Fine-needle aspiration biopsy and liquid-based cytology of the nodular goiter: diagnostic value and analysis of the results

Objective: to analyze the results of fine-needle aspiration biopsy (FNAB) and liquid-based cytology of nodular goiters performed in the medical center ‘Medgard’ between 2016 and 2018. Material and methods. A total of 300 biopsies of the nodular goiter were performed in the medical center ‘Medgard’ during 2016. Non-neoplastic tumors were diagnosed in 74% of cases (including colloid goiter in 67% and chronic autoimmune thyroiditis in 7%); papillary carcinoma was observed in 5% of cases; medullary carcinoma was diagnosed in 1% of patients; follicular tumors were found in 13% of cases; other findings (including suspected cancer or follicular tumors or metastases of other cancers to the thyroid gland) were observed in 2% of patients. Five percent of samples were uninformative. In 2017, we analyzed 415 specimens from nodular goiter obtained using FNAB. Non-neoplastic tumors were found in 75.4% of cases (including colloid goiter in 72% and chronic autoimmune thyroiditis in 3.4%); papillary carcinoma was diagnosed in 7.5% of cases; medullary carcinoma was observed in 0.7% of patients; follicular tumors were found in 13.5% of cases; parathyroid tumors were diagnosed in 0.5% of patients. Uninformative results were obtained in 2.4% of cases. A total of 635 specimens of nodular goiter were examined in 2018. Of them, 68.1% were non-neoplastic tumors (including colloid goiter observed in 62% of patients and chronic autoimmune thyroiditis detected in 6.1% of patients); 7.4% of patients had papillary carcinoma; 0.3% of individuals had medullary carcinoma; 20.6% of patients had follicular tumors; 0.5% of patients had parathyroid tumors. Uninformative results were obtained in 3.1% of cases. Conclusion: 1. Ultrasound-guided FNAB with subsequent liquid-based cytology is a highly reliable method for differential diagnosis of nodular goiter. 2. The majority of patients examined had benign thyroid tumors. 3. The proportion of patients with thyroid carcinomas did not significantly increase during the observation period (2016-2018), whereas the number of follicular tumors increased. 4. The main limitation of thyroid FNAB is its inability to differentiate between follicular adenomas and carcinomas in the structure of the follicular neoplasms.