Comparison of Folicular, Hurthle Cell Neoplasm and Oncocytic Changes Diagnosed by Thyroid Fine Needle Aspiration with Postoperative Histopathological Results

ABSTRACT

Purpose: Main diagnostic method of thyroid nodules is fine needle aspiration biopsy (FNAB), but sensitivity of this method in the evaluation of follicular lesions is low. We reevaluated patients who underwent operation with FNAB reports of follicular neoplasm, Hurthle cell neoplasm and oncocytic changes. Postoperative histopathological examination and thyroid ultrasound (TUS) results, scintigraphic features of nodules were reevaluated.
Material and Method: One hundred and three patients who were diagnosed with FNAB as follicular neoplasm, Hurthle cell neoplasm, oncocytic changes and who underwent thyroidectomy were reevaluated, retrospectively. FNAB and postoperative histopathological thyroidectomy specimen results were compared.
Results: Comparison results of FNAB cytologic evaluation and postoperative histopathological examination of those nodules were as follows. Eight patients who were diagnosed as follicular lesion in FNAB were papillary carcinoma, 6 were follicular carcinoma. One patients who were diagnosed as Hurthle cell neoplasm in FNAB was papillary carcinoma. Six patients who were diagnosed as oncocytic changes in FNAB were papillary carcinoma. According to postoperative histopathology results, all patients’ diagnoses were as follows: 21 patients (20.4%) were diagnosed with thyroid malignancy in which 15 patients (14.6%) were papillary carcinoma, 6 patients (5.8%) were follicular carcinoma. Hypoechoic appearance of nodule in TUS was found to be the only independent risk factor in prediction of malignancy.
Discussion: One fifth of the patients who were reported as follicular neoplasm, Hurthle cell neoplasm and oncocytic changes in FNAB were consistent with malignancy. Hypoechoic appearance of these nodules in TUS was found to be an independent risk factor in prediction of malignancy.