Us-gui̇ded cytology i̇n the management of beni̇gn thyroi̇d nodules di̇agnosed by fna;followi̇ng and evaluation wi̇th us properties

Background: Tyroid nodules are common .Up to 5% of the population have a palpable nodule and on ultrasound , 50 % of the population will have subclinical thyroid nodules. Of the these, approximately 5% will be malignant. Fine needle aspiration cytology (FNAC) is the best method in the diagnosis of thyroid nodules.It is safe , cost-effective and most accurate method for differentiating beingn from malignant tyroid nodules. Objective: US-guided cytology in the management of benign thyroid nodules diagnosed by FNA; with suspected malignancy will require significant re-FNA to determine the US indications. In this way, the number jumped malignant FNA cases with false-negative results may be reduced; also low malignant potential unnecessary repetition rate nodule FNA could also be reduced.Materials and methods: January 2009 - February 2014 , 513 patients were evaluated retrospectively redirected from various clinics of Baskent University Faculty of Medicine, Ankara Hospital . Inclusion criteria for the study; first with benign FNA results and follow-up in the 6-12 month range again ultrasonography (US) and then were included patients who underwent FNA. Ultrasonography (US) features increased in size, echogenicity, internal structure (solid / cystic), the number of nodules, the presence of calcification, and atypical lymphadenopathy and increase in size lymphadenopathy were considered. Included in the study in patients with multinodular thyroid nodules; nodules indicated that FNA is performed in interventional radiology report. Interventional radiology report from the same nodule FNA done that can not be understood as a certain internal structure of the nodules and nodules in the US deteriorated after the first FNA procedure, were excluded from being certain that again for the same nodule FNA done. Results: 498 nodules in the evaluation of cytological 'i benign, 15 of them are malignant. Statistical significant (p <.05) finding of malignancy were microcalcification (sensitivity,60%; specificity74.5%), hypoechogenicity and to be single (sensitivity,46,7%; specificity 91%), hypoechogenicity and to be single and increase in size (sensitivity,46,7%; specificity 95.4%), lymph node presence (sensitivity, 33.3%; specificity%95) . Nodule size, increase in size, components, number of nodule were not associated with malignancy. The US finding for benign nodules were isoechogenicity, hyperechogenicity , cystic appearance . Conclusion: Microcalcifications, hypoechogenicity and to be single ,hypoechogenicity and to be single and increase in size , lymph node presence that important US properties increased the malignancy .Hyperechoic , cystic internal structure as a significant supporting evidence benign nodules. In our study, only one US feature is not the hallmark of malignancy diagnosis but in cases where a combination of several suspicious findings showed significant residual risk of malignancy was observed.