Will Real Time Visualization of Needle in Target Thyroid Nodules Minimize False Negative FNA Results?

Abstract Introduction: Prevalence of thyroid nodules in the adult population based on detection by ultrasonography is about 20-76% which only 5% account for cancer. All patients with a suspected nodule either physical examination or noted incidentally other imaging should be evaluated ultrasound. Any >= 1 cm ultrasound investigated FNAC. Ultrasound guided FNAC techniques are used to reduce false negative results. We present patient suspicious finding initial and subsequent presenting few years later papillary Case Presentation: A 32 y.o. female history thyroiditis presented endocrine clinic follow-up her nodule. 5 ago, she was diagnosed nodule, found an scan workup dysphagia. The then showed diffusely heterogeneous gland ill-defined area decreased echogenicity right lobe left superior possible lower pole thyroid. Blood work TSH 1.71 (n 0.34-3.00 uIU/ml) peroxidase antibody levels 27.8 < 9.0 IU/ml). CT neck contrast done no concerning mass seen. had after 8 months small bilateral lesions, somewhat ill-defined. FNA biopsy nodule: results were consistent benign follicular year, findings unchanged. came back 3 complaints new palpable neck. unchanged some cervical adenopathy. 2.2 lymph node punctate echogenic foci along lateral margin internal jugular vein at level gland, Subsequently done. cells from nodes positive malignancy atypical. Overall appearance carcinoma. underwent total thyroidectomy modified dissection pathology as multifocal cancer side 1.2 0.4 cm, metastasis 2 nodes. Conclusion: reported rate ultrasound-guided variable. Success US-FNA depends experience operator cyto-pathologist intrinsic nature Malignancy rates 1-2% repeat prior nodules. Good real-time visualization needle target can further decrease negatives.