[Ultrasound-guided core-needle biopsy for diagnosis of thyroid cancer].

Abstract

Objective: To improve preoperative examination of patients with follicular thyroid tumors using ultrasound-guided core-needle biopsy.

Material and methods: All patients with Bethesda IV (follicular tumor) underwent ultrasound-guided core-needle biopsy of thyroid neoplasm according to original technique (patent No. 2826474 RU). Preoperative histological specimen after core needle biopsy was compared with urgent and elective histological examination. Statistical analysis was carried out using Kolmogorov-Smirnov and Kruskal-Wallis tests. Differences were significant at p<0.05.

Results: Thyroid tumors were available for core needle biopsy in all 45 cases (100%). Repeated cytological analysis confirmed TI-RADS category 3 in 22 (48.89%), TI-RADS 4 in 15 (33.33%) and TI-RADS 5 in 8 (17.77%) patients. Histological examination revealed colloidal goiter in 13 patients (28.89%), adenomatous hyperplasia in 15 (33.33%), follicular adenoma in 9 (20%), and follicular neoplasia with undetermined malignant potential in 2 (4.44%) cases. The quality of histological material made it possible to assess morphological type of tumor, capsule vascularization and cell atypia, invasion into capsule or vessels. In case of colloidal goiter, we were able to assess dimensions of follicles, presence of colloid, cell polymorphism, mitosis and cytoplasm content.

Conclusion: Ultrasound-guided core-needle biopsy can reduce the number of unjustified surgical interventions in patients with follicular tumors and optimize management of patients with nodular thyroid lesions.