[Clinical experience in a high-resolution thyroid nodule clinic].

The finding of a thyroid nodule is a very common occurrence in clinical practice. Management of thyroid nodules requires a multidisciplinary approach that may be eased by a high-resolution thyroid nodule clinic. We report our clinical experience and outcomes in a high-resolution thyroid nodule clinic. All patients referred to Virgen de la Victoria Hospital (Málaga) from 2005 to 2007 were evaluated following thyroid nodule guidelines. Statistical analysis was performed using SPSS software. In the study period, 658 patients (mean age 48.6 years, 89.8% females) were seen at the thyroid nodule clinic. Thyroid nodules were discovered in 85.5% of patients. Mean nodule diameter was 1.96 cm. Of these nodules, 74.2% were solid, 55.8% hypoechogenic, and 4.7% showed microcalcifications. Fine needle aspiration (FNA) was performed in 475 patients (76.5% of all cytological samples were benign, 19.1% had suspected malignancy, 2.1% were malignant, and 2.3% inadequate). Referral for surgery was required in 23.3% of patients (mainly because of nodule size or suspected malignancy). Malignancy was confirmed in 24.9% of nodules. Sensitivity and specificity of cytology (considering biopsy as gold standard) were 81.8% and 94.7% respectively. Implementation of a high-resolution thyroid nodule clinic decreases delay in diagnosis and optimizes available resources, thus providing for satisfactory clinical outcomes.

Sebastián-Ochoa N ，Fernández-García JC ，Mancha Doblas I ，Sebastián-Ochoa A ，Fernández García D ，Ortega Jiménez MV ，Gallego Domínguez E ，Tinahones Madueño F ... -  《-》

Reliability of fine-needle aspiration and ultrasound-based characteristics of thyroid nodules for diagnosing malignancy in Iranian patients.

Sonography and fine-needle aspiration biopsy (FNA-B) have been approved as method of choice in diagnosis of malignant thyroid nodules. Unnecessary FNA-B not only is invasive and costly but also results in second biopsy or unnecessary surgery. So we aimed to determine the specificity and sensitivity of sonography and FNA-B, without sonography guidance, in diagnosis of malignant and benign thyroid nodules. Patients with thyroid nodule referred to Baqiyatallah Hospital in 2014-2015 and candidates for surgical nodule resection were selected using simple random sampling method. Patients were evaluated by sonography and FNA. Sonographic characteristics of nodule were described. All patients underwent surgical resection and gross samples were sent for pathological evaluation, the gold standard for measuring the specificity and sensitivity of sonographic findings and FNA in diagnosis of malignant nodules. Ninety patients with the mean age of 45.95 ± 12.3 years were evaluated (17 male and 73 female). Comparing the patients with correct and incorrect sonography-based diagnosis showed significant differences in nodule's width, area, calcification, border, and cervical lymphadenopathy (P < 0.05). Comparing the patients with correct and incorrect FNA-based diagnosis showed significant differences in patients' age and tall-shape nodule (P < 0.05). The diagnosis of sonographist had 56.25% sensitivity and 95.9% specificity, and the FNA-based diagnosis had 81.25% sensitivity and 93.7% specificity. Among sonography findings, width and area of nodule, calcification, and nodule border have significant effect on malignancy diagnosis. Also FNA is necessary in nodules with calcification, border irregularity, and less width and area, especially in younger patients.

Akhavan A ，Jafari SM ，Khosravi MH ，Khajehpour H ，Karimi-Sari H ... -  《-》

Diagnostic and functional structure of a high-resolution thyroid nodule clinic.

Appearance of a thyroid nodule has become a daily occurrence in clinical practice. Adequate thyroid nodule assessment requires several diagnostic tests and multiple medical appointments, which results in a substantial delay in diagnosis. Implementation of a high-resolution thyroid nodule clinic largely avoids these drawbacks by condensing in a single appointment all tests required for adequate evaluation of thyroid nodule. This paper reviews the diagnostic and functional structure of a high-resolution thyroid nodule clinic.

Fernández-García JC ，Mancha-Doblas I ，Ortega-Jiménez MV ，Ruiz-Escalante JF ，Castells-Fusté I ，Tofé-Povedano S ，Argüelles-Jiménez I ，Tinahones FJ ... -  《-》

Ultrasonographic features associated with malignancy in cytologically indeterminate thyroid nodules.

Thyroid nodules with indeterminate cytology usually are treated with surgery, but most are benign. Neck ultrasonography has varied results in predicting malignancy. To evaluate the predictive value of ultrasonography and the frequency of malignancy in patients who had indeterminate thyroid nodules. Retrospective study. University hospital. There were 78 patients who had thyroid nodules that were diagnosed on cytology (fine needle aspiration) as a follicular lesion (atypia of undetermined significant) or follicular neoplasm. Ultrasonography was available in 69 patients (88%). Diagnostic fine needle aspiration (cytology), ultrasonography, and surgical pathology of thyroid nodules. Fine needle aspiration was indeterminate in all patients, with follicular lesions in 60 patients (77%) and follicular neoplasm in 18 patients (23%). Ultrasonography showed micro calcification in 6 patients (9%), irregular border in 15 patients (22%), size ≥ 3 cm in 31 patients (45%), and hypoechogenicity in 43 patients (62%). Surgical pathology showed that the nodules were benign in 50 patients (64%) and malignant in 28 patients (36%). Malignancy was significantly associated with male sex (relative risk, 2.3), solid nodule structure (relative risk, 2.6), and irregular border (relative risk, 3.6). Compared with other ultrasonographic characteristics, irregular borders had the highest specificity (93%), positive predictive value (80%), and accuracy (78%) for malignancy. The frequency of malignancy is high in indeterminate thyroid nodules. Based on the limited accuracy or predictive value of ultrasonographic risk factors, surgery is the treatment of choice for indeterminate thyroid nodules.

Batawil N ，Alkordy T 《-》

The diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy and the sonographic differences between benign and malignant thyroid nodules 3 cm or larger.

Yoon JH ，Kwak JY ，Moon HJ ，Kim MJ ，Kim EK ... -  《-》