Core needle biopsy in the management of thyroid nodules with an indeterminate fine-needle aspiration report

Younghee Yim, Jung Hwan Baek


Ultrasonography (US)-guided fine-needle aspiration (FNA) cytology is widely used but is limited due to its pathologically indeterminate results in diagnosing thyroid nodules. Recently, US-guided core-needle biopsy (CNB) was introduced as an effective and safe technique for diagnosing indeterminate thyroid nodules. Using CNB, information about architectural histologic structure such as nodule capsule or more immunochemical staining can be obtained which lead to a more accurate diagnosis. Up to 98% of indeterminate thyroid lesions can be classified as malignant or benign when CNB is used for follow-up analysis. Other evidences revealed the effectiveness of CNB in reducing inconclusive results and improving the diagnostic performance of thyroid nodules initially diagnosed as AUS/FLUS by FNA. In this review, we investigate how to deal with indeterminate thyroid nodules diagnosed by FNA and determine how CNB has a role in diagnosing these indeterminate thyroid nodules.