KES
Search
- Page Path
- HOME > Search
Original Articles
- Risk of Malignancy in Thyroid Nodules 4 cm or Larger
- Uchechukwu C. Megwalu
- Endocrinol Metab. 2017;32(1):77-82. Published online February 6, 2017
- DOI: https://doi.org/10.3803/EnM.2017.32.1.77
- 7,703 View
- 75 Download
- 18 Web of Science
- 21 Crossref
-
Abstract
PDF
PubReader Background Several authors have questioned the accuracy of fine-needle aspiration cytology (FNAC) in large nodules. Some surgeons recommend thyroidectomy for nodules ≥4 cm even in the setting of benign FNAC, due to increased risk of malignancy and increased false negative rates in large thyroid nodules. The goal of our study was to evaluate if thyroid nodule size is associated with risk of malignancy, and to evaluate the false negative rate of FNAC for thyroid nodules ≥4 cm in our patient population.
Methods This is a retrospective study of 85 patients with 101 thyroid nodules, who underwent thyroidectomy for thyroid nodules measuring ≥4 cm.
Results The overall risk of malignancy in nodules ≥4 cm was 9.9%. Nodule size was not associated with risk of malignancy (odds ratio, 1.02) after adjusting for nodule consistency, age, and sex (
P =0.6). The false negative rate for FNAC was 0%.Conclusion Nodule size was not associated with risk of malignancy in nodules ≥4 cm in our patient population. FNAC had a false negative rate of 0. Patients with thyroid nodules ≥4 cm and benign cytology should not automatically undergo thyroidectomy.
-
Citations
Citations to this article as recorded by
- Comparative accuracy of fine-needle aspiration cytology between larger and smaller size thyroid nodules
Saad Samargandy, Yousef Zaki Khedher, Shaza Ahmed Samargandy, Ghaida Ahmed Alzahrani, Hesham Tariq Nahhas, Mohammed Abdulrahman Alshaikh, Khalid Abdulaziz Alzahrani, Samah Saharti
Cytojournal.2025; 22: 44. CrossRef - The Utility of ACR TI-RADS in Predicting False-Negative Fine Needle Aspiration for Thyroid Cancer
Katrina L. Dimaano, Valerie A. Dib, Taylor Parnall, Audrey Covington, Amy H. Kaji, Patrick Choi, Kathryn T. Chen
The American Surgeon™.2024; 90(6): 1156. CrossRef - The Effect of Thyroid Nodule Size and Characteristics on the Accuracy of Fine-Needle Aspiration Biopsy and the Risk of Malignancy
Mehmet Alperen Avcı, Can Akgün, Mustafa Gün, Selim Tamam, Meltem Türk
Hitit Medical Journal.2024; 6(3): 321. CrossRef - Correlation between ultrasonographic and cytologic features of thyroid nodules: a single-center cross-sectional study
Imane Ziani, Anouar Jamal, Imane Assarrar, Ikram Karabila, Siham Rouf, Hanane Latrech
Journal of Medicine and Life.2024; 17(6): 593. CrossRef - The necessity of fine-needle aspiration biopsy in surgical decision-making for thyroid nodules larger than 3 cm
Serkan Erkan, Hakan Yabanoğlu, Tevfik Avci, Ramazan Gündoğdu, Murat Kuş, Murathan Erkent, Caner İncekaş
Medicine.2024; 103(51): e40373. CrossRef - Effect of thyroid nodule size on cytology reliability and incidence of malignancy: A large cohort of 1205 patients from a single center
Muhammed Erkam Sencar, Murat Calapkulu, Hayri Bostan, Davut Sakiz, Sema Hepsen, Muhammed Kizilgul, Ilknur Ozturk Unsal, Ozgur Ozcelik, Emre Arslan, Bekir Ucan, Cem Azili, Mustafa Ozbek, Erman Cakal
Annales d'Endocrinologie.2023; 84(2): 238. CrossRef - Accuracy of fine‐needle aspiration cytopathology to differentiate malignant and benign thyroid nodules with ≥4 cm diameter: A retrospective study
