Follow‐up of atypia and follicular lesions of undetermined significance in thyroid fine needle aspiration cytology

Dinçer, Nazmiye; Balcı, Serdar; Yazgan, Aylin; Güney, Güven; Ersoy, Reyhan; Çakır, Bekir; Güler, Gülnur

doi:10.1111/cyt.12021

Cited by 81 publications

(100 citation statements)

References 15 publications

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“…The literature contains quality studies for both groups with varied results. Malignancy rates that were reported by first group studies, including all undetermined patients for follow-up, are found between 15.7% and 44.1% (Horne Dincer et al, 2013;Chen et al, 2014;Ho et al, 2014;Hyeon et al, 2014;Rosario, 2014). In contrast, these rates are reported between 22.8% and 54% in the second group of studies that have only selected the patients who underwent surgery (Alexander et al, 2012;Jeong et al, 2013;Chen et al, 2014;Cuhaci et al, 2014;Ho et al, 2014;Park et al, 2014;Ryu et al, 2014).…”

Section: Discussionmentioning

confidence: 92%

Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

Kayilioglu¹,

Dinç²,

Sozen³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p=0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p=0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.

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Section: Discussionmentioning

confidence: 92%

Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

Kayilioglu¹,

Dinç²,

Sozen³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) has six categories, one of which is AUS or FLUS, which is a heterogeneous group that is difficult to classify as benign, follicular neoplasm, suspicious for malignancy, or malignant. [1][2][3][4][5][6] In AUS/FLUS, the risk of malignancy in resected nodules is 5 to 15%, but a variation from 6 to 48% is in record. [6][7][8][9] It has been reported that with repeated FNAB in AUS/ FLUS cases, about 56 to 68% will have a more definitive result and 15.6 to 48.6% will be interpreted as AUS/FLUS.…”

Section: Introductionmentioning

confidence: 99%

“…10 It has been recommended that if there is an indication for surgical intervention, it is not necessary to repeat the FNAB. 4 Although it has been suggested that the usage of AUS/FLUS should not exceed 7% of thyroid FNABs, 3,7,9,10 there is variation of this percentage from 3 to 29% across laboratories and from 2.5 to 28.6% among cytopathologists. 5 Ultrasound findings can facilitate reaching a diagnosis of nodules with AUS/FLUS, 11 although they may not differentiate benign from malignant nodules.…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy

Alqahtani¹,

Al-Sobhi²,

Alsalloum³

et al. 2017

World Journal of Endocrine Surgery

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Aim: To correlate selected clinical and ultrasonographic (US) characteristics with the final histopathological diagnosis in patients with atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS), and whether this information can be used in planning the surgical approach. Materials and methods:It is a retrospective study including the operated cases of AUS/FLUS from 2011 to 2014 treated at one center.Results: This cohort included 87 women and 28 men. To test for independence between categorical variables, the chi-square test was used. There was no significant correlation between age or US variables and final pathological diagnosis. However, final diagnosis of malignancy was higher in men compared with women (64.3 and 41.4% respectively; p = 0.035). Furthermore, a significant association between the diagnosis of repeated fine needle aspiration biopsy (FNAB) and the final pathological diagnosis was noted (benign vs malignant, p = 0.005). Conclusion:The FNAB has a significant role in the assessment of thyroid nodules. Our results showed no correlation between age, US variables, and the risk of malignancy. Male gender is associated with higher risk of malignancy.Clinical significance: Determining the risk of malignancy and prediction of surgical outcome may help triaging cases for repeat FNA or proceeding to surgery.

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“…However, the published reports after the widespread use of BRSTC informed highly variable risk of malignancy ranging between 6 %-96,7% in this group (3)(4)(5)(6)(7)(8). The malignancy rate in AUS/FLUS category of our center was 45,8% and is placed centrally in previosly reported wide risk spectrum (3)(4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 74%

Malignancy Rates in Bethesda Category AUS/FLUS: Single Center Experience

Can¹,

Ayturk²,

Tastekin³

et al. 2016

Acta Oncol Tur.

