Is Fine Needle Aspiration Biopsy Effective in Detecting Malignancy in Giant Thyroid Nodules?

INTRODUCTION: Thyroid fine needle aspiration biopsy (TFNAB) is important diagnostic method to determine malignancy in thyroid nodules. However, its effectiveness in diagnosing malignancy in large thyroid nodules (greater than 4 cm) is controversial. We compared the postoperative histopathologic results of 147 patients who had thyroid nodules greater than 4 cm and underwent surgery with preoperative ultrasonography and FNAB findings. Our aim is evaluate the efficacy of FNAB in giant thyroid nodules
METHODS: 147 patients who were operated in our general surgery clinic for a thyroid nodule with a diameter of 4 cm and above were included in the study. The patients’ data including Gender, age, preoperative laboratory findings, thyroid imaging results, FNAB reports, and postoperative histo-pathology results were evaluated
RESULTS: Thyroid ultrasonography revealed isoechoic heterogeneity in 95 patients, hypoechoic in 32 patients, and hyperechoic heterogeneity in 20 patients. Microcalcification was detected in 44 patients, microcalcification in 32 patients, and peripheral calcification in 18 patients.
Biopsy results were reported as benign in 99 patients, aspiration of uncertain significance in 19 patients, follicular-nodular hyperplasia in 4 patients, suspected malignancy in 9 patients, and ma-lignancy in 4 patients.

DISCUSSION AND CONCLUSION: The preoperative FNAB could not detect the malignancy in 33 pa-tients whose postoperative histopathology results were malignant. The most significant parame-ters in detecting malignancy with ultrasonography were evaluated as increased vascularity, wall irregularity, and hypoechoic heterogeneity, respectively. Ultrasonography was found to be more significant than FNAB for the detection of malignancy in giant thyroid nodules in our study.