Jung Chan Kwon, Baek Jung Hwan
Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Endocrinol Metab (Seoul). 2017 Dec;32(4):407-412. doi: 10.3803/EnM.2017.32.4.407.
Core needle biopsy (CNB) was introduced as an alternative diagnostic tool to fine-needle aspiration (FNA), and is increasingly being used in the preoperative assessment of thyroid nodules. CNB provides a definitive diagnosis in most cases, but it sometimes may be inconclusive. CNB has the advantage of enabling a histologic examination in relation to the surrounding thyroid tissue, immunohistochemistry, and molecular testing that can provide a more accurate assessment than FNA in selected cases. Nevertheless, CNB should be performed only by experienced experts in thyroid interventions to prevent complications because CNB needles are larger in caliber than FNA needles. As recent evidence has accumulated, and with improvements in the technique and devices for thyroid CNB, the Korean Society of Thyroid Radiology released its 2016 thyroid CNB guidelines and the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group published a consensus statement on the pathology reporting system for thyroid CNB in 2015. This review presents the current consensus and recommendations regarding thyroid CNB, focusing on indications, complications, and pathologic classification and reporting.
粗针穿刺活检(CNB)作为细针穿刺抽吸活检(FNA)的替代诊断工具被引入,并且越来越多地用于甲状腺结节的术前评估。在大多数情况下,CNB可提供明确诊断,但有时可能无法得出结论。CNB的优势在于能够对周围甲状腺组织进行组织学检查、免疫组织化学检查以及分子检测,在某些特定病例中,这些检测能够提供比FNA更准确的评估。然而,由于CNB针的口径比FNA针大,因此CNB仅应由甲状腺介入方面的经验丰富的专家进行操作,以预防并发症。随着近期证据的积累,以及甲状腺CNB技术和设备的改进,韩国甲状腺放射学会发布了其2016年甲状腺CNB指南,韩国内分泌病理学甲状腺粗针穿刺活检研究组于2015年发表了关于甲状腺CNB病理报告系统的共识声明。本综述介绍了目前关于甲状腺CNB的共识和建议,重点关注适应证、并发症以及病理分类和报告。