Large-needle aspiration biopsy for the preoperative selection of palpable thyroid nodules diagnosed by fine-needle aspiration as a microfollicular nodule or suspected cancer

The palpable thyroid nodules with a fine-needle aspiration (FNA) diagnosis of microfollicular nodule or suspected cancer usually are excised; however; most of them are proven benign by postoperative histologic examination. We reviewed the clinical and pathologic data for patients with thyroid nodule s with an FNA diagnosis of microfollicular nodule or suspected cancer: nodu les also were examined by large-needle aspiration biopsy (LNAB) to assess w hether the distinction achieved by LNAB into pure microfollicular or mixed microfollicular-macrofollicular nodules could be used preoperatively to bet ter-predict malignancy. One hundred fourteen nodules of this type were exci sed. The prevalence of cancer was 22% (14/63) among the microfollicular and 4% (2/51) among the microfollicular-macrofollicular nodules at LNAB. These data indicate that histologic examination of the LNAB specimen can be used for preoperative selection of thyroid nodules diagnosed by FNA as a microf ollicular nodule or suspected cancer.