Thyroid nodules are present in between 21-68% of the general population. The evaluation of these nodules to exclude thyroid carcinoma includes fine-needle aspiration cytology (FNAC) and a non-diagnostic cytology result occurs between 8-20% of the time. This retrospective cohort study aimed to determine the risk of malignancy in non-diagnostic thyroid nodule FNAC and to identify factors associated with malignancy. This is particularly important in managing patients with repeated non-diagnostic FNACs.

Over a six-year period, 495 patients with non-diagnostic thyroid nodule FNACs were followed up and 3% of these went on to develop thyroid cancer. This is lower than the estimated risk of a thyroid nodule being malignant (4-6.5%).

The study found the presence of calcifications to be the strongest predictor for malignancy. A smaller nodule size was also significantly associated with a higher risk of malignancy. Interestingly, no patients with repeatedly non-diagnostic FNACs were diagnosed with thyroid malignancy on follow up during the study.

Risk of malignancy in thyroid nodules with non-diagnostic fine-needle aspiration: a retrospective cohort study.
Espinosa De Ycaza AE, Lowe KM, Dean DS, et al.
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Serge Latis

Liverpool Hospital, Sydney, NSW, Australia.

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