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Cytologic and histopathologic results of euthyroid patients with multinodular goiter: Comparison with ultrasonographic features

Keywords: Multinodular goiter (MNG) , Fine-needle aspiration biopsy (FNAB) , dominant nodule

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Abstract:

Objectives: Fine-needle aspiration biopsy (FNAB) is thegold standard in the management of thyroid nodules andspecimen should be obtained from dominant nodule. Inour study, we aimed to compare the FNAB and histopathologyresults of dominant and non-dominant nodulesand to evaluate the association between nodule size andhistopathology results in patients with MNG.Materials and methods: Between 2009 and 2010, 197cases who had diagnosed MNG were analyzed. Thesecases were performed FNAB from both dominant noduleand non-dominant nodule. 26 patients with inadequatecytological results were excluded and 171 cases were includedin the analysis. Malignant ultrasonographic (US)features were defined as showing marked hypoechogenicity,microcalcifications, solid structure and not havingperipheral halo.Results: No statistically significant difference was observedbetween malign cytology and suspected cytologyratios of dominant nodules and non-dominant nodules(p=0.083). Malignancy rates were higher at dominantnodules not having peripheral halo and non-dominantnodules including microcalcification at US. Also statisticallysignificant difference was not observed (p=0.485)between malign histopathology rates of dominant andnon-dominant nodules after surgery.Conclusions: According to cytological and histopathologicalresults of patients with MNG, there was no significantdifference between the malignancy ratio of dominantand non-dominant nodules. There is no obvious correlationbetween malignancy and nodule size in patients withMNG. We think that FNAB obtained not from only dominantnodules but also nodules with suspicious featuresof malignancy is necessary for most accurate diagnosis.

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