Houra Rastegar, Ashkan Torshizian, Mohammad Ali Yaghoubi, Nastaran Khoshhal, Mehdi Asadi, Negar Morovatdar, Masoud Mohebbi
Diagnostic Cytopathology.2023; 51(4): 263. CrossRef - Risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy in thyroid nodules with diameters greater than 4 centimeters
Rafaela N. Barcelos, Cléber P. Camacho, Maria da Conceição de O. C. Mamone, Elza S. Ikejiri, Felipe A. B. Vanderlei, Ji H. Yang, Rosália P. Padovani, Leandro A. L. Martins, Rosa Paula M. Biscolla, Danielle Macellaro, Susan C. Lindsey, Rui M. B. Maciel, Jo
Archives of Endocrinology and Metabolism.2023;[Epub] CrossRef - Concordance of the ACR TI-RADS Classification With Bethesda Scoring and Histopathology Risk Stratification of Thyroid Nodules
Elaine Y. F. Huang, Nern Hoong Kao, Snow Yunni Lin, Isabelle J. H. Jang, Kimberley Liqin Kiong, Anna See, Nanda Venkatanarasimha, Kristen Alexa Lee, Chwee Ming Lim
JAMA Network Open.2023; 6(9): e2331612. CrossRef - Probable impact of environmental radiation on thyroid swellings in areas of Eastern Hyderabad and Nalgonda
Namit Kant Singh, Neemu Hage, Shailaja Prabhala, Balaji Ramamourthy, Sushmitha Nagaraju, Krishna Medha Kappagantu
The Egyptian Journal of Otolaryngology.2023;[Epub] CrossRef - Predictive Value of a Genomic Classifier in Indeterminate Thyroid Nodules Based on Nodule Size
Jared C. Dublin, Michael Papazian, Elcin Zan, Thaira Oweity, Wei Sun, Adam Jacobson, Kepal Patel, Tamar C. Brandler, Babak Givi
JAMA Otolaryngology–Head & Neck Surgery.2022; 148(1): 53. CrossRef - Navigating the Debate on Managing Large (≥4 cm) Thyroid Nodules
Samantha N. Steinmetz-Wood, Amanda G. Kennedy, Bradley J. Tompkins, Matthew P. Gilbert, Claudio Casella
International Journal of Endocrinology.2022; 2022: 1. CrossRef - Clinicopathologic features of thyroid nodules with PTEN mutations on preoperative testing
Jacob A Quaytman, Yuri E Nikiforov, Marina N Nikiforova, Elena Morariu
Endocrine-Related Cancer.2022; 29(9): 513. CrossRef - The risk of thyroid carcinoma in multinodular goiter compared to solitary thyroid nodules: A retrospective analysis of 600 patients
Khaled Y. Ajarma, Ashraf F. Al-Faouri, Maysoon K. Al Ruhaibeh, Feras A. Almbaidien, Rima T. Nserat, Abdallah O. Al-Shawabkeh, Khaldon K. Al-Sarihin, Yousef A. Al-Harazi, Haitham S. Rbihat, Mohammad E. Aljbour
Medical Journal Armed Forces India.2020; 76(1): 23. CrossRef - A Study to Evaluate the Size of Thyroid Nodules as an Indicator for Malignancy
Ajay Kumar Jha, Ajit Kumar Sinha
Academia Journal of Surgery.2020; 3(1): 16. CrossRef - Thyroid nodules over 4 cm do not have higher malignancy or benign cytology false-negative rates
Muhammed Kizilgul, Rupendra Shrestha, Angela Radulescu, Maria R. Evasovich, Lynn A. Burmeister
Endocrine.2019; 66(2): 249. CrossRef - Clinical and Ultrasound Thyroid Nodule Characteristics and Their Association with Cytological and Histopathological Outcomes: A Retrospective Multicenter Study in High-Resolution Thyroid Nodule Clinics
María Molina-Vega, Carlos Antonio Rodríguez-Pérez, Ana Isabel Álvarez-Mancha, Gloria Baena-Nieto, María Riestra, Victoria Alcázar, Ana Reyes Romero-Lluch, Juan C. Galofré, José C. Fernández-García
Journal of Clinical Medicine.2019; 8(12): 2172. CrossRef - The influence of thyroid nodule size on the diagnostic efficacy and accuracy of ultrasound guided fine‐needle aspiration cytology
