Sharma Chetna, Krishnanand Geeta
Department of Pathology, Kasturba Medical College, Manipal, Karnataka, India.
Acta Cytol. 2008 Jan-Feb;52(1):56-64. doi: 10.1159/000325435.
To assess histologic alterations following fine needle aspiration (FNA) of the thyroid and differentiate these from ominous lesions, such as papillary carcinoma thyroid, as well as assess and compare the degree of tissue trauma from the techniques: needle only vs. needle with syringe, size of needle and number of aspirations.
Thyroidectomy specimens of 100 cases with prior FNA biopsy were selected. The changes called "worrisome histologic alteration following fine needle aspiration of the thyroid" (WHAFFT) were studied. Number of FNAs, needle size and technique were tabulated for 73 of 100 cases.
Worrisome changes were confined to areas near the needle tract and hence could be differentiated from ominous lesions. Control cases did not show WHAFFT lesions. Non-aspiration FNA cytology (FNAC) technique results in fewer, less frequent WHAFFT changes. The increasing number of FNAs leads to statistically significant increase in infarction, necrosis and vascular changes. A gradation in the WHAFFT changes, directly proportional to the increasing diameter of the needle, was observed.
The pathologist should be aware of WHAFFT to avoid misinterpretation. The technique of non-aspiration FNAC is significantly less traumatic. An increase in FNAs or size of needle results in more severe WHAFFT changes.
评估甲状腺细针穿刺（FNA）后的组织学改变，并将这些改变与诸如甲状腺乳头状癌等恶性病变相鉴别，同时评估和比较不同穿刺技术造成的组织创伤程度，这些技术包括单纯针穿刺与带注射器的针穿刺、针的大小以及穿刺次数。
选取100例曾接受FNA活检的甲状腺切除标本，研究所谓的“甲状腺细针穿刺后令人担忧的组织学改变”（WHAFFT）。对100例中的73例记录了FNA次数、针的大小和穿刺技术。
令人担忧的改变局限于针道附近区域，因此可与恶性病变相鉴别。对照病例未显示WHAFFT病变。非抽吸式FNA细胞学检查（FNAC）技术导致的WHAFFT改变更少、更不常见。FNA次数增加会导致梗死、坏死和血管改变在统计学上显著增加。观察到WHAFFT改变存在分级，与针直径增大成正比。
病理学家应了解WHAFFT以避免误诊。非抽吸式FNAC技术造成的创伤明显更小。FNA次数增加或针的尺寸增大导致更严重的WHAFFT改变。
