Session: MON 471-496-Thyroid Neoplasia & Case Reports
Poster Board MON-478
Methods: We investigated the outcomes of repeated FNAs in patients with thyroid nodules, by reviewing our prospectively collected database of patients who underwent FNA at the University of Wisconsin Thyroid Multidisciplinary clinic, to identify predictors or risk factors of malignancy. We collected data for age, gender, FNA indications, cytology, ultrasound characteristics, TSH, free T4, history of hypothyroidism, TPO antibodies titer and surgical indications/surgical pathology when patients were referred for surgery. We compared categorical data by Fisher’s exact test and numerical data by student’s t test.
Results: We reviewed data from 412 repeated FNAs of 189 thyroid nodules from 153 patients: 133 females and 20 males; 15 (9.8%) had thyroid cancer on final surgical pathology. Male gender OR 5.9 (1.8-8.7; p=0.005), history of hypothyroidism (as suggested by treatment with levothyroxine) OR 3.3 (1.2-5.0; P=0.039) and presence of ultrasound identified calcifications OR 8.1 (2.4-9.7; P<0.001) at the initial FNA, were more frequent in cancer patients. Hashimoto’s cytology OR 4.5 (1.3-16.1; p=0.03) or a non-diagnostic initial FNA OR 3.5 (1.1-11.1; p=0.04) were associated with thyroid cancer. The history of radiation exposure and family history of thyroid cancer did not reach statistical significance due to small sample size (p<0.20). Age at first FNA, percentage growth of the nodule, thyroid nodule volume, baseline TSH, Free T4 or TPO titer were not predictive of cancer.
Conclusions: Repeat FNA biopsies are useful, because they identify cancer in a significant number of patients with non-diagnostic initial FNA. Male gender, history or cytological findings of Hashimoto’s and calcifications on ultrasound should further raise the index of suspicion for thyroid cancer in patients undergoing repeat FNA.
Nothing to Disclose: RP, JCJ
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