Interinstitutional review of thyroid fine‐needle aspirations: Impact on clinical management of thyroid nodules

Routine interinstitution pathology consultation can result in change in pathologic diagnosis in up to 10% of patients. In this study, we compared the outside cytopathologic diagnosis of thyroid fine‐needle aspiration (FNA) specimens with the in‐house diagnosis at the University of Pennsylvania Medical Center over an 18‐mo period and its effect on patient management. One hundred ten (60%) diagnostic disagreements were identified among 183 patients. In 16 cases, the diagnosis was changed from benign to malignant, and in 12, the diagnosis was reversed from neoplastic/malignant to benign. Histologic follow‐up was available in 109 cases; the overall accuracy of outside diagnosis was 73%, and that of inside diagnosis was 85%. In conclusion, we strongly recommend interinstitution cytology consultation on referred thyroid FNA cases, since our data showed a significant change in diagnosis, thus affecting patient management. Diagn. Cytopathol. 25:231–234, 2001. © 2001 Wiley‐Liss, Inc.