Should encountering atypia of undetermined significance / follicular lesion of undetermined significance after thyroid biopsy lead to the operation?

Authors : Bilgin ÇELEBİ, Halil Afşin TAŞDELEN, Eray KURNAZ

Pages : 708-716

Doi:10.18621/eurj.1203523

View : 124 | Download : 85

Publication Date : 2023-07-04

Article Type : Research Paper

Abstract :Objectives: Nodular goiter is the most common disease of the thyroid gland. Thyroid nodules are malignant in 3-5% cases. To determine the incidence of malignancy in patients defined as atypia of undetermined significance insert ignore into journalissuearticles values(AUS); or follicular lesion of undetermined significance insert ignore into journalissuearticles values(FLUS); as a result of fine needle aspiration biopsy insert ignore into journalissuearticles values(FNAB); and evaluate the clinical, biochemical and sonographic features as possible predictors of malignancy. Methods: Patients who had undergone at least one FNAB and diagnosed as AUS/FLUS from January 2011 to December 2015 were included in the study. Age, gender, benign disease, thyroid stimulating hormone insert ignore into journalissuearticles values(TSH); level, size, localization, number, time of FNAB, ultrasonography insert ignore into journalissuearticles values(USG); characteristics, follow-up data on repeated FNAB results and, if surgical excision was performed, final pathological results were analyzed. Results: A total of 5181 thyroid nodules were biopsied in 4089 patients, and the biopsy specimen taken from 611 nodules was diagnosed histopathologically as AUS/FLUS insert ignore into journalissuearticles values(11.79%);. After FNAB, 167 of 611 patients diagnosed with AUS/FLUS were operated. While 65.9% insert ignore into journalissuearticles values(n = 110); of 167 patients who underwent surgery were made a benign diagnosis; malign diagnosis was made to 34.1% insert ignore into journalissuearticles values(n = 57);. Conclusions: The rate of malignancy in surgically confirmed nodules was 34.1% in this study, which is higher than the Bethesda classification. Due to the high malignancy rate which determined in cytologically diagnosed AUS/FLUS, we think that the repeat decision of the FNAB should be reconsidered and the surgical plan after the first FNAB should be considered more seriously.
Keywords : Thyroid biopsy, thyroid cancer, thyroidectomy

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