Fine-needle aspiration biopsy of benign thyroid nodules: an evidence-based review.

World Journal of Surgery
C I LundgrenLambert Skoog

Abstract

Since the development of fine-needle aspiration biopsy (FNAB) techniques, preoperative diagnosis and subsequent strategies for patient treatment have changed and evolved greatly. This is true also for thyroid FNAB: the vast majority of thyroid nodules are benign, and hence do not necessarily require surgical treatment. A comprehensive Medline and Cochrane Library search was performed evaluating FNAB in the thyroid. In the last decade more than 400 articles on the subject have been published. Data in relation to the experience with FNAB at the Karolinska University Hospital since its introduction were also reviewed. The development of FNAB since the 1960s at the Karolinska University Hospital is described. During the period 1992-1996 the accuracy of the clinical routine was evaluated by studying the outcomes of almost 4,000 FNAs of the thyroid. The results were good, with only a few false-negative and false-positive results, but the problem of differentiating follicular adenoma from follicular carcinoma remained a significant problem. The use of immunological analysis has greatly increased the possibility of obtaining valuable information on cellular characteristics. A successful FNAB service rests on several factors, and the im...Continue Reading

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