ABSTRACT Objectives To assess cytologic outcomes of thyroid nodules ≥ 4 cm undergoing FNA and compare malignancy risk between nodules that underwent an FNA by TIRADS criteria versus size alone. Methods A retrospective review of thyroid FNAs from January 2012 to August 2025 was conducted. Nodules ≥ 4 cm were included, with data extracted from RIS and pathology records. Age, gender, nodule size, TIRADS, FNA indication, and Bethesda category were recorded. Cytology was grouped into benign/non‐diagnostic (Bethesda I–II) versus indeterminate/malignant (Bethesda III–VI). The Bethesda classification (I–VI) corresponds to increasing malignancy risk. Statistical analysis used a chi‐square test ( p 10% of large nodules without suspicious features were Bethesda III or higher, FNA is recommended for all nodules ≥ 4 cm to minimise missed malignancies.
Lavender et al. (Sun,) studied this question.
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