Core needle biopsy: An additional diagnostic armamentarium

Shrikant Somani, Narendra Kotwal

Thyroid Research and Practice 2016 13(2):52-56

Fine needle aspiration cytology (FNAC) is considered to be most effective and accurate diagnostic test to differentiate benign from malignant thyroid nodules and most guidelines recommend FNAC as the initial test. However, significant percentage of FNAC results are inconclusive owing to nodule characteristic, operator limitations, or limitations of the procedure itself. Core needle biopsy (CNB) in the evaluation of thyroid nodules have been performed since many decades; however, due to large bore needle, complication rates, and previous reports of inaccuracies, presently CNB has not been included by most guidelines in the diagnostic algorithm of thyroid nodules. Multiple recent studies have shown much higher rates of sensitivity, specificity, and accuracy using CNB in differentiating benign from malignant lesions, particularly when initial FNA is indeterminate, nondiagnostic or if there are discordant results between radiologic and cytologic tests or in nodules with macrocalcifications or fibrosis.

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