Fine-Needle aspiration biopsy and suppression with thyroid hormone in the diagnosis of thyroid carcinoma

Abstract

Seventy-seven patients with cold thyroid nodules were studied with flne-needle aspiration biopsy and suppression with thyroid hormone. The volume of the nodule was calculated ultrasonographycally at the beginning of the study and after six months of oral therapy with thyroglobulin, at doses sufficient to maintain TSH at the low limits of the normal values. The cytological analysis was informed in every case as either follicular neoplasia or nodular or coloid goiter. This procedure could not diagnose any of the 16 cases of thyroid carcinoma observed at the surgical biopsy. Causes for the misleading diagnoses are discussed. As expected the thyroid hormone suppression test was not accurate to differentiate malignant from benign nodules. In 31% of the patients with surgically demonstrated malignant nodules the lesion decreased 0.41 cm3. Conversely 7.8% of the benign nodules Increased during therapy 3.7 cm3. At surgery It was found that 20.8% of these cold nodules were malignant. Currently we found It necessary to advise surgical treatment until further refinement of the diagnostic reliability of the aspiration biopsy is achieved.