J Korean Radiol Soc.  2006 Nov;55(5):437-442. 10.3348/jkrs.2006.55.5.437.

Thyroglobulin Measurement in the Fine-Needle Aspiration Washout for Diagnosing Cervical Lymph Node Metastasis in the Patients with Differentiated Papillary Thyroid Cancer

• Kim BM
• Kim EK
• Kim MJ

• KMID: 2024460
• DOI: http://doi.org/10.3348/jkrs.2006.55.5.437

Abstract

PURPOSE
We wanted to evaluate the utility of thyroglobulin measurement in the washout of the needle (FNA-Tg) used for fine needle biopsy for detecting lymph node metastasis in patients with differentiated papillary thyroid carcinoma (DPTC).
MATERIALS AND METHODS
We performed ultrasonography-guided fine-needle aspiration cytology (FNAC) and FNA-Tg for 50 ultrasonographically suspicious lymph nodes in 45 DPTC patients. Eighteen patients underwent thyroidectomy before FNA and the remaining 27 patients underwent fine-needle aspiration prior to surgery. The final diagnoses were determined based on the results of histological examination of the excised specimens (n=21) or on the follow-up examination that was done least 12 months after surgery.
RESULTS
Lymph node metastases were confirmed in 19 patients. FNAC detected 14 metastatic lymph nodes in 14 patients, and FNA-Tg detected 18 metastatic lymph nodes in 18 patients. While none of 3 cystic lymph nodes metastasis was detected via FNAC, they all revealed positive results via FNA-Tg. One patient with a negative result on both methods had one metastatic lymph node among 9 excised lymph nodes, and this one node had not been sampled via FNAC or FNA-Tg. The sensitivities and specificities of FNAC and FNA-Tg were 73.6% (14/19) and 100% (27/27), and 94.7% (18/19) and 96.2% (26/27), respectively.
CONCLUSION
FNA-Tg is a useful technique for the early detection of lymph node metastasis, and especially for detecting cystic lymph node metastasis in patients with DPTC.

Keyword

Thyroid, neoplasms; Head and neck neoplasms, metastases; Lymphatic system, biopsy; Ultrasound (US), guidance

MeSH Terms

Biopsy, Fine-Needle*
Diagnosis
Follow-Up Studies
Humans
Lymph Nodes*
Needles
Neoplasm Metastasis*
Thyroglobulin*
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy
Thyroglobulin