Use of fine needle aspiration cytology in the management of the solitary cold thyroid nodule.

The aim of this study was to evaluate the use of fine needle aspiration cytology (FNA) in the management of the solitary cold thyroid nodule and set up a thyroid cytology service in a district general hospital. One hundred and eight patients underwent FNA and then went on to have thyroid lobectomy. The results of cytology were compared with histology. The percentage of cancers was 8% and of benign lesions 92%. The overall accuracy of FNA was 86%. There were no false positive results and one false negative result. If one includes a suspicious cytology as positive then six of seven cancers were diagnosed by FNA. Also, 49 benign colloid nodules were accurately diagnosed by FNA and could have avoided surgery (55% of the Series). We conclude that fine needle aspiration cytology is a useful adjunct to the management of the solitary cold thyroid nodule and should be used with other clinical information to decide the best form of treatment for the patient.