촉지되지 않고 우연히 발견되는 갑상선 결절에서초음파 유도하 세침흡인검사의 의의

Abstract

Background and Objectives：With the availability of more sensitive ultrasonography, a larger number of nonpalpable thyroid d nodule. The purpose of this study is to investigate the clinical significance of thyroid incidentaloma and the usefulnes of the USG-FNA in the management of thyroid incidentaloma. Subjects and Method：A retrospective study was performed on 208 pa-tients who underwent USG-FNA for thyroid incidentaloma smaller than 1.5 cm from 2001 to 2005. The cytologic findings were compared with the ultrasonographic findings and the surgical pathology. Results：Suspicious malignant sonographic findings cytologicaly diagnosed as benign lesion (76.4%), 7 cases as follicular neoplasm (3.3%), 33 cases as malignancy (15.8%), and 9 cases as inadequate specimen (4.4%). Of the 40 cases with folicular neoplasm and malignant cytology, 37 cases underwent sur-gery and 30 cases were confirmed to malignancy on the postoperative pathologic diagnosis. In the cases diagnosed to malig-nancy on pathology, extracapsular extension was present in 9 cases (30% ) (26.7%). The sensitivity, specificity, and accuracy of the USG-FNA for malignancy were 93.3%, 71.4%, and 89.1%, respectively. Conclusion：USG-FNA is a useful diagnostic tol in the management of thyroid incidentaloma especially when more than two suspicious malig-nant sonographic findings need to be detected. The clinical characteristics is not significantly diferent between palpable and nonpalpable nodules. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :622-6)