미세침 흡인 세포진단 검사상 불명확한 소견을 보이는 갑상선 결절의 병리학적 진단 = Pathologic Diagnosis of Thyroid Nodules Showing Indeterminate Cytology on Fine Needle Aspiration

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Objectives: Thyroid nodule is a common clinical problem but there is a few cases of malignant lesions requiring surgery. So it is a critical issue to distinguish benign from malignant nodules and to select a patient for surgery. Although there are some variations in the accuracy of the diagnosis, fine needle aspiration biopsy of thyroid nodule has been accepted as a accurate diagnostic procedure in the management of nodular thyroid disease. So it was desirable to verify the usefulness of the fine needle aspiration (FNA) cytology in differentiating from malignant lesions and to clarify the problematic issues concerning the cytopathologic features of indeterminate cytology, which is equivocal to describe benign or malignant lesion, Methods: We examined the medical records retrospectively of all patients who wore engaged in fine needle aspiration cytology or thyroidectomy due to thyroid nodules from 1988 to 1992. Results: 1) Eighty hundreds fifty nine cases of FNA cytology was done in 1992 and 659 cases(75.9%) were adequate for cytopathologic diagnosis. And the diagnoses showed 558 cases of benign, 37 cases of malignant and 57 cases of indeterminate features. 2) The sensitivity of benign nodules were 91.2% and that of malignant lesion were 85.7%, respectivety. The overall accuracy of fine needle aspiration cytology of the thyroid nodule was 88.4%. 3) From 1988 to 1992, the medical records of 140 patients showing indeterminate cytology of thyroid nodules by FNA were reviewed. Among them, 67 patients were operated for the thyroid nodule till June 1993 and pathologic diagnoses were confirmed, The pathologic diagnoses were consisted of 27 cases(40.3 %) of benign lesions and 40 cases(59.7%)of malignant lesions. Conclusion: FNA cytology of the thyroid nodule was useful in distinguishing benign from malignant nodules and surgical excision of the cases showing in- determinate cytopathologic features seems reasonable.