Abstract
Objective: Investigate the findings in repeat samples of patients with initial ultrasound-guided non-diagnostic fine needle aspirates (FNA) of thyroid tissue performed and interpreted over the most recent 10-year period at the University of Vermont.
Method: Retrospective review of medical records for patients with nondiagnostic thyroid FNAs. Patients were identified using a pathology laboratory information system according to specific search parameters. Patients were excluded if ultrasound guidance was not used and if documentation in the medical records was limited.
Results: A total of 239 patients met inclusion criteria. Of the 239, 145 have undergone follow-up FNA, surgical intervention, or both. There were 19 documented neoplasms after initial non-diagnostic FNA, including 2 incidental papillary microcarcinomas, 3 incidental follicular variant of papillary microcarcinomas, 1 follicular carcinoma, 7 papillary carcinomas, 2 follicular variant of papillary carcinomas, 1 non-Hodgkin DLBCL, 2 Hurthle cell neoplasms, and 1 follicular neoplasm. Excluding the 3 microcarcinomas, there were 13 significant neoplasms in the ipsilateral lobe (5%). For the 61 patients (25%) who were lost to follow-up before a definitive diagnosis was made, we cannot draw final conclusions regarding malignancy.
Conclusion: Our study reveals significant potential for malignancy in patients with nondiagnostic FNAs. The IRB has granted permission to contact the 61 patients lost to follow-up before a definitive diagnosis was made. Delayed samples will be included as a separate analysis to profile this series of patients with nondiagnostic cytology.