The diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules is not affected by coexistent chronic autoimmune thyroiditis: Results from a cyto-histological series of patients with indeterminate cytology.

in European Journal of Endocrinology
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  • 1 M Rotondi, Unit of Internal Medicine and Endocrinology, , Maugeri Clinical Research Institutes IRCCS, Pavia, Italy
  • 2 M Molteni, Unit of Internal Medicine, Medical-Oncologic Department, ASST Lodi, Lodi, Italy
  • 3 C Cappelli, Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Universita degli Studi di Brescia, Brescia, Italy
  • 4 L Croce, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
  • 5 A Caputo, Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
  • 6 G Groppelli, Unit of Internal Medicine, Medical-Oncologic Department, ASST Lodi, Lodi, Italy
  • 7 F Liboà, Postgraduate School in Endocrinology and Metabolism, University of Pavia, Pavia, Italy
  • 8 V Guazzoni, Unit of Internal Medicine, Medical-Oncologic Department, ASST Lodi, Lodi, Italy
  • 9 L Villani, Pathology Unit, Maugeri Clinical Research Institutes IRCCS, Pavia, Italy
  • 10 P Zeppa, Medicine and Surgery, University of Salerno, Fisciano, Italy
  • 11 L Chiovato, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy

Correspondence: Luca Chiovato, Email: luca.chiovato@icsmaugeri.it
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Objective

Indeterminate cytological result at Fine-needle-aspiration-cytology (FNAC) remains a clinical challenge for endocrinologists. Aim of the present study was to evaluate whether a coexistent Chronic-Autoimmune-Thyroiditis (CAT) might affect the diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules.

Design and Methods

A retrospective cohort study was designed including all nodules receiving an indeterminate cytology result (TIR3A or TIR3B) undergoing thyroid surgery and subsequent histological confirmation. Patients were stratified in two groups according to the presence or absence of CAT.

The hypothesis to be tested was whether follicular cell alterations induced by CAT might increase the rate of indeterminate cytological results in histologically benign thyroid nodules. Additional control groups were represented by nodules with determinate cytology, either benign (TIR 2) or malignant (TIR5).

Results:

One-hundred-eighty-nine indeterminate thyroid nodules were included (67 TIR3A and 122 TIR3B). At post-surgical histology 46 nodules (24.3%) were malignant. No significant differences were observed in the rate of histologically proven malignancy between patients without CAT and patients with CAT in the TIR3B (29.4% vs 32.4%; p=0.843) nor TIR3A (13.0% vs 11.4%; p=1.000) nodules. The rate of coexistent CAT was similar between TIR3B and TIR5 nodules harboring PTC at histology (30.4% vs 39.4%, p=0.491) and between indeterminate nodules and a control group of TIR2 nodules (39.2% vs 37.0%; p=0.720).

Conclusions: The similar rates of histologically proven malignancy found in cytologically indeterminate nodules in the presence or absence of concomitant CAT, would not support that CAT itself affects the diagnostic accuracy of fine-needle aspiration cytology.

 

     European Society of Endocrinology