Analysis of inconclusive fine-needle aspiration of XXXX .

@entity1 @entity189 @entity400 @entity4383 @entity5651 @entity652 @entity1374
To evaluate all inconclusive @entity400 ( @entity400 ) specimens from @entity1374 with subsequent histologic diagnosis at St John Hospital and Medical Center, Detroit, MI. The criterion for specimen adequacy used in our institution was also reexamined to determine whether it was too stringent. We reviewed 45 inconclusive @entity400 samples. Only cases that underwent surgical intervention were considered. Specimen adequacy was determined by the presence of at least 8-10 tissue fragments of well-preserved follicular epithelium on at least two slides; each tissue fragment should have a minimum of 8-10 cells. Different cytologic characteristics-cellularity, cellular architecture, nuclear pleomorphism, inclusion/grooves, chromatin, H  rthle cell change, lymphocytes, macrophages, colloid, and multinucleated giant cells-were scored and compared with final surgical diagnosis. The surgical procedure performed was also analyzed. Review of these 45 surgical specimens found 28 (62.2%) multinodular @entity5651 , 14 (31.1%) @entity4383 , 2 (4.4%) @entity652 , and one (2.2%) with invasive @entity189 . Forty-three (95.6%) of these cases were female and 2 (4.4%) were male. Cytologic review showed 2 acellular samples, 10 cases containing macrophages only, 10 aspirates with macrophages and an inadequate number of follicular cells, and 23 specimens with an inadequate number of follicular cells. Twenty-three @entity1 underwent total thyroidectomy; 20, lobectomy; and 2, isthumusectomy. Almost 98% of the @entity1 with inconclusive @entity400 had benign lesions. This finding encouraged us to continue using our criteria for adequacy because of the importance of a negative report. @entity1 in our series, who underwent thyroidectomy after an inconclusive or nondiagnostic aspirate, had a malignancy rate of 2.2%, which was no worse than @entity1 with a benign preoperative diagnosis. A balanced approach with careful follow-up for nondiagnostic cytology is prudent.
