@article {Hakala1046, author = {T Hakala and I Kholov{\'a} and J Sand and R Saaristo and P Kellokumpu-Lehtinen}, title = {A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy}, volume = {66}, number = {12}, pages = {1046--1050}, year = {2013}, doi = {10.1136/jclinpath-2013-201559}, publisher = {BMJ Publishing Group}, abstract = {Background and aims The most commonly used diagnostic method for the preoperative diagnosis of thyroid nodules is ultrasound-guided fine-needle aspiration biopsy (FNA), which often yields non-diagnostic or non-definitive results and seldom produces definite malignant diagnoses. To improve upon the malignancy-specific sensitivity, we tested core needle biopsies (CNBs) of thyroid lesions taken from surgical specimens. Material and methods 52 consecutive patients with malignant or malignant-suspicious thyroid nodules were referred to Tampere University Hospital between May 2010 and December 2011. Preoperative FNAs were categorised as follicular neoplasm (48\%), suspicion for malignancy (46\%) or malignancy (6\%). Intraoperative FNA and CNB samples were acquired from surgical specimens removed during surgery. The results of the needle biopsies were compared with the final pathological diagnosis. Results CNBs had a high definitive sensitivity for malignancy (61\%, CI 41\% to 78\%) whereas the definitive sensitivity for malignancy of FNAs was significantly lower (22\%, CI 10\% to 42\%). CNB was not beneficial in the diagnosis of follicular thyroid lesions. When all suspected follicular tumours were excluded, the definitive sensitivity of CNB rose to 70\% (CI 48\% to 86\%). Conclusions CNB may be beneficial for the diagnosis of papillary thyroid carcinoma and other non-follicular thyroid lesions. CNB may be considered as an additional diagnostic procedure in cases with FNA suspicious for malignancy.}, issn = {0021-9746}, URL = {https://jcp.bmj.com/content/66/12/1046}, eprint = {https://jcp.bmj.com/content/66/12/1046.full.pdf}, journal = {Journal of Clinical Pathology} }