Clinical parameters predictive of malignancy of thyroid follicular neoplasms

Davis, Noelle; Gordon, Marla; Eva, Gudumac; Robins, R.Edward; McGregor, Gregor I.

doi:10.1016/0002-9610(91)90901-o

Cited by 59 publications

(43 citation statements)

References 5 publications

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“…12,21 In an attempt to avoid unnecessary surgery of thyroid nodules with follicular neoplasm, some authors have further stratified the indeterminate thyroid aspirates into high-and low-risk groups for a malignancy based on clinical parameters. [24][25][26] Baloch et al 24 reported male sex, age >40 years, and a nodule size >3 cm to be significantly associated with a higher likelihood of a malignancy. Similarly, Davis et al 25 added a history of neck irradiation to those parameters associated with a risk of a malignancy, including size >3 cm and age >50 years; however, sex and family history of goiter or neoplasm were not predisposing factors.…”

Section: Discussionmentioning

confidence: 99%

“…[24][25][26] Baloch et al 24 reported male sex, age >40 years, and a nodule size >3 cm to be significantly associated with a higher likelihood of a malignancy. Similarly, Davis et al 25 added a history of neck irradiation to those parameters associated with a risk of a malignancy, including size >3 cm and age >50 years; however, sex and family history of goiter or neoplasm were not predisposing factors. On the other hand, McHenry et al 26 reported that these clinical factors were not helpful in predicting a carcinoma in patients with a follicular neoplasm.…”

Section: Discussionmentioning

confidence: 99%

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Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Lee

Kim

et al. 2007

J of Clinical Ultrasound

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Purpose. To analyze the discrepancies between the cytologic results of sonographically (US)-guided fine needle aspiration (FNA) of thyroid nodules and final histopathologic results and to discuss the limitations of US-guided FNA.Materials and Methods. The results of US-guided FNAs performed by a single experienced radiologist in 315 thyroid nodules in 292 patients (246 women, 46 men aged 12-79 years) were retrospectively correlated with their surgical pathologic results. The FNA results were classified as nondiagnostic, indeterminate, negative, or positive, whereas final pathologic diagnoses were classified as malignant or benign.Results. The FNA results were nondiagnostic in 31 cases (9.8%), indeterminate in 97 cases (30.8%), and determinate in 187 cases (59.4%). Of the 187 conclusive cases, 169 (90.4%) were concordant with the final pathologic results, whereas 18 (9.6%) were discordant with 14 false-positive and 4 false-negative results. These discrepancies were caused by atypical nuclear features. Among the 97 indeterminate and 31 nondiagnostic cases, a malignancy was found in 14 (14.4%) and 8 (25.8%) cases, respectively. In addition, 10 papillary carcinomas, which were not visualized on sonograms, were detected incidentally in thyroidectomy specimens.Conclusion. The diagnostic accuracy of US-guided FNA of thyroid nodule has limitations that should be minimized by careful interpretation of the cytologic findings and accurate sampling. V V C 2007 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Lee

Kim

et al. 2007

J of Clinical Ultrasound

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“…Although some studies suggested that sonographic characteristics of thyroid nodules, such as hypoechogenicity, solid echo structure, irregular borders, the presence of microcalcifications are associated with malignancy [2,9,10,11,12,13,14,15, 27,31,32,33], other studies found overlap in the presence of many of these characteristics between malignant and BN [29, 34]. Some authors recommended biopsy of nodules larger than 1.0 or 1.5 cm, based on the belief that occult papillary CA of the thyroid (defined in the literature as 10 mm or less in size) generally shows an indolent course and little risk for local invasion or metastasis, whereas others have not shown a relationship between size and malignancy [16, 19, 20, 33].…”

Section: Discussionmentioning

confidence: 99%

The Association of Colour Flow Doppler Sonography and Conventional Ultrasonography Improves the Diagnosis of Thyroid Carcinoma

