Article Text

Download PDFPDF
Thyroid diagnostic modalities (fine needle aspiration and core needle biopsy) with histology correlation: a tertiary centre experience
  1. Sona J Appukutty,
  2. Anna Paterson,
  3. Nishant S Patel,
  4. Adam Duckworth,
  5. James Chan,
  6. Maria O'Donovan,
  7. Alison J Marker
  1. Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Sona J Appukutty, Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; sona.appukutty{at}nhs.net

Abstract

Aims To determine the proportion of thyroid fine needle aspiration (FNA) and core needle biopsy (CNB) cases reported at a single institute into each UK Royal College of Pathologists (RCPath) Thy1-5 and local T category, respectively. Where subsequent histology was available, malignancy rates, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were compared for both procedures.

Methods 1591 FNAs (2010–2018) and 514 CNBs (2013–2018) cases were identified, together with paired histology excision specimens.

Results The FNA samples were classified as: Thy1: 45.3%, Thy2/Thy2c: 22.1%, Thy3a/Thy3f: 28%, Thy4: 1.6% and Thy5: 3%; while the CNB were classified as: T1: 7.2%, T2: 22.4%, T3 59.3%, T4: 1% and T5: 10.1%. Comparison of FNA and CNB classified as Thy5/T5 showed a 100% risk of malignancy (ROM), sensitivity (98% vs 100%), specificity (14.1% vs 12.1%), PPV (29.4% vs 29.4%), NPV (94.9% vs 100%) and accuracy (36.5% vs 35.6%), respectively, for a diagnosis of malignancy. ROMs for other categories were: Thy1/T1 (9% vs 6.7%), Thy2/T2 (5.1% vs 0%), Thy3/T3 (17.5% vs 18.4%) and Thy4/T4 (73.3% vs 100%).

Conclusions The proportion of cases in each RCPath Thy category has remained relatively stable during the 9-year study period, with the exception of the Thy3a category, which has increased over time. This finding is in line with other more recent reports in the literature and the proportion of T3 cases in the CNB group. The proportion of Thy2/Thy2c cases has also reduced over time, reflecting a local change in the triaging protocol for probable benign lesions. Both FNA and CNB showed comparable performance in our study.

  • thyroid gland
  • thyroid neoplasms
  • cytological techniques
  • image-guided biopsy
  • diagnostic techniques and procedures

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. Data collected was from the printed histology and cytology reports.

Statistics from Altmetric.com

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. Data collected was from the printed histology and cytology reports.

View Full Text

Footnotes

  • Handling editor Dhirendra Govender.

  • Contributors SJA and AJM wrote the manuscript. The data collection and analysis was done by SJA, AP, NSP and AD. All the authors contributed with critical revision and final approval of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.