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October 4, 1985

Differentiating Cervical Lipomas From Thyroid Nodules

Author Affiliations

UCLA School of Medicine Los Angeles

JAMA. 1985;254(13):1719. doi:10.1001/jama.1985.03360130051011

To the Editor.—  In the article entitled "Cervical Lipomas Masquerading as Thyroid Nodules," authors Leonidas et al1 conclude by recommending computed tomographic (CT) scanning to evaluate and differentiate "cold" nodules of the thyroid from extrathyroidal tissue, specifically lipomas. We would like to point out a valuable diagnostic test that apparently was overlooked, that of fine-needle aspiration (FNA).This modality has been successfully and safely used in the diagnosis of head and neck tumors since the 1930s. Fine-needle aspiration has been found to be highly accurate in its diagnostic capabilities, notably in establishing the diagnosis of "cold" solid thyroid nodules.2,3 With aspiration cytology, unnecessary surgery and excessive radiation exposure can often be avoided.4 In an exhaustive review of the literature on FNA of thyroid nodules, Ashcraft and Van Herle5 report an impressive diagnostic reliability of 97.8%, with an overall false-negative incidence of malignancy in 1.7%, and a