Journal of Pathology and Translational Medicine

Original Articles

Diagnostic yield of fine needle aspiration with simultaneous core needle biopsy for thyroid nodules: Mohammad Ali Hasannia, Ramin Pourghorban, Hoda Asefi, Amir Aria, Elham Nazar, Hojat Ebrahiminik, Alireza Mohamadian; J Pathol Transl Med. 2025;59(3):180-187. Published online April 16, 2025; DOI: https://doi.org/10.4132/jptm.2025.03.04

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Background
Fine needle aspiration (FNA) is a widely utilized technique for assessing thyroid nodules; however, its inherent non-diagnostic rate poses diagnostic challenges. The present study aimed to evaluate and compare the diagnostic efficacy of FNA, core needle biopsy (CNB), and their combined application in the assessment of thyroid nodules.
Methods
A total of 56 nodules from 50 patients was analyzed using both FNA and simultaneous CNB. The ultrasound characteristics were categorized according to the American College of Radiology Thyroid Imaging Reporting and Data Systems classification system. The study compared the sensitivity, specificity, and accuracy of FNA, CNB, and the combination of the two techniques.
Results
The concordance between FNA and CNB was notably high, with a kappa coefficient of 0.837. The sensitivity for detecting thyroid malignancy was found to be 25.0% for FNA, 66.7% for CNB, and 83.3% for the combined FNA/CNB approach, with corresponding specificities of 84.6%, 97.4%, and 97.4%. The accuracy of the FNA/CNB combination was the highest at 94.1%.
Conclusions
The findings of this study indicate that both CNB and the FNA/CNB combination offer greater diagnostic accuracy for thyroid malignancy compared to FNA alone, with no significant complications reported. Integrating CNB with FNA findings may enhance management strategies and treatment outcomes for patients with thyroid nodules.

Citations

Citations to this article as recorded by

Clinicopathological Correlation of Core-Needle Biopsy in Thyroid Nodule Assessment: Insights from a Tertiary Care Center
Neha Nigam, Rishabh Sahai, Anil Singh, Anjali Mishra, Sabaretnam Mayilvaganan, Ojas Gupta, Prabhakar Mishra, Nirbhay Kumar, Amit Rastogi
Journal of Cytology.2026; 43(4): 235. CrossRef

Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia: Hee Young Na, Miyoko Higuchi, Shinya Satoh, Kaori Kameyama, Chan Kwon Jung, Su-Jin Shin, Shipra Agarwal, Jen-Fan Hang, Yun Zhu, Zhiyan Liu, Andrey Bychkov, Kennichi Kakudo, So Yeon Park; J Pathol Transl Med. 2024;58(6):331-340. Published online November 7, 2024; DOI: https://doi.org/10.4132/jptm.2024.10.12

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Abstract PDF Supplementary Material

Background
This study was designed to compare diagnostic categories of thyroid fine needle aspiration cytology (FNAC) and incidence of thyroid tumors in the multi-institutional Asian series with a special focus on diagnostic category IV (suspicious for a follicular neoplasm) and follicular thyroid carcinomas (FTCs). Methods: Distribution of FNAC categories, incidence of thyroid tumors in resection specimens and cytologic diagnoses of surgically confirmed follicular adenomas (FAs) and FTCs were collected from 10 institutes from five Asian countries and were compared among countries and between FAs and FTCs. Results: The frequency of category IV diagnoses (3.0%) in preoperative FNAC were significantly lower compared to those in Western countries (10.1%). When comparing diagnostic categories among Asian countries, category IV was more frequent in Japan (4.6%) and India (7.9%) than in Taiwan (1.4%), Korea (1.4%), and China (3.6%). Similarly, incidence of FAs and FTCs in surgical resection specimens was significantly higher in Japan (10.9%) and India (10.1%) than in Taiwan (5.5%), Korea (3.0%), and China (2.5%). FTCs were more commonly diagnosed as category IV in Japan (77.5%) than in Korea (33.3%) and China (35.0%). Nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were more common in FTCs compared with FAs. Conclusions: Our study highlighted the difference in FNAC diagnostic categories of FTCs among Asian countries, which is likely related to different reporting systems and thyroid cancer incidence. Cytologic features such as nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were found to be useful in diagnosing FTCs more effectively.

Citations

Citations to this article as recorded by

Deep Learning-Based Multimodal Fusion of Ultrasound, Cytology, and Clinical Features to Distinguish Follicular Thyroid Carcinoma from Adenoma: A Multicenter Study
Xiao-Fei Guo, Li Zhou, Xin-Yi Bao, Shui-Qing Liu, Jia-Wei Feng, You-Long Zhu, Yong Jiang, Shu-Ying Zhang
Academic Radiology.2026; 33(7): 2921. CrossRef
Molecular Testing in Indeterminate Thyroid Nodules: Genomic Landscape, Diagnostic Performance, and Integrated Risk-Stratified Management
Sayaka Tanaka, Naomi Kitayama, Kyouko Kawamoto, Tomoko Wakasa, Yanhua Bai, Kennichi Kakudo
Cancers.2026; 18(10): 1661. CrossRef
A Clinicopathological Study on Thyroid Swellings with Comparison of Findings of Ultrasonography and Bethesda Reporting System of Fine Needle Aspiration Cytology to Histopathology: a Cross-Sectional Study
Amit Kumar Shukla, Debjit Jana, Maumita De, Krishna Kumar Yadav, Divya Daga, Diptanshu Mukherjee, Saumendra Nath Bandyopadhyay, Anukriti, Snehasish Halder
Indian Journal of Otolaryngology and Head & Neck Surgery.2026; 78(7): 3808. CrossRef
Diagnostic thresholds in thyroid cytopathology: toward biological risk stratification
Sayaka Tanaka, Tomoko Wakasa, Kennichi Kakudo
Journal of the American Society of Cytopathology.2026;[Epub] CrossRef
Western versus Asian utilization of molecular testing for indeterminate thyroid nodules: A meta‐analysis of divergent clinical impact
Chanchal Rana, Truong Phan‐Xuan Nguyen, Chan Kwon Jung, Andrey Bychkov, Kennichi Kakudo
Cancer Cytopathology.2026;[Epub] CrossRef
Misdiagnosed follicular adenoma with 11 year postoperative liver and lung metastases a case report and literature review
Kai-Li Yang, Heng-Tong Han, Shou-Hua Li, Xiao-Xiao Li, Ze Yang, Li-Bin Ma, Yong-Xun Zhao
Discover Oncology.2025;[Epub] CrossRef

Review

Cytologic hallmarks and differential diagnosis of papillary thyroid carcinoma subtypes: Agnes Stephanie Harahap, Chan Kwon Jung; J Pathol Transl Med. 2024;58(6):265-282. Published online November 7, 2024; DOI: https://doi.org/10.4132/jptm.2024.10.11

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