AUDIT ON FINE NEEDLE ASPIRATION OF THYROID NODULE
Dr.Kumar Thulasidass SpR Endocrinology, North Middlesex Hospital, London
Dr.Penny Hyatt Consultant in Endocrinology, North Middlesex Hospital, London
Methods – We selected 25 patients over 6 months period between July 2008 to December 2008 who have had FNA of thyroid nodule and analysed if the procedure was done in accordance with the Royal College of Physicians guidelines and if the results of the FNA have been interpreted and acted upon as per the guidelines.
Results of analysis –
8. 11/25 procedures were diagnostic in the first attempt. 14/25 were non diagnostic –
Repeat FNA was done only in 5 of the 14.
to ENT surgeons.
to be non malignant. 1 patient was not referred for surgery
1.There were inadequate clinical details and details of the procedure and site of aspiration were not communicated to the histopathologist.
However, it is difficult to get histopathologist interested in thyroid disease to do the analysis in all centers.
2.(i) repeat FNA was done in only 56% of those in whom first FNA was non diagnostic.
(ii)Among the three patients with follicular lesion, only two (66%) had immediate surgery.
This delay could be dangerous.
(iii)Ultrasound guidance was used for only 5 out of 14 (35%) patients in whom the first
FNA attempt failed.
FNA procedure will be improved by following the RCP guidelines more closely.