The role of large-needle aspiration biopsy in the preoperative selection of palpable thyroid nodules: a summary of principal data.

This report summarizes clinical and pathologic data showing the role of preoperative large-needle aspiration biopsy (LNAB) histology for a better evaluation of the palpable thyroid nodules that were non-diagnostic or microfollicular at fine-needle aspiration (FNA) cytology. LNAB performed on 261 nodules with non-diagnostic cytology showed findings which were adequate for diagnosis in 130 (49.8%) and inadequate in 131 (50.2%) cases. Two hundred sixty nodules that were diagnosed as microfollicular at FNA were also examined by LNAB; inadequate specimens were obtained in 17% of cases; pure microfollicular structure was confirmed by aspiration needle biopsy in 35% of the nodules and LNAB showed the remaining 48% to contain a macrofollicular component suggesting a benign hyperplastic lesion. Seventeen nodules that were found to be microfollicular at FNA and micromacrofollicular at LNAB were excised and the postoperative result was benign in all cases. Twenty-five nodules diagnosed as microfollicular on both FNA and LNAB were excised and the postoperative diagnoses were benign (20 nodules) or malignant (five nodules). These data indicate that LNAB histology can be used for the preoperative selection of the palpable thyroid nodules that were non-diagnostic or microfollicular at FNA cytology.