갑상선 결절 진단에서의 초음파유도하 중심부바늘생검의 유용성 = The Utility of US-Guided Core-Needle Biopsy in the Diagnosis of Thyroid Nodules

다국어 초록 (Multilingual Abstract)

Ultrasonography (US)-guided fine needle aspiration biopsy (FNAB) is widely considered to be the diagnostic technique of choice in the assessment of nodular disease of the thyroid gland. Although the accuracy of FNAB analysis approaches 95% where there is an adequate sample, non-diagnostic sampling occurs in 10-20% of cases. Additionally, equivocal pathological results are obtained in 10-30% of cases, and there are limitations in detecting subtypes of certain diseases, such as lymphoma. Generally, US-guided core needle biopsy (CNB) allows for the procurement of a large, grossly visible specimen and a more precise pathological diagnosis. Therefore, US-guided CNB is indicated in the following situations: 1) when an inadequate specimen is obtained by FNAB, 2) when FNAB yields indeterminate or inadequate information, 3) when targeting of the lesion is difficult because it is diffuse, and 4) when there is a discrepancy between the imaging findings and the FNAB results. In this article, we describe the situations in which US-guided CNB is useful for diagnosing thyroid lesions.

국문 초록 (Abstract)

갑상선의 결절질환을 평가하는데 있어 초음파유도하 세침흡인세포생검법은 1차적 진단기법으로 인식되고 있다. 세침흡인세포생검법은 적합한 검체를 채취하였을 경우 진단의 정확도가 약 95%정도로 높은 검사이나 약 10-20%에서 부적합 검체의 채취로 인해 정확한 진단이 어려운 경우가 발생한다. 뿐만 아니라 약 10-30%에서는 세포 병리학 검사 상 불확실한 결과를 얻을 수 있으며 림프종등의 아형 등의 추가적인 정보를 제공하기 어려운 한계점이 있다. 일반적으로 초음파유도하 중심부
바늘생검은 세포의 조직 구조적 형태를 볼 수 있는 큰 검체를 얻을 수 있어 정확한 조직 병리학적 진단을 가능케 한다. 따라서 1) 세침흡인세포생검법 상에서 부적합 검체가 채취된 경우, 2) 세침흡인세포생검법의 결과가 불확실하거나 불충분한 정보를 주는 경우, 3) 정확한 병변의 조준이 어려운 미만성 갑상선 질환인 경우, 4) 영상 소견과 세침흡인세포생검법의 결과가 불일치하는 경우 등에서는 중심부바늘생검을 시행하는 것이 정확한 진단에 보다 도움을 줄 수 있다. 따라서 이 화보에서는
갑상선 결절질환에서 중심부바늘생검이 유용한 경우들에 관한 조명을 하고자 한다.

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