Appetecchia¹,

Solivetti

2006

Horm Res Paediatr

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Objective: In the present study, we compared the results of conventional ultrasonography (US) and colour flow Doppler sonography (CFDS) with those of US guided fine needle aspiration biopsy (FNAB) and of pathologic staging of resected thyroid nodules, to assess the relative importance of US and CFDS in discriminating malignant thyroid nodules. Subjects and Study Design: We retrospectively reviewed records of 230 patients submitted to US-guided FNAB before surgery for solitary, not hot thyroid nodules. Before US guided FNAB, they were examined with conventional US and CFDS. Conventional US evaluated nodule size, echogenicity, presence of halo sign and microcalcifications. CFDS evaluated the vascular pattern classified as types I, II and III. Twenty-seven patients with inadequate cytology were excluded from this study (11.7%). Results: Two hundred and three patients underwent surgery. At histology a thyroid carcinoma was found in 36 patients (17.7%) and a benign nodule was observed in 167 patients (82.3%). We did not find any difference in cancer prevalence between nodules with a primary tumour size ≤1 cm and those >1 cm (17.6 vs. 17.7%; p = 0.99). A solid echo texture was not statistically significant to suggest malignancy (p = 0.32). Microcalcifications were seen in 83.3% (30/36) of malignant nodules and in33.5% (56/167) ofbenign nodules. These results were statistically significant (p < 0.0001). The type III flow as determined by CFDS was a statistically significant criterion to suggest malignant disease (p < 0.005). The most predictive findings of malignancy on conventional US was the combination of microcalcifications plus the absence of halo sign (sensitivity 75%, specificity 71.9%, p < 0.0001). The combination of an absence of halo sign on conventional US and a type III pattern on CFDS presented the higher sensitivity (83.3%) for malignancy with a specificity of 43.7%. Microcalcifications on US in combination with a type III CFDS pattern showed a lesser sensitivity (80.6%) with an improved specificity (75.4%). In our opinion, the better balanced combination of US and CFDS features was the absence of halo sign plus microcalcifications and a type III CDFS pattern (sensitivity 72.2%, specificity 77.2%). Conclusions: The combination of conventional US and CFDS provides benefits in increasing the screening sensitivity and accuracy in distinguishing malignant thyroid nodules.

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“…About 20% of indeterminate thyroid nodules are malignant, but less is known about whether the indeterminate FN and HN cytology provides information concerning the risk or type of malignancy (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). In this retrospective study we analyzed the risk for malignancy and the types of malignancies in 463 thyroid nodules that had a cytology diagnosis of FN indeterminate for malignancy and 140 thyroid nodules that had a cytology diagnosis of HN indeterminate for malignancy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Malignancy Rate in Thyroid Nodules with Cytology of Indeterminate Follicular or Indeterminate Hürthle Cell Neoplasm

Sorrenti

Trimboli

Catania

et al. 2009

Thyroid

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There is little difference in the rate of malignancy between thyroid nodules with a cytological reading of FN indeterminate for malignancy and HN indeterminate for malignancy but there is a difference in the types of thyroid cancers in these groups. Hürthle cell thyroid cancer and the oncocytic variant of PTC is more common in nodules with an HN indeterminate for malignancy cytology reading than in nodules with a FN indeterminate for malignancy cytology reading. Since Hürthle cell thyroid cancer and the oncocytic variant of PTC are more aggressive than other thyroid cancers, it is likely that patients with an HN indeterminate for malignancy cytology will, as a group, have more aggressive thyroid cancers than those with an FN indeterminate for malignancy cytology.

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Clinical parameters predictive of malignancy of thyroid follicular neoplasms

Cited by 59 publications

References 5 publications

Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

The Association of Colour Flow Doppler Sonography and Conventional Ultrasonography Improves the Diagnosis of Thyroid Carcinoma

Comparison of Malignancy Rate in Thyroid Nodules with Cytology of Indeterminate Follicular or Indeterminate Hürthle Cell Neoplasm

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