Sources of diagnostic error in fine needle aspiration of the thyroid

T. L. Hall, L. J. Layfield, A. Philippe, Dorothy Rosenthal

Research output: Contribution to journalArticle

Abstract

Smears obtained from 795 patients with suspicious thyroid nodules by fine needle aspiration (FNA) of the thyroid gland were seen over a 5-year period at the UCLA Center for the Health Sciences. From 72 patients who underwent subsequent surgical excision of their nodules, inadequate or discrepant FNA diagnosis were noticed in 20 cases (27.8%). These errors could be attributed to inadequate material for diagnosis (n = 6), sampling errors (n = 2), and cytodiagnostic errors (n = 12). If the diagnosis of follicular neoplasm was treated as indeterminate for malignancy, the overall efficiency of FNA was 88.9%. All false-negative diagnosis were related to procedure (i.e., inadequate smears or missed sampling of the lesion). The frequency of inadequate smears, in turn, was strongly related to the type of physician performing the aspiration. The frequency was highest among community-based clinicians (32.4%) and lowest among hospital-based cytopathologists (6.4%). With adequate sampling, the finding of 100% sensitivity in the diagnosis of malignant neoplasms by FNA cytology reaffirms its role as the procedure of choice in the initial screening of thyroid nodules.

Original languageEnglish (US)
Pages (from-to)718-725
Number of pages8
JournalCancer
Volume63
Issue number4
Publication statusPublished - 1989
Externally publishedYes

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hall, T. L., Layfield, L. J., Philippe, A., & Rosenthal, D. (1989). Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer, 63(4), 718-725.