Purpose: Fine-needle aspiration cytology (FNA) and frozen section biopsy (FS) have been used for the purpose of distinguishing benign lesions from malignancies and for deciding the operative procedures to be used in the management of the thyroid
nodules. We performed this study the diagnostic value of the FNA, the need for the FS in intraoperative procedures, and to determine their values in deciding the extent of surgery. Methods: The medical records of 365 consecutive patients who had
undergone surgery for thyroid nodules at the Department of Surgery, Hanyang University Hospital, between Jan. 1996 and Dec. 1998 were reviewed retrospectively. FNA and FS were performed on all patients who underwent thyroid surgery during this
period.
Among them, 35 patients who were diagnosed as insufficient for diagnosis by FNA were excluded. Results: Definitive histopathological diagnosis revealed benign lesions in 232 patients and malignancies in 98. A borderline group consisted of
patients
whose
specimen were interpreted as follicular neoplasms by FNA and FS. Overall results for FNA and FS were: sensitivity, 98 versus 100; specificity, 97 versus 99; diagnostic accuracy, 97 versus 99%. Five patients who were diagnosed with benign lesions
by
FNA
were rediagnosed by FS as having malignant lesions. The tinal diagnosis was a papillary carcinoma. Of the 45 patients who were interpreted borderline by FNA, 7 patients had benign lesions, and 38 were borderline by FS. Finally, 34 patients were
diagnosed as having benign lesions and 11 as having malignancies. Conclusion: FNA has a high diagnostic accuracy for differentiatve diagnosis in the thyroid nodules. FS may be unnecessary for patients whose FNA results indicate malignancy
especially
papillary carcinoma, so routine use of FS for patients who were diagnosed as having a papillary carcinoma by FNA may be omitted. If FNA results are borderline, FS may be helpful to confirm a follicular neoplasm. If FNA indicates benign, FS seems
to
be
necessary to decide the extent of surgery.
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