The usefulness of fine-needle aspirates for detection of recurrent carcinoma in the thyroid bed.

ABSTRACT

INTRODUCTION: Locoregional recurrence of thyroid carcinoma has a negative impact on patient prognosis. In the current study, we retrospectively reviewed cases of thyroid bed lesions in the last 3 years, correlating cytologic diagnoses with clinical findings and, whenever available, final surgical diagnosis. MATERIALS AND METHODS: Cytologic results and needle wash thyroglobulin results from patients with fine-needle aspiration (FNA) of thyroid bed lesions were retrospectively collected from our electronic files. Additional retrieved data included sex, age at diagnosis, previous thyroidectomy diagnosis, time lapse since surgery, and corresponding surgical diagnosis (whenever available). RESULTS: A total of 91 cases from 72 patients (54 F, 18 M) were retrieved from the electronic files, with a median age of 49 years. Average interval between surgery and thyroid bed FNA was 5 years. Thyroglobulin levels were available for 60 (65.2%) cases. The average level was 276.2 ug/mL, with a range of <0.1 to 4720 ug/mL. Information on final surgical diagnosis was available for 31 samples. Complete agreement between final cytologic and histologic diagnoses was achieved in 28 of 31 (90.3%) of the cases, with 1 false negative and 2 false positives. Cytology sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.2%, 71.4%, 90.9%, 83.3%, and 89.1%, respectively. CONCLUSIONS: Ultrasound-guided FNA is an accurate and minimally invasive diagnostic method for suspicious thyroid bed lesions, with high sensitivity and positive predictive value.