Bethesda classification is a valuable guide for fine needle aspiration reports and highly predictive especially for diagnosing aggressive variants of papillary thyroid carcinoma

Evranos, Berna; Polat, Şefika Burçak; Başer, Hüsniye; Özdemır, Didem; Kılıçarslan, Aydan; Yalçın, Abdussamet; Ersoy, Reyhan; Çakır, Bekir

doi:10.1111/cyt.12384

Cited by 25 publications

(37 citation statements)

References 44 publications

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“…Liu et al from the USA concluded that the Bethesda cytological categories successfully stratify patients based on their observation that recurrence, distant metastases and death increased as cytology progressed from AUS/FLUS to SM to malignant categories. Evranos et al from Turkey reported that SM or malignant cytological diagnoses were more often given to aggressive variant PTC (92.0%) and conventional PTC (56.6%), but less frequently to follicular variant PTC (24.3%). However, the authors of this article attribute all these observations and conclusions to the fact that significant numbers of borderline/precursor tumours were classified in the AUS/FLUS, FN/SFN and SM categories, and that they were included as malignant tumours.…”

Section: Prognosis Of Thyroid Carcinomas In Indeterminate Categoriesmentioning

confidence: 99%

“…FT-UMP (10) As the majority of cases with indeterminate cytology are benign or borderline tumours, and the majority of thyroid carcinomas in indeterminate categories were low-risk, [49][50][51][52] clinical follow-up of these nodules is one method recommended by the JTA clinical guidelines as long as they have benign clinical features. 16,17,45 Proper better risk stratification of thyroid cancer, which is a common practice in Asia.…”

Section: Thyroid Fnac In Asiamentioning

confidence: 99%

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Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

et al. 2017

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Although Asian thyroid practices have implemented the American Thyroid Association guidelines, significant deviations in actual risk of malignancy (ROM) have been reported. With review of the literature from Asia, the authors examine the underlining reasons for actual ROMs reported in Asia being so different from western practice based on the author's perspective. Although the most popular diagnostic system for thyroid cytology used in Asian countries is the Bethesda system, the Japan Thyroid Association published clinical guidelines, including a national reporting system for thyroid cytology, to adapt conservative clinical management (active surveillance and strict triage patients for surgery) for low-risk thyroid carcinomas. As less aggressive clinical management is favoured in Asian societies, strict triage of patients with indeterminate thyroid nodules for surgery is usually applied, which ultimately reduces overtreatment of indolent thyroid tumours. As a result, low resection rates and high ROMs for indeterminate nodules were achieved in Asian practices using the same Bethesda system. Recently, borderline thyroid tumours were introduced in the thyroid tumour classification and significant decreases in ROMs have been reported in the indeterminate categories in western practice.However, ROM of indeterminate nodules remained high in Asian practice even after borderline tumours were deemed benign. These results suggested that the diagnostic threshold of papillary thyroid carcinoma-type nuclear features varied among practices (stricter in Asia than in western practice), and diagnostic surgery was not performed for a significant number of indeterminate nodules with benign clinical features in Asian practice, resulting in low rates of borderline tumours in surgicallytreated patients. K E Y W O R D SAsia, borderline tumour, indeterminate cytology, resection rate, risk of malignancy, thyroid FNAC

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Section: Prognosis Of Thyroid Carcinomas In Indeterminate Categoriesmentioning

confidence: 99%

Section: Thyroid Fnac In Asiamentioning

confidence: 99%

Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

et al. 2017

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“…The neoplastic cells are elongated with distinct cell borders and apically placed and protruding “hobnailed” nuclei. Nuclear features of PTC are often present …”

Section: Discussionmentioning

confidence: 99%

“…The variants have been described based on size, nature of tumor boundaries, architecture, cellular characteristics, stromal features or a combination of the above mentioned characteristics . PTC is considered a well differentiated neoplasm; however, some of its variants are known to have an aggressive clinical course and imply poor prognosis . However, poorly differentiated carcinoma of the thyroid is characterized by solid, insular and/or scirrhous growth pattern with increased mitoses .…”

Section: Introductionmentioning

confidence: 99%

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Hobnail variant of papillary thyroid carcinoma: A case with an unusual presentation

Lilo

Bishop

Ali

2017

Diagnostic Cytopathology

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Variants of papillary thyroid carcinoma (PTC) account for up to 25% of the cases, some of which are proven to be associated with aggressive clinical behavior such as tall cell and columnar cell variants. Hobnail variant of PTC (HVPTC) is recently described as a rare and aggressive variant of PTC. Herein, we are reporting a case of HVPTC in a patient who presented with hemoptysis and an intratracheal blood clot that was aspirated and submitted for cytopathological examination. Cytomorphology displayed neoplastic cells with profound micropapillary architecture, elongated nuclei, and prominent hobnail configuration. Nuclear features of PTC such as pseudoinclusions, nuclear overlapping, crowding, and grooves were readily identified. Subsequent total thyroidectomy revealed a 1.4 cm PTC with columnar and hobnail components. HVPTC is a rare locally aggressive subtype, which may present with metastasis from an occult thyroid primary. HVPTC needs to be included in the differential diagnosis of metastatic carcinoma with micropapillary architecture on fine needle aspiration, particularly in head and neck area. Diagn. Cytopathol. 2017;45:754-756. © 2017 Wiley Periodicals, Inc.

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The Diagnosis and Management of Thyroid Nodules

Durante

Grani

Lamartina

et al. 2018

JAMA

485

334

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Bethesda classification is a valuable guide for fine needle aspiration reports and highly predictive especially for diagnosing aggressive variants of papillary thyroid carcinoma

Abstract: The Bethesda classification is a reliable indicator of malignancy in nodules with different cytology results and seems to be very effective in predicting the malignancy for the nodules diagnosed with aggressive variant PTC on the final histological examination.

Cited by 25 publications

References 44 publications

Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

Hobnail variant of papillary thyroid carcinoma: A case with an unusual presentation

The Diagnosis and Management of Thyroid Nodules

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