Analysis of cytopathologic and sonographic features for false-positive diagnosis in fine-needle aspiration of thyroid nodules / 中华超声影像学杂志

ABSTRACT

Objective:To analyze the cytopathologic and sonographic features of false-positive diagnosis in fine-needle aspiration (FNA) of thyroid nodules.Methods:The false-positive diagnosis of thyroid nodules FNA which was confirmed by histopathology in the Affiliated Hospital of Sun Yat-sen University from Jan 2016 to Sep 2020 were collected and analyzed.Results:A total of 2, 626 patients with 2, 971 thyroid nodules were performed ultrasonography (US)-guided FNA, and 1, 061 thyroid nodules (35.7%) were confirmed by histopathology.Among these 1, 061 nodules, 817 (77.0%) were histopathologic malignancy, and 748(70.5%) were cytopathologic malignancy (TBSRTC Ⅴ-Ⅵ). Twenty-one patients with 23 thyroid nodules were false-positive diagnosis, showing TBSRTC Ⅴ, with a false-positive rate of 9.4%. In these false-positive cases, 18 patients showed normal thyroid function and 13 showed negative thyroid antibodies. All the false-positive nodules showed part of cytopathologic features of papillary thyroid carcinoma, but were insufficient to diagnose TBSRTC Ⅵ. In sonographic features, 16 nodules (69.6%) were classified as ACR TI-RADS 2-4, 12 (52.2%) were classified as C-TIRADS 3-4A or sonographic benign, and none of the nodules were found suspicious cervical lymph nodes metastasis.Conclusions:The overlapping of cytopathologic features is the main cause of false-positive diagnosis in thyroid nodules FNA. Sonographic features may play a role in decreasing the false-positive diagnosis.