Clinical evaluation of atypia of undetermined significance, follicular lesion, and suspicious cytology results in patients undergoing thyroid fine needle aspiration biopsy

Objective: We aimed to clinically evaluate the ultrasound features, age, gender, TSH, anti TPO values and postoperative histopathology of patients who were reported to have atypia of undetermined significance, follicular lesion and suspicious cytology as a result of thyroid FNA in our hospital. Materials and Methods: Retrospectively, the files of 875 patients who applied to Erzincan Binali Yıldırım University Faculty of Medicine Mengücek Gazi Research Hospital Internal Medicine Clinics between 2012 and 2022 and were reported to have atypia/follicular lesion of undetermined significance, suspicious, nondiagnostic, malignant cytology, and follicular neoplasia according to the Bethesda system were examined. FNA, postoperative histopathology reports, ultrasound features, TSH and anti-TPO values were evaluated. Nodules were evaluated in terms of hardness, diameter, number, echogenicity, structure, microcalcification, macrocalcification, pathological lymphadenopathy, border irregularity and were investigated for statistical significance according to postoperative histopathology results. Results and Conclusion: The patients in our study; 665 were women and 210 were men, the average age of the patients was 52.43±13.83. Postoperative histopathology reports were found in 264 patients. Of the operated patients, 158 were benign and 106 were malignant. Of the 106 malignant patients, 81 were women and 25 were men. FNA results were found to be atypia/follicular lesion of undetermined significance in 330(37.7%), nondiagnostic cytology in 396(45.3%), follicular neoplasia in 24(2.7%), suspicious cytology in 108(12.3%), and malignant cytology in 17(1.9%). The average TSH value of the postoperative malignant group was 1.73±1.42 mIU/mL and the average TSH of the postoperative benign group was determined to be 2.28±3.00 mIU/mL. The average age of 81 women diagnosed with postoperative cancer was 45.27±12.96, and the average age of 25 male patients diagnosed with postoperative cancer was 54.76±12.67. No statistically significant relationship was found between anti-TPO, nodule size between ≥15 mm and <20 mm, macrocalcification, cystic structure, gender, TSH level, number of nodules and postoperative histopathology results. There was a statistically significant relation between the histopatology results and echogenicity, nodule size, microcalcification, irregüler border, diamater increase, hard nodule, pathological lymph node, solid, semisolid character, suspicious, malignant, nondiagnostic cytology of nodules. In our study, it is envisaged that ultrasound findings and cytology results will be evaluated together to give the clinician an idea about malignancy and to guide the diagnosis, follow-up and treatment of the nodule. Key Words: Fine needle aspiration biopsy, Thyroid cancer, Thyroid nodules, Thyroid ultrasound. Fine needle aspiration biopsy, Thyroid cancer, Thyroid nodules, Thyroid ultrasound, Atypia of Undetermined Significance, Suspicious For Malignancy