Ultrasound-guided fine needle aspiration cytology (US-guided FNAC) of regional nodal basins is increasingly incorporated into the national follow-up schemes of high risk melanoma patients. In this paper we describe an additional added value of US-guided FNAC in the detection and verification of subcutaneous/in-transit metastases. A patient presented with a long lasting, smooth, movable node, close to the scar of the primary melanoma, mimicking a lipoma in every clinical follow-up. Ultrasound at once suspected a metastasis. FNAC was performed within one day of sampling in an outpatient setting, without side effects. A hypothesis of an auto-vaccination in this case could not be proven by examining the T-cell response. Despite the clinically benign aspect of this metastasis, US-guided FNAC can provide diagnosis within 1 day. FNAC is a rapid, cost-effective method, free of complications, of great value in the diagnosis of putative metastases.
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Diagnostic sensitivity of fine-needle aspiration cytology in thyroid cancer.
Sci Rep
October 2024
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, 70185, Sweden.
Article Synopsis
- Fine-needle aspiration cytology (FNAC) is an important diagnostic method for evaluating thyroid cancer in Sweden, assessing its effectiveness by comparing FNAC results with final histology post-surgery.
- In a study involving over 2,500 patients, FNAC correctly diagnosed thyroid cancer in 73% of cases, showing a higher sensitivity for larger nodules (>1 cm) compared to smaller ones (<1 cm).
- The majority of FNAC procedures (85%) were guided by ultrasound, leading to an improved diagnostic sensitivity of 86.9% in larger lesions, highlighting FNAC’s role in the diagnostic process for thyroid cancer.
Evaluation of US Elastography in Thyroid Nodule Diagnosis: The ElaTION Randomized Control Trial.
Radiology
October 2024
From the Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences (H.M., P.N., T.F.L.), Birmingham Clinical Trials Unit (R.W., A.P., J.T., J.D.), and Institute of Applied Health Research (K.B., A.P.), University of Birmingham, Robert Aitken Building, 2nd Floor, Birmingham, UK, B15 2TT; Department of Imaging Sciences, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK (P.S.S.); Department of Radiology, King's College Hospital NHS Foundation Trust, London, UK (P.S.S.); Department of Imaging, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK (G.M.); Department of Pathology, University Hospitals Leicester, Leicester, UK (P.D.F., K.M.); Department of Head and Neck Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (N.S.); Department of Radiology, Lister Hospital, Stevenage, UK (K.R.); Department of Radiology, Portsmouth Hospitals University NHS Trust, Portsmouth UK (J.B.); Department of Radiology, Leicester Royal Infirmary, Leicester, UK (R.V.); and Department of Radiology, Mid and South Essex NHS Foundation Trust, Basildon University Hospital, Basildon, UK (T.R.).
Article Synopsis
- - The study aimed to compare the effectiveness of ultrasound (US) elastography-guided fine-needle aspiration cytology (FNAC) versus conventional US-guided FNAC in diagnosing thyroid nodules, focusing on reducing nondiagnostic results.
- - Conducted across 18 hospitals in England, the trial involved 982 participants who were randomized to either the elastography (493 patients) or conventional method (489 patients), finding no significant differences in the nondiagnostic rates or time to diagnosis between the two methods.
- - The results showed similar rates of malignancy and benign findings in both groups, indicating that US elastography-guided FNAC may not provide additional benefits compared to standard US-guided FNAC for thyroid nodules. *
Diagnostic performance of ultrasound vs. ultrasound-guided FNAc in thyroid nodules: data from the ElaTION trial.
J Clin Endocrinol Metab
October 2024
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT, UK.
Introduction: ElaTION is a large multi-centre pragmatic randomised controlled trial, performed in 18 secondary/tertiary hospitals across England, comparing elastography ultrasound-guided fine needle aspiration cytology (EUS-FNAC) with ultrasound-guided FNAC (US-FNAC) alone in the diagnostic assessment of thyroid nodules. Secondary trial outcomes, reported here, assessed the accuracy of ultrasound-alone (US) compared with US-guided FNAC to inform and update current practice guidelines.
Methods: Adults with single or multiple thyroid nodules who had not undergone previous FNAC were eligible.
Correlation between ultrasonographic and cytologic features of thyroid nodules: a single-center cross-sectional study.
J Med Life
June 2024
Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital, Mohamed the First University, Oujda, Morocco.
A thyroid nodule is managed according to the clinical context, ultrasound (US) findings, and fine needle aspiration (FNA) results. Most thyroid nodules are benign; however, nodule classification is crucial to avoid unnecessary thyroid surgery. We conducted this study to compare the findings of fine-needle aspiration cytology (FNAC) expressed using the Bethesda system with the features of thyroid US classified using the EU-TIRADS classification to assess the risk of malignancy.
View Article and Find Full Text PDFRepeatedly non-diagnostic thyroid nodules: the experience of two thyroid clinics.
Minerva Endocrinol (Torino)
September 2024
Unit of Pathology, Città della Salute e della Scienza, Turin, Italy.
Background: The clinical management of repeatedly non-diagnostic thyroid nodules (RNDNs) via fine needle aspiration cytology (FNAc) is a matter of debate because current recommendations and clinical practice are not based on high-quality evidence. Our purpose was to characterize RNDNs and evaluate their clinical management in our centers.
Methods: This retrospective observational study included 319 consecutive patients who underwent ultrasound (US-)guided FNAc in two Italian academic hospitals between 2016 and 2020 and had previous cytology non-diagnostic result (TIR1).
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