Interinstitutional review of thyroid fine-needle aspirations: Impact on clinical management of thyroid nodules

Authors

  • Zubair W. Baloch M.D., Ph.D.,

    Corresponding author
    1. Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
    • Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, 6 Founders Pavilion, 3400 Spruce Street, Philadelphia, PA 19104
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  • Samantha Hendreen M.D.,

    1. Department of Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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  • Prabodh K. Gupta M.D.,

    1. Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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  • Virginia A. LiVolsi M.D.,

    1. Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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  • Susan J. Mandel M.D.,

    1. Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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  • Randal Weber M.D.,

    1. Department of Otorhinolaryngology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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  • Douglas Fraker M.D.

    1. Department of Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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Abstract

Routine interinstitution pathology consultation can result in change in pathologic diagnosis in up to 10% of patients. In this study, we compared the outside cytopathologic diagnosis of thyroid fine-needle aspiration (FNA) specimens with the in-house diagnosis at the University of Pennsylvania Medical Center over an 18-mo period and its effect on patient management. One hundred ten (60%) diagnostic disagreements were identified among 183 patients. In 16 cases, the diagnosis was changed from benign to malignant, and in 12, the diagnosis was reversed from neoplastic/malignant to benign. Histologic follow-up was available in 109 cases; the overall accuracy of outside diagnosis was 73%, and that of inside diagnosis was 85%. In conclusion, we strongly recommend interinstitution cytology consultation on referred thyroid FNA cases, since our data showed a significant change in diagnosis, thus affecting patient management. Diagn. Cytopathol. 25:231–234, 2001. © 2001 Wiley-Liss, Inc.

Ancillary