Purpose: Fine needle aspiration cytology has a high sensitivity for
the diagnosis of solitary thyroid nodules. Fine needle aspiration cytology
(FNA) and frozen section biopsy (FS) have been used to distinguish benign
lesions from malignant ones and for deciding the extent of the operative
areas. In this study, we correlated data from fine needle aspiration
cytology and frozen section biopsy, used in the diagnosis of thyroid
nodules, to determine their effectiveness. Methods: During the period
from June 1996 to May 2001, the medical records of 104 patients who
underwent a thyroidectomy for a thyroid nodule, at the department of surgery
Inha university hospital, were reviewed retrospectively. One hundred and
four cases were classified according to whether the FNA cytological
diagnosis was inadequate, benign, suspicious, or malignant and the FS
diagnosis benign or malignant. Results: Permanent histopathological
diagnoeis revealed that 44 cases were benign and 60 cases were malignant.
According to the FNA cytologic interpretation, 11 cases were diagnosed as
inadequate, 52 cases benign, 20 cases suspicious, and 21 cases malignant.
The sensitivity and specificity for FNA alone were 87.8% and 67.3%
respectively and for FS 100% and 91.7%. The accuracy of FNA and FS were
76.3% and 96.2% respectively. Conclusion: Based on the results, FNA
cytology is a useful tool in the initial evaluation of the thyroid nodules
and it is as reliable as FS for predicting malignant lesions. In the
inadequate, benign and suspicious cases, intraoperative FS is a valuable
diagnostic tool to confirm the cytological diagnosis and identify
malignancy.
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