Cytologic and Architectural Mimics of Papillary Thyroid Carcinoma

Baloch, Zubair W.; LiVolsi, Virginia A.

doi:10.1309/yy72m308wpekl1yy

Cited by 34 publications

(20 citation statements)

References 78 publications

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“…Papillary clusters of follicular cells are also observed in some cases of papillary hyperplastic nodule or papillary Hürthle cell carcinoma. In these cases, papillary formation associated with marked cytoplasmic oncocytic change and nuclear atypia could lead to a false-positive diagnosis of PTC [6]. Four patients in our series had other benign thyroid diseases, including chronic lymphocytic thyroiditis and nodular hyperplasia.…”

Section: Discussionmentioning

confidence: 97%

“…However, these are seen in other benign and malignant conditions of the thyroid, including chronic lymphocytic thyroiditis, nodular hyperplasia, hyalinizing trabecular adenoma, Hürthle cell tumor, and medullary thyroid carcinoma [11,12,13]. Some nodular hyperplasias have cytopathological features similar to those of PTC, such as papillary clusters, nuclear atypia including intranuclear grooves, and poorly formed intranuclear pseudoinclusions [6,14]. Overlap of these cytopathological features is reported in about 17% of cases with nodular hyperplasia [15].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, some small thyroid nodules within chronic lymphocytic thyroiditis tend to have atypical nuclei that are indistinguishable from nuclear features of microcytic PTC [16,17]. Chronic lymphocytic thyroiditis can display large syncytial fragments, papillary clusters, and atypical nuclear changes including nuclear enlargement, marked nuclear membrane irregularities, chromatin clearing, and nuclear grooves [6,17]. Papillary clusters of follicular cells are also observed in some cases of papillary hyperplastic nodule or papillary Hürthle cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…It is very rare to have a result of no evidence of malignancy by histological evaluation of the thyroid in patients with a preoperative cytological diagnosis of papillary thyroid carcinoma (PTC) [6,7]. One report noted disappearing thyroid tumors after FNA in 3 patients [7].…”

Section: Introductionmentioning

confidence: 99%

“…One of the reasons for a positive cytology finding and a negative histological diagnosis of PTC in the thyroid is a false-positive diagnosis of PTC by FNAC. Some benign or malignant conditions of the thyroid may have a characteristic nuclear atypia similar to PTC in FNAC findings such as intranuclear grooves and intranuclear pseudoinclusions [6]. Histologic alterations in thyroid nodules including hemorrhage, vascular thrombosis, fibrosis, infarction, fibrinoid necrosis, cystic degeneration, pseudocapsular invasion, and squamous metaplasia can be seen after FNA [8].…”

Section: Introductionmentioning

confidence: 99%

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Positive Cytology Findings and a Negative Histological Diagnosis of Papillary Thyroid Carcinoma in the Thyroid: Is It a False-Positive Cytology or a Disappearing Tumor

et al. 2013

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Background: It infrequently occurs that cytologic diagnosis of papillary thyroid carcinoma (PTC) cannot be confirmed by histology after surgery. This phenomenon may be a false-positive cytology or a true disappearing tumor. Objectives: We evaluated patients who had consistent findings of PTC at fine needle aspiration cytology (FNAC) and no evidence of PTC in surgical specimens. Methods: Positive cytology findings and a negative histological diagnosis of PTC in the thyroid was defined as thyroid nodules with FNAC findings of PTC prior to surgery and no evidence of malignancy on histological examination of surgically removed thyroids. We retrospectively reviewed patients who underwent fine needle aspiration (FNA) and thyroidectomy in Asan Medical Center from 2004 to 2012. Results: Six patients were found who fit the definition of positive cytology findings and a negative histological diagnosis of PTC in the thyroid. The FNAC diagnosis of 6 patients was ‘malignancy' suggesting PTC according to the Bethesda system. All patients underwent thyroidectomy with central neck dissection. Three patients had reactive changes after FNA due to needle passage. Among these 3 patients, 2 had pathologically confirmed metastatic PTC in dissected lymph nodes. These 2 patients could be defined as true disappearing PTC in the thyroid after FNA. The remaining 3 patients had neither histologic alterations nor evidence of PTC in the thyroid and lymph nodes specimens. Conclusions: Both disappearing PTC and a false-positive result of FNAC should be considered in patients with positive cytology findings and a negative histological diagnosis of PTC in the thyroid.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Positive Cytology Findings and a Negative Histological Diagnosis of Papillary Thyroid Carcinoma in the Thyroid: Is It a False-Positive Cytology or a Disappearing Tumor

et al. 2013

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Accuracy of fine‐needle aspiration cytology of head and neck masses

Rammeh

Romdhane

Sassi

et al. 2018

Diagnostic Cytopathology

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Background Head and neck masses are a common presentation in daily practice and can be challenging to both clinicians and cytopathologists. Fine needle aspiration cytology (FNAC) is a widely used method for the diagnosis of head and neck masses. The aim of the study was to assess our institutional experience of the accuracy of FNAC in the diagnosis of head and neck masses. Methods A total of 1262 FNACs were conducted from January 2013 to December 2016 and subdivided into benign and malignant categories. The thyroid and salivary glands FNACs were classified according to the Bethesda System for Reporting Thyroid cytopathology and to the Milan System for Reporting Salivary Gland Cytopathology respectively. The measures of diagnostic accuracy of FNAC were determined taking histology as a gold standard. Results A total of 7 false negative (FN) and 6 false positive (FP) FNACs were identified. Overall sensitivity and specificity of FNAC for a malignant diagnosis were 92% and 94.4%, respectively. Accuracy of FNACs of head and neck masses was 93.5% for all sites. The salivary gland group had the highest rate of FN (2.8%). All FP were reported in the thyroid group. These cases were cytologically classified suspicious for malignancy (n = 3) and papillary carcinoma (n = 3) and proved to be lymphocytic thyroiditis on final histology. Among the most common locations, cytology of lymph nodes provided the best sensitivity (98.2%). Salivary glands as well as lymph nodes had the best specificity (100%). Conclusion FNAC of head and neck masses has a high accuracy allowing a correct therapeutic management. However, this accuracy depends on the anatomic location of the mass.

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Fine Needle Aspiration of the Thyroid

Bose

2011

Thyroid Cancer

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Cytologic and Architectural Mimics of Papillary Thyroid Carcinoma

Cited by 34 publications

References 78 publications

Positive Cytology Findings and a Negative Histological Diagnosis of Papillary Thyroid Carcinoma in the Thyroid: Is It a False-Positive Cytology or a Disappearing Tumor

Positive Cytology Findings and a Negative Histological Diagnosis of Papillary Thyroid Carcinoma in the Thyroid: Is It a False-Positive Cytology or a Disappearing Tumor

Accuracy of fine‐needle aspiration cytology of head and neck masses

Fine Needle Aspiration of the Thyroid

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