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ÖZETAmaç: Tiroid nodüllerinin prevelansı yüksek olmasına rağmen, bu nodüller için malignite oranları düşüktür. Bu nedenle, cerrahi yaklaşım gerektiren malign nodülleri, benign nodüllerden ayırmak çok önemlidir. Ultrasonografi, ultrasonografi eşliğinde ince iğne aspirasyonu ve ayrıca Tiroid Sitopatolojisi için Bethesda Raporlama Sistemi tiroid nodüllerinin değerlendirilmesinde fayda sağlamaktadır. Ancak, bu sistem 'Önemi Belirsiz Atipi/ Önemi Belirsiz Foliküler Lezyon (ÖBA/ÖBFL)' olarak adlandırılan problemli bir kategori içermektedir. Bu kategori için son zamanlarda bildirilen malignite yüzdeleri %5 ile %96,7 arasında değişmektedir. Bu çalışmada merkezimizde incelenen ilk ince iğne aspirasyon tanısı ÖBA/ÖBFL olan tiroid nodüllerindeki malignite oranlarının sunulması amaçlanmaktadır. Yöntem: Yedi yıl süresince, Trakya Üniversitesi Tıp Fakültesi Patoloji Anabilimdalı'nda (Edirne, Türkiye) incelenen hastaların tanıları (ince iğne aspirasyon ve tiroidektomi) geriye dönük olarak değerlendirildi. Bulgular: İnce iğne aspirasyon sitolojisinde ÖBA/ÖBFL tanısı alan 153 hastadan 68'inde (%44,4) histopatolojik tanı papiller tiroid karsinomu, 1'inde (%7) foliküler karsinom ve 1'inde (%7) de medüller karsinom idi. Tartışma ve Sonuç: Tiroid Sitopatolojisi için Bethesda Raporlama Sistemi bazı tanı kategorilerinde standardizasyon sağlamışsa da, ÖBA/ÖBFL kategorisi hala subjektif sitolojik kriterleri barındırmakta ve farklı çalışmalarda oldukça değişken histolojik malignite oranları bildirilmektedir. Bu nedenle, immünositokimya ve özellikle moleküler testler gibi yardımcı yöntemlerin kullanılması tiroid nodüllerinin preoperatif tanısında faydalı olabilir. Anahtar Kelimeler: Tiroid Karsinomu, Sitoloji, Önemi Belirsiz Atipi/ Önemi Belirsiz Foliküler Lezyon ABSTRACT Introduction: Although the prevelance of thyroid nodules is high, the rate of malignancy in these nodules is low. Thus, the distinction between the malignant nodules requiring surgical approach and the benign ones is very important. Ultrasound, ultrasound guided fine needle aspiration and also The Bethesda Reporting System for Thyroid Cytopathology are useful tools for interpretation of thyroid nodules. However, this system includes a problematic category titled as 'Atypia of Undetermined Significance/ Follicular Lesion of Undetermined Significance (AUS/FLUS)'. The reported percentages of malignancy in these nodules range between 5-96,7%, recently. We aimed to present the rate of malignancy in thyroid nodules with initial fine needle aspiration diagnosis as AUS/FLUS. Methods: The final diagnosis (fine needle aspiration and thyroidectomy) of patients who presented at the Department of Pathology of the Trakya University Medical Faculty (Edirne, Turkey) were reviewed for seven years. Results: Histological diagnosis was papillary thyroid carcinoma in 68 (44,4%), follicular carcinoma in 1 (0.7%) and medullary carcinoma in 1 (0.7%) of the 153 patients with prior fine needle aspiration diagnosis as AUS/FLUS. Discussion and Conclusion: Although, The Bethesda Reporting System for...

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Follow‐up of atypia and follicular lesions of undetermined significance in thyroid fine needle aspiration cytology

Abstract: Although in this category repeat FNA is expected rather than excision, we suggest evaluation of all AUS/FLUS patients in multidisciplinary meetings to decide management and recommend follow-up of all patients with this diagnosis.

Cited by 81 publications

References 15 publications

Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy

Malignancy Rates in Bethesda Category AUS/FLUS: Single Center Experience

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