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

Routine interinstitution pathology consultation can result in change in pat hologic diagnosis in zip to 10% of patients. In this study, we compared the outside cytopathologic diagnosis of thyroid fine-needle aspiration (FNA) s pecimens with the in-house diagnosis at the University of Pennsylvania Medi cal Center over an 18-mo period and its effect on patient management. One h undred ten (60%) diagnostic disagreements were identified among 183 patient s. In 16 cases, the diagnosis was changed from benign to malignant, and in 12, the diagnosis was reversed from. neoplastic/malignant to benign. Histol ogic 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 thyro id FNA cases, since our data showed a significant change in diagnosis, thus affecting patient management. (C) 2001 Wiley-Liss, Inc.