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Jonathan C. Irish, MD, MSc, FRCSC; A. W. Peter van Nostrand, MD, FRCPC; Sylvia L. Asa, MD, PhD, FRCPC; Patrick Gullane, MD, FRCSC; Lome Rotstein, MD, FRCSC

Arch Otolaryngol Head Neck Surg. 1992;118(9):918-922.

Abstract
• Although there is much literature devoted to the role that fine-needle biopsy plays in the management of the thyroid mass, only a handful of studies deal with the diagnostic accuracy of the frozen section and final paraffin section of thyroid lesions. Fine-needle biopsy results, frozen-section diagnoses, final paraffin-section diagnoses, and panel review diagnoses were recorded for 137 consecutive patients who underwent thyroidectomy procedures. The overall accuracy of fine-needle biopsy, frozen-section, and paraffinsection diagnoses was 81%, 87%, and 94%, respectively. The high positive predictive value and specificity of both the fine-needle and frozen-section modalities suggests that intraoperative pathology consultation, given that the preoperative needle aspirate is positive for malignant neoplasia, can offer little further in the treatment of the patient. Stastistical analysis of the accuracy of the three modalities suggests strategies for accurate treatment of the thyroid nodule.

(Arch Otolaryngol Head Neck Surg. 1992;118:918-922)

Author Affiliations
From the Departments of Otolaryngology (Drs Irish and Gullane) and General Surgery (Dr Rotstein), Head and Neck Program, and the Department of Pathology (Dr van Nostrand), The Toronto (Ontario) Hospital, and the Department of Pathology, St Michael's Hospital, Toronto (Dr Asa).

Footnotes
Accepted for publication May 6, 1992.

Presented at the Combined Otolaryngological Spring Meetings, Waikaloa, Hawaii, May 8, 1991.

Reprint requests to Department of Otolaryngology, The Toronto Hospital, Toronto General Site, 200 Elizabeth St, EN7-228, Toronto, Ontario, Canada M5G 2C4 (Dr Irish).

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