Gender, clinical findings, and serum thyrotropin measurements in the prediction of thyroid neoplasia in 1005 patients presenting with thyroid enlargement and investigated by fine-needle aspiration cytology

One thousand five euthyroid patients (870 females and 135 males, mean age 4 7 years), who presented with thyroid enlargement were evaluated by fine-nee dle aspiration cytology (FNAC) of the thyroid as the first-line investigati on. The final cytological or histological diagnosis was determined after su rgery (n = 312) or clinical followup for a minimum period of 2 years (range 2-14 years, mean 6.7 years). Goiter type was assessed clinically and was c lassified as diffuse in 147, multinodular in 247, or solitary nodule in 611 . The overall sensitivity and specificity of the procedure in the detection of thyroid neoplasia was 88% and 89%, respectively. Males who presented wi th thyroid enlargement had significantly higher rates of malignancy (p = 0. 007) and neoplasia (benign + malignant) (p = 0.002) than females, as did su bjects with solitary nodule compared with diffuse or multinodular goiters ( malignancy p = 0.001, neoplasia p < 0.001). Subjects with normal thyrotropi n (TSH) (>0.4 mU/L) at presentation had a nonsignificantly increased risk o f thyroid neoplasia (p = 0.07) and malignancy, in contrast to those with lo w TSH (<0.4 mU/L). We confirmed FNAC of the thyroid to be an accurate test in the detection of thyroid neoplasia. Gender and goiter type at presentati on both contribute significantly to the prediction of the diagnosis of thyr oid neoplasia.