Abstract:

SUMMARY Aim: The false negative rate of fine needle aspiration biopsy (FNAB) in large thyroid nodules ranges from 7.7% to 53%. The treatment of nodules that are 4 cm or larger is controversial because of the potential for false-negative FNAB results. In order to make treatment recommendations for nodules ≥4 cm in size, we compared the results of preoperative FNAB with thyroid surgery specimens. Materials and Methods: We evaluated patients who underwent thyroid surgery and had preoperative FNAB between 2017 and 2022. Patients were divided into two groups based on nodule size (<4 cm and ≥4 cm). FNAB and specimen pathology results of both groups were compared. Results: 982 patients who underwent surgery for nodular disease were evaluated. Patients in the Bethesda 2 group (n=231) were divided into two categories based on nodule size: ≥4 cm (n=56) and <4 cm (n=175). Malignancy rates were higher in the group with tumors smaller than 4 cm. FNAB and specimen results were compared. A statistically significant difference was found between the groups (p = 0.039). Conclusion: The benign fine-needle aspiration biopsy results were consistent with the specimen results in patients with nodules that were 4 cm or larger. Thyroid surgery should not be considered as the initial treatment for nodules ≥4 cm with benign cytology.

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