Early diagnosis and detection of clinically non-suspected thyroid neoplasia by the cytologic method a critical review of 1536 aspiration biopsies

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Abstract
Aspiration biopsies were performed on 1536 patients with goiter who showed scintigraphically “cold” nodules. Twelve among them had clinical and cytological positive diagnosis. The remaining 1524 patients had aspiration biopsies without suspicion of the malignant nature of their goiters. Among them, 45 patients had a positive or suspect cytological diagnosis. Fourteen had not been yet operated on. Thirty-one were operated on and 28 malignancies were confirmed histologically. In three patients, cytological diagnosis was false positive. The remaining patients were cytologically negative. Thirty-seven were operated on and four false negative cases were found. The application of aspiration biopsy on every patient with a cold thyroid nodule resulted in the detection and very early diagnosis of clinically unsuspected thyroid neoplasms, the great majority of which were confined to the gland itself without metastatic spread. This fact makes the prognosis better. In addition, it is probable that the early detection of differentiated thyroid neoplasms and their surgical ablation interrupt their natural course towards anaplastic carcinoma, with its grim prognosis.