REGIONAL NODAL RECURRENCE OF DIFFERENTIATED THYROID CANCER– LIMITATIONS OF FNA

FNA cytology and thyroglobulin (Tg) measurement in the aspirate could be used when nodal involvement is suspected in patients with regional recurrence of differentiated thyroid cancer. However, the clinician should keep in his/her mind the following limitations of this approach:

1. FNA cytology may be falsely negative in a significant percentage of patients (~ 25 %); therefore, FNA could be avoided when radiographic findings are highly suggestive of malignancy

2. FNA may be difficult or even impossible due to the specific location of the suspicious lymph node.

3.Tg measurement in the aspirate may be high (positive) with thyroid bed persistent benign thyroid remnant tissue (if the patient has not been treated with RAI); therefore, accurate sampling is required to avoid errors regarding interpretation/evaluation of these results

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