RELATIVE ACCURACY OF FINE-NEEDLE ASPIRATION AND FROZEN-SECTION IN THEDIAGNOSIS OF WELL-DIFFERENTIATED THYROID-CANCER

The need for and extent of thyroid surgery for a thyroid nodule is usu ally primarily based on fine-needle aspiration (FNA) and frozen sectio n diagnosis. The relative role of these modalities in BE patients who] had undergone FNA and subsequent thyroidectomy with frozen section was investigated. Cases that demonstrated discordance between FNA and fro zen section (n = 22; 33%) were identified, and all slides were re-revi ewed by a cytopathologist using current established cytologic criteria . A change in diagnosis was made in 13 cases with an increase in accur acy of FNA, from 71% to 88%. The accuracy of frozen section (92%) did not change appreciably with re-review (94%). The accuracy of FNA and f rozen section combined was found to be 98%, The rate of discordance de creased from 33% to 13% with re-review. When strict histologic and cyt ologic criteria are applied, FNA and frozen section are accurate and c omplementary methods that help in determining the operative management , of thyroid masses. However, when FNA yields a diagnosis of ''follicu lar neoplasm,'' frozen section is unlikely to change this diagnosis.