Keywords: cytology diagnosis, follicular thyroid lesions.
Introduction
Over the past twenty years, the incidence of thyroid cancer in our country has increased from 3.9 to 5.1 per 100,000 population on average. Fine-needle aspiration cytology remains the leading minimally invasive method for preoperative diagnosis of thyroid nodules.
Aim
To evaluate the morphological features contributing to diagnostic errors and propose measures for improvement.
Methods
From January to December 2024, 5,124 fine-needle aspiration biopsies of thyroid nodules were performed at the A.S. Loginov Moscow Clinical Scientific Center. Of these, 388 patients underwent surgery (372 women and 77 men), with an average age of 55 years.
Results
Cytological results identified benign lesions in 6.4% of cases (25 cases), follicular tumors in 22.1% (86 cases), suspicion of malignancy in 11.8% (46 cases), and malignant lesions in 59.7% (231 cases). All cases underwent cytological-histological correlation (table 1), with an overall diagnostic accuracy of 90%. False-positive results included 6 cases (2.3%) of papillary cancer and 17 cases (27.4%) of follicular tumors due to follicular-nodular lesions and nodular hyperplasia of the thyroid gland. False-negative results were observed in 7 cases (2.7%), including 4 cases (6.4%) of follicular tumors.
Conclusions
Our data demonstrate that follicular thyroid lesions pose significant diagnostic challenges for cytopathology. Therefore, additional diagnostic methods, such as molecular genetic testing, should be introduced.
Biography
Voropaeva Yana Yuryevna is a Clinical Laboratory Diagnostics Physician at the A.S. Loginov Moscow Clinical Scientific Center.
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