Berna İmge Aydoğan, Mustafa Şahin, Koray Ceyhan, Olgun Deniz, Özgür Demir, Rifat Emral, Vedia Tonyukuk Gedik, Ali Rıza Uysal, Demet Çorapçıoğlu
Diagnostic Cytopathology.2019; 47(7): 682. CrossRef - Update on Thyroid Nodule Management
Alan A Parsa, Hossein Gharib
US Endocrinology.2019; 15(1): 32. CrossRef - Large Cytologically Benign Thyroid Nodules Do Not Have High Rates of Malignancy or False-Negative Rates and Clinical Observation Should be Considered: A Meta-Analysis
Nicole A. Cipriani, Michael G. White, Peter Angelos, Raymon H. Grogan
Thyroid.2018; 28(12): 1595. CrossRef - Hemoptisis aislada en una paciente no fumadora
A. Hidalgo Rodríguez, C.A. Fignani Molina, I. Alfonso Zamora, J.C. Aguirre Rodríguez, M. Mene Llorente
SEMERGEN - Medicina de Familia.2017; 43(8): e65. CrossRef
- Comparative accuracy of fine-needle aspiration cytology between larger and smaller size thyroid nodules
- Influence of Anti-thyroglobulin Antibody on the Measurement of Thyroglobulin using the Immunoradiometric Assay.
- Byeong Cheol Ahn, Jin Ho Bae, Shin Young Jeong, Ho Yong Park, Jung Guk Kim, Sung Woo Ha, Jaetae Lee, Bo Wan Kim, Kyu Bo Lee
- J Korean Endocr Soc. 2004;19(1):42-47. Published online February 1, 2004
- 1,653 View
- 24 Download
-
Abstract
PDF
- BACKGROUND
Serum thyroglobulin(Tg) is a valuable and sensitive tool needed in the follow-up of patients with differentiated thyroid cancer(DTC), but antithyroglobulin antibody(Anti-Tg), common in patients with DTC, can interfere with the assay for Tg. In this study, we evaluated the influence of Anti-Tg on the measurement of Tg using the immunoradiometric assay(IRMA). METHODS: In using ELSA-hTg in vivo test(CIS international, Schering, France), a solid phase two-site IRMA was used to measure Tg(23.5ng/mL, 62.5ng/mL) under the absence or presence of three concentrations of Anti-Tg(25U/mL, 50U/mL, 100U/mL). We also performed Tg measurement using patients serum that was mixed with patients serum containing high Anti-Tg. ANOVA and Scheffe tests were performed to evaluate the effect of Anti-Tg on Tg IRMA, and an inverse regression was made to calculate the level of Tg from measured Tg and used Anti-Tg levels and also to assess the degree of effect of anti-Tg on Tg IRMA. RESULTS: In measuring Tg using the standard solution, the presence of Anti-Tg resulted in a falsely suppressed Tg value. The IRMAs for 23.5ng/mL of the standard Tg solution resulted in 24.5+/-.1 ng/mL under no Anti-Tg, 11.8+/-.4ng/mL under 25U/mL of Anti-Tg, 7.7+/-.1ng/mL under 50U/mL of Anti-Tg, and 4.5+/-.4ng/mL under 100U/mL of Anti-Tg. IRMAs 62.5ng/mL of the standard Tg solution resulted in 65.9+/-.7ng/mL under no Anti-Tg, 36.3+/-.2ng/mL under 25U/mL of Anti-Tg, 23.7+/-.7ng/mL under 50U/mL of Anti-Tg, and 14.0+/-.0ng/mL under 100U/mL of Anti-Tg. (ANOVA test, p=0.000). The degree of suppression of the measured Tg value was positively correlated with the Anti-Tg level (Quadratic model regression, Sig T=0.000). The presence of Anti-Tg also resulted in a falsely suppressed Tg value for the Tg measurement using patient's serum. CONCLUSION: The presence of Anti-Tg could consist of the use of Tg as a tumor, therefore Anti-Tg should be measured in all patients diagnosed with DTC. The interpretation of the Tg level must be performed with extreme caution in patients with Anti-Tg.
First
Prev
