Fine Needle Aspiration Cytology vs. the Postoperative Histology – the Continuing Need for Multi-Disciplinary Approach?

We set out to investigate the concordance rates that were observed between fine needle aspiration cytology (FNA) compared with that of the post operative histology obtained for thyroid nodules over an 8 year period at a large university hospital. A retrospective analysis of 355 cases was conducted; patients operated for hyperthyroidism were excluded for the purposes of this study. We identified malignancy in a total of 101 cases (28%) The chance of malignancy with 2 Thy1 specimens was 5% in this study and 9% was observed in those with a Thy 2 FNA. On the converse, 7% of patient had malignant cytology on FNA though post-operative histology turned out to be benign. This therefore highlights the potential for discordance between thyroid FNA cytology and post-operative histology in the assessment of any thyroid nodule and thus reinforcing the need for a multidisciplinary approach in the assessment of all thyroid nodules.