Cytologic artifacts and pitfalls of thyroid fine-needle aspiration using ThinPrep®

Afify, Alaa M; Liu, Jing; Al-Khafaji, Basim

doi:10.1002/cncr.9027

Cited by 97 publications

(126 citation statements)

References 12 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…Some studies have shown that conventional smears has a lower rate of nondiagnostic specimens and a higher proportion of accurate diagnosis. [7][8][9][10] More recent studies, however, have supported comparable or better results with liquid-based cytology. [11][12][13] Most published articles discuss thyroid FNAC using the ThinPrep system.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Liquid‐based FNAC of the thyroid

Geers

Bourgain²

2010

Cancer Cytopathology

View full text Add to dashboard Cite

BACKGROUND:The aims of this study were to analyze cytomorphological features of Tripath PREP (BD SurePath, Burlington, NC) preparations in thyroid nodules and to examine adequacy and accuracy of SurePath and frozen sections for both clinical outcome and histological diagnosis when applicable.METHODS:Gathered during a period of 4 years, 712 SurePath specimens of the thyroid were included. Histological (n = 207) or clinical follow‐up (n = 505) was available in all cases. During the same period, 253 frozen sections of surgical thyroid resection specimens were also assessed. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated.RESULTS:Sensitivity was 77% for SurePath and 29% for frozen section; specificity was 81% for SurePath and 100% for frozen section; accuracy was 80% for SurePath and 90% for frozen section. One hundred seventy‐eight (25%) SurePath patients were considered unsatisfactory for diagnosis. In this study, sensitivity, specificity, and accuracy were comparable for SurePath and other reported results of liquid‐based thyroid cytology. Presence of free colloid or pure cystic changes favored a benign diagnosis. Cellular smears with nuclear atypia of papillary carcinoma allowed an overt diagnosis of malignancy.CONCLUSIONS:The authors concluded that SurePath is a reliable technique for assessment of thyroid nodules and offers the advantage of easy identification of colloid and atypical nuclei. Supplementary frozen section analysis should be limited to an FNAC diagnosis of suspicious for papillary carcinoma. Cancer (Cancer Cytopathol) 2011. © 2010 American Cancer Society.

show abstract

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] Most published articles discuss thyroid FNAC using the ThinPrep system. [7][8][9][10]12,13 The reported inadequate rates varied from 22% up to 41%. Sensitivity and specificity varied from 87% to 94% and from 67% to 99%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Liquid‐based FNAC of the thyroid

Geers

Bourgain²

2010

Cancer Cytopathology

View full text Add to dashboard Cite

show abstract

“…This technique has been introduced to obtain thin-layer smears in cervical cytology. The excellent results in this field prompted a wider application to virtually all cytological branches, including thyroid FNAB (20)(21)(22)(23)(24)(25)(26)(27). The current investigation has been carried out to evaluate the effectiveness of a panel made up by HBME-1 and Galectin-3 on LBC in identifying two subsets of FN/AUS with low and high malignant risk that might be managed differently to achieve a reduction of inappropriate surgery.…”

Section: Introductionmentioning

confidence: 99%

Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology

Fadda¹,

Rossi²,

Raffaelli

et al. 2011

European Journal of Endocrinology

101

142

View full text Add to dashboard Cite

Design: Fine-needle aspiration biopsy (FNAB) is the most reliable diagnostic tool in the diagnosis of thyroid nodules. A cytologic diagnosis of follicular neoplasm with atypical cells of undetermined significance (FN/AUS) implies that the selection of patients between surgery and follow-up is difficult. In this setting immunocytochemical stainings might be helpful. The efficacy of a panel made up of HBME-1 and Galectin-3 antibodies is evaluated in cases processed by liquid-based cytology (LBC). Methods: Out of 7091 thyroid FNAB processed by LBC method, 120 cases undergoing surgery successively were selected. These cases were classified as benign lesion (BL, eight cases), FN, including the ACUS category of the Bethesda classification (FN/AUS, 50 cases), suspicious for malignancy (SM, 59 cases), and malignant neoplasm (MN, three cases). Immunostains for HBME-1 and Galectin-3 were carried out on the LBC slides. Results: All MN and BL were histologically confirmed. FN/AUS and SM showed a malignancy risk of 24 and 72.9% respectively. The complete immunocytochemical panel was positive in 83.3% of the cases resulting in malignancy and negative in 87.5% of cases resulting in benign histology. Among the FN/AUS, the complete positive immunocytochemical panel was detected in 76.9% of cases resulting as malignant and the complete negative immunocytochemical panel was observed in 96.8% of cases resulting as benign at histology. Conclusions: The expression of HBME-1 and Galectin-3 in cases classified as FN/AUS on LBