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Comparison of Thyroid Fine-Needle Aspiration and Core Needle Biopsy

Andrew A. Renshaw MD, Nat Pinnar MD
DOI: http://dx.doi.org/10.1309/07TL3V58337TXHMC 370-374 First published online: 1 September 2007


We compared the adequacy and accuracy of fine-needle aspiration (FNA) with core needle aspiration in a total of 377 patients who underwent both tests.

The adequacy rate for core needle biopsy (82.2%) was significantly higher than that of FNA (70.3%; P < .001), but the combined adequacy was significantly higher than that for either test alone (88.9%; P < .001). Overall concordance between the tests was 67.9%. In 70 cases, the core was adequate and negative (55 cases) or atypical (15 cases) and the aspirate was nondiagnostic; in 25 cases, the aspirate was adequate and negative (15 cases) or atypical (10 cases) and the core was nondiagnostic. In 21 cases, the FNA diagnosis was atypical and the core was negative; histologic follow-up supported the FNA diagnosis in all 14 cases with resection, of which 9 were malignant, and 8 of the 9 were papillary carcinoma. On review, it seemed that the core biopsy missed the lesion.

Core needle biopsy has a higher adequacy rate than FNA but seems less sensitive, especially for papillary carcinoma. The combination of FNA with core needle biopsy seems to have the highest adequacy rate and sensitivity.

Key Words:
  • Thyroid
  • Neoplasia
  • Carcinoma
  • Cytology
  • Fine-needle aspiration
  • Core needle biopsy
  • Diagnosis
  • Adequacy
  • Accuracy