The utility of fine needle aspiration biopsy cytology in the management of thyroid tumors

This report is a retrospective survey of our experience with fine needle aspiration biopsy cytology in the evaluation of thyroid tumors in the years 1974–1978. The method was used as a routine procedure with 17 surgeons involved in the sampling and 4 cytopathologists involved in analyses of the smears. In 264 patients treated surgically, the preoperative cytopathologic diagnoses have been compared to the postoperative diagnoses. In 43 patients (16%), the biopsies were not representative. In patients with representative biopsies, a preoperative benign cytologic diagnosis was obtained in 112 of 160 patients with benign postoperative histology (70%), and a malignant or suspected malignant preoperative cytologic diagnosis was found in 52 of 61 patients (85%) with carcinomas. In 9 patients, the preoperative cytologic diagnoses were false‐negative (4.1% of the representative biopsies). No false‐positive cytologie diagnosis occurred. Sampling of adequate cellular material was the major problem in our experience. The high diagnostic reliability from representative material makes fine needle aspiration biopsy cytology a useful method in planning operations and in selecting patients for surgery. Due to the risk of false‐negative biopsies, a clinical suspicion of malignancy must not be ruled out by this method .