1) in 19/121 (15.6%) of the cases, compared with 66/141 (46.8%) of freehand FNACs (p value=<0.0001). Ten out of eleven patients (91%) had a satisfactory USS-guided core after an unsatisfactory freehand FNA; 7/15 patients (46.7%) had satisfactory repeat freehand FNACs following an initial unsatisfactory freehand FNAC (p value=0.0191). There were no complications as a result of either freehand FNAC or USS-guided core sampling. Conclusion: USS-guided cores provided more satisfactory samples for assessment than freehand FNACs. The USS-guided technique is safe despite the use of the larger cutting needle. The USS-gulded core sampling was also a useful tool for repeat thyroid nodule sampling after an unsatisfactory freehand FNAC

Publication metadata

Author(s): Mehrotral P, Hubbard JGH, Johnson SJ, Richardson DL, Bliss R, Lennard TWJ

Publication type: Article

Publication status: Published

Journal: The Surgeon

Year: 2005

Volume: 3

Issue: 1

Pages: 1-5

ISSN (print): 1479-666X

ISSN (electronic):