Objective: To report the results of cytology and histology obtained for a series of systematically resected thyroid nodules >or= 4 cm.
Methods: A group of 151 patients with thyroid nodules >or= 4 cm was submitted to surgery despite the cytology result.
Results: Malignancy was confirmed histologically in 22.5% of the patients. Excluding cases of insufficient material, cytology was benign in only 3/31 carcinomas (90.3% sensitivity). The frequency of malignancy was 35% among nodules with indeterminate cytology (follicular neoplasm), and there was a predominance (77%) of papillary carcinoma. The negative predictive value of benign cytology was 96.4%.
Conclusions: The false-negative rate of cytology in thyroid nodules >or= 4 cm does not justify systematic resection of these nodules in asymptomatic patients with benign cytology.
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