MacDonald L, Yazdi H M
Department of Laboratory Medicine, Ottawa Civic Hospital, Ontario, Canada.
Acta Cytol. 1996 May-Jun;40(3):423-8. doi: 10.1159/000333893.
To evaluate all nondiagnostic fine needle aspiration biopsy (FNAB) specimens from the thyroid gland with subsequent histopathologic diagnoses at Ottawa Civic Hospital. The criterion for specimen adequacy used in our institution was also reexamined to determine if it was too stringent.
Review of 114 nondiagnostic FNAB samples from 91 patients with subsequent histopathologic diagnoses formed the basis of this study. Specimen adequacy was determined by the presence of 8-10 fragments of well-preserved follicular cells on at least two smears.
Review of the 91 surgical specimens found 50 nodular goiters, 23 follicular adenomas, 6 macrofollicular adenomas, 5 cases of thyroiditis, 5 true cysts, 1 papillary carcinoma and 1 minimally invasive follicular carcinoma. Forty-two percent of lesions showed cystic change. In addition, nine cases of papillary microcarcinoma were diagnosed. A considerable difference in the rate (22% vs. 45%) of inadequate thyroid FNAB samples was identified among different groups of physicians at our institution.
Ninety-eight percent of the patients with nondiagnostic FNAB of the thyroid gland had benign lesions. This finding encouraged us to continue using our criteria for adequacy because of the importance of a negative report. The higher rate of nondiagnostic thyroid aspiration in our series may reflect the varied experience of the different aspirators at our institution and/or the cystic nature of many of the lesions.
评估渥太华市民医院所有经后续组织病理学诊断的甲状腺细针穿刺活检（FNAB）非诊断性标本。同时重新审视我院使用的标本充足性标准，以确定其是否过于严格。
对91例患者的114份非诊断性FNAB样本进行回顾，并结合后续组织病理学诊断构成了本研究的基础。标本充足性通过至少两张涂片上存在8 - 10个保存良好的滤泡细胞碎片来确定。
对91份手术标本的回顾发现，有50例结节性甲状腺肿、23例滤泡性腺瘤、6例大滤泡性腺瘤、5例甲状腺炎、5例真性囊肿、1例乳头状癌和1例微侵袭性滤泡癌。42%的病变显示有囊性改变。此外，还诊断出9例乳头状微小癌。在我院不同医生组中，甲状腺FNAB样本不足率存在显著差异（22%对45%）。
甲状腺FNAB非诊断性的患者中，98%患有良性病变。这一发现促使我们继续使用我们的充足性标准，因为阴性报告很重要。我们系列中甲状腺穿刺非诊断率较高，可能反映了我院不同穿刺者的经验差异和/或许多病变的囊性本质。
