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- A Study of Usefulness of Fine Needle Aspiration Cytology of the Thyroid Lesions.
- Kye Hyun Kwon, So Young Jin, Dong Wha Lee
- Korean J Cytopathol. 1996;7(2):111-121.
- 1,646 View
- 14 Download
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Abstract
PDF - Fine needle aspiration cytology(FNAC) is preferred because of simplicity, safety, and reliability in the evaluation of patients with thyroid nodule or hyperplasia. However, there are a few limitations such as false-negative or false-positive cases and nondiagnostic material. To evaluate the usefulness of FNAC in thyroid lesions, we reviewed 704 FNAC cases of thyroid nodules from 1988 to 1994 at Soonchunhyang University Hospital. The results are as follows. 1. Among 704 FNAC cases of thyroid gland, 571(81.1%) cases were benign, 12 (1.7%0) were suspicious, 71(10.1%0) were malignancy, and 50(7.1%)-were material insufficiency. The cytologic diagnoses of the benign lesions included 168 cases of follicular neoplasm, 139 cases of adenomatous goiter, 162 cases of follicular lesion such as follicular neoplasm or adenomatous goiter, 61 cases of Hashimoto's thyroiditis, 13 cases of subacute thyroiditis, and 28 cases of colloidal nodule or benign nodule. The malignant lesions included 68 cases of papillary carcinoma, two medullary carcinomas and a case of metastatic colon cancer. 2. The average number of cytologic smear slides was 4.12+/-1.81 in material insufficiency and 5.63+/-1.79 in diagnostic cases. This difference was statistically significant(p<0.00001). 3. Histological assessment of 150 cases revealed 2 false negative and 1 false positive cases. The false negative cases were a case of marked sclerosis in papillary carcinoma and an occult case of papillary, carcinoma. The false positive case resulted from pseudo-ground glass nuclei due to marked dry artifact. 4. Comparison between the FNAC and the histologic diagnosis revealed that INAC had a sensitivity of 93.5%, a specificity of 99.2%, a false negative rate of 64%, a false positive rate of 0.8%, and an overall diagnostic accuracy of 98.0%. Therefore, FNAC of thyroid gland is a very reliable diagnostic method with excellent accuracy rate.
- Diagnostic Usefulness of Fine Needle Aspiration Cytology on Lymphadenopathy: An analysis of 1,216 Cases .
- Dong Won Kim, So Young Jin, Dong Wha Lee, Chan Soo Lee
- Korean J Cytopathol. 1997;8(1):11-19.
- 1,894 View
- 17 Download
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Abstract
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- Clinical lymphadenopathies are subjected to fine needle aspiration cytology(FNAC) for diagnosing not only benign lesions but also malignant ones, as the first diagnostic procedure. While the diagnostic reliability in metastatic carcinoma is high, it is difficult to differentiate malignant lymphoma from reactive conditions. We evaluated the diagnostic reliability of FNAC in lymphadenopathy, and discuss the diagnostic limitation and its place in clinical practice in this study. Over 8 years from January 1988, FNAC of 1,216 lymphadenopathies were analyzed and among them 170 cases were compared with histopathology. The results are as follows. 1. Of all the cases, 890 cases(73.2%) were diagnosed cytologically as benign, 312 cases(25.7%) as malignant, and 14 cases(1.1%) as unsatisfactory material. Reactive hyperplasia was diagnosed in 585 cases(65.7%) of the benign lesions, and among the malignant diseases, metastatic carcinoma was diagnosed in 248 cases(79.5%), and malignant lymphoma in 62 cases(19.9%). 2. The overall diagnostic accuracy was 89.2%, and no false positive case and 9 false negative results were observed among 170 cases which were proven by histopathology. Six cases of sampling error of false negative diagnoses included 3 of metastatic carcinomas and 3 of malignant lymphomas. The causes were difference between aspiration and biopsy site, poor fixation, or scanty cellularity with bloody smear. All 3 cases of misinterpretation error were malignant lymphomas, one of mixed type on biopsy which was diagnosed as reactive hyperplasia cytologically. In summary, FNAC technique is thought to be useful in the initial diagnosis of lymphadenopathies as well as in the follow-up of patients with known malignancy. Although the results of malignant lymphoma was less accurate than other malignant lesions, the application of strict cytologic criteria or lymphoid marker studies of aspiration material will reduce the false negative rate.
- Diagnostic Usefulness and Limitation of Fine Needle Aspiration Cytology of Lymph Node: Analysis of 176 Cases Confirmed by Biopsy .
- Hee Sung Kim, Dae Soo Kim, Young Lyun Oh, Young Hyeh Ko, Howe J Ree
- Korean J Cytopathol. 1999;10(1):35-42.
- 3,081 View
- 53 Download
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Abstract
PDF
- The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
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