Purpose: To determine diagnostic effects of fine needle aspiration cytology (FNA) and frozen section of thyroid follicular neoplasm and its role in the therapeutic approach.
Methods: We performed a retrospective analysis of the data of patients who underwent thyroid surgery at the Gwangju Christian Hospital, between March 2000 and December 2004, and had a report of preoperative fine needle aspiration (FNA) biopsy of thyroid follicular lesions, which comprises cellular lesion, suspicious for follicular neoplasm or follicular carcinoma.
Results: Out of 45 patients with preoperative FNA biopsy diagnosis of follicular neoplasm, reveals true follicular carcinoma in 20 (44.4%), a follicular adenoma in 11 (24.5%), a papillary carcinoma in 7 (15.5%), a papillary carcinoma with follicular variant in 4 (8.9%), an adenomatous goiter in 3 (6.7%). Among the 45 patients having an intraoperative frozen sections, only 7 patients (15.5%) were true follicular carcinoma, suspicious for malignant follicular neoplasm in 14 patients (31.1%) and suspicious for benign follicular neoplasm in 8 patients (17.8%). final diagnosis were changed from suspicious for benign follicular neoplasm at intraoperative frozen section to malignant in 3 patients, from suspicious for malignant follicular neoplasm to benign in 1 patient. Three patients underwent a lobectomy and 1 patients a subtotal thyroidectomy followed by a completion thyroidectomy.
Conclusion: Fine needle aspiration cytology and frozen section results are not good indicators in making the decision of operative extent. the best way to establish a diagnosis and to predict prognosis is to surgically remove the tumor for a proper histopathologic examination. (J Korean Surg Soc 2005;69:439-442)
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