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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
7
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pubmed:dateCreated |
1990-8-13
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pubmed:abstractText |
A retrospective study of 221 surgically resected thyroid nodules disclosed that 71 (32%) were cystic and 150 (68%) were solid lesions. Ultrasonography correctly characterized cystic nodules in all but one case. Comparing cystic and solid nodules, there were no differences in patient demographics (mean ages, 47.7 +/- 1.8 SEM vs 45.9 +/- 1.2 years; sex, 78% females both groups), the proportion that were solitary (39% vs 40%), or the nodule size (49% vs 47% greater than or equal to 2 cm in diameter). Of cystic thyroid lesions, 4% were simple cysts, 82% were degenerating benign adenomas or colloid nodules, and 14% were malignant compared with 23% of solid lesions that were malignant. Most cystic lesions (81%) contained bloody fluid. One benign true cyst was filled with thick brown fluid, while clear yellow fluid was repeatedly aspirated from one malignant cystic nodule. Malignant fine-needle aspiration cytology was the best predictor of cancer (100%). Much less predictable were signs of local compression or invasion (43%), a history of head or neck irradiation (33%), cyst recurrence after aspiration (29%), or an increase in the cystic nodule's size (7%). Indeterminate cytology identified malignancy with about half the frequency in cystic lesions as compared with solid nodules (13% vs 27%). The only false-negative fine-needle aspiration cytology occurred in a cystic lesion. In patients with cystic papillary cancers, needle aspirates contained insufficient material for diagnosis in 20% that occurred in no patient with solid papillary carcinoma. The sensitivities and specificities of fine-needle aspiration cytology for solid nodules were 100% and 55%, and for cystic nodules were 88% and 52%. Thus, cystic lesions are as likely as solid thyroid lesions to harbor a malignancy that cannot be predicted from the cyst's clinical characteristics or the patient's demographic data. Although fine-needle biopsy is the best predictor of malignancy in either cystic or solid thyroid lesions, it is slightly less reliable when a thyroid lesion is fluid filled rather than solid. We believe that most cysts not abolished by aspiration should be surgically excised.
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pubmed:grant | |
pubmed:commentsCorrections | |
pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:status |
MEDLINE
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pubmed:month |
Jul
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pubmed:issn |
0003-9926
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
150
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1422-7
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pubmed:dateRevised |
2007-11-14
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pubmed:meshHeading |
pubmed-meshheading:2196027-Adult,
pubmed-meshheading:2196027-Biopsy, Needle,
pubmed-meshheading:2196027-Carcinoma, Papillary,
pubmed-meshheading:2196027-Cysts,
pubmed-meshheading:2196027-Diagnosis, Differential,
pubmed-meshheading:2196027-Female,
pubmed-meshheading:2196027-Humans,
pubmed-meshheading:2196027-Male,
pubmed-meshheading:2196027-Middle Aged,
pubmed-meshheading:2196027-Predictive Value of Tests,
pubmed-meshheading:2196027-Recurrence,
pubmed-meshheading:2196027-Retrospective Studies,
pubmed-meshheading:2196027-Thyroid Diseases,
pubmed-meshheading:2196027-Thyroid Neoplasms,
pubmed-meshheading:2196027-Ultrasonography
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pubmed:year |
1990
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pubmed:articleTitle |
Cystic thyroid nodules. The dilemma of malignant lesions.
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pubmed:affiliation |
Department of Endocrinology, Ohio State University, Columbus.
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pubmed:publicationType |
Journal Article,
Research Support, U.S. Gov't, P.H.S.
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