Fine-needle aspiration cytology of the thyroid gland: puzzling points regarding palpable and nonpalpable nodules

The aim of the present study was to evaluate whether fine-needle aspiration cytology (FNAC) is a useful method for the investigation, in out patients, of both palpable and nonpalpable thyroid nodules. A total of 299 FNAC thyroid punctures performed in 147 palpable and 152 nonpalpable lesions (ultrasound-guided) between 1996 and 1998 were compared. FNAC of palpable lesions was performed at the Outpatient Clinic of São Paulo Hospital, Federal University of São Paulo - UNIFESP and nonpalpable cases were submitted to ultrasound-guided fine-needle aspiration at São Caetano Beneficiente Hospital. Both series were examined during the same period from April 1997 to May 1998. Guided puncture (nonpalpable nodules) showed the following results: 50 percent goiter and nodular goiter; 17.10 percent cellular follicular lesions; 15.10 percent lymphocytic thyroiditis; 2.63 percent papillary carcinoma; 1.97 percent follicular and Hürthle cell neoplásias; and 13,15 percent unsatisfactory samples. Palpable nodules showed the following results: 54.42 percent nodular goiter; 17 percent follicular cell lesions; 10.2 percent lymphocytic thyroiditis; 4.76 percent papillary carcinoma; 4.08 percent Hürthle and follicular neoplasia, 0.68 percent anaplastic carcinoma, and 8.84 percent unsatisfactory samples. Similar frequencies of the specific cytopathological diagnosis were observed for the two series of palpable and nonpalpabie lesions. The frequencies of malignant conditions were similar for the two series and to the frequencies reported in epidemiological studies.

Punçäo aspirativa de ganglio linfático: revisäo de 283 casos puncionados no Hospital das Clínicas da F. M. de Botucatu / Aspiration puncture of lymph node: review of 283 cases punctured in the Hospital das Clínicas of Botucatu F. M

Com o objetivo de avaliar a eficácia do método de punçäo aspirativa por agulha fina (PAAF) em nódulos linfáticos, bem como avaliar a distribuiçäo das diferentes lesöes diagnosticadas, estudamos 283 casos aspirados no HC da FMB. Tivemos 187 casos negativos para células neoplásicas (66,07//) 10 casos suspeitos (3,53//) e 86 casos positivos para neoplasia (30,38//). Os casos de material insuficiente näo foram considerados nesta análise. Das lesöes benignas, a maior parte correspondia a linfadenites. Estas foram caracterizadas em três grandes grupos: 32 casos de linfadenite aguda (11,31//), 83 casos de linfadenite reacional inespecífica (29,32//) e 46 casos de processo inflamatório crônico granulomatoso (16,25//), 1 caso de histoplasmose e 1 caso sugestivo de doença de Kikuchi. As neoplasias foram subdivididas em primárias e metastáticas, sendo que das primárias 13 eram linfomas de Hodgkin (4,59// e 14 linfomas näo Hodgkin (4,94//). Mais recentemente temos introduzido técnicas imunocitoquímicas para melhor caracterizaçäo dos linfomas e como auxiliar na detecçäo de sítios primitivos em punçöes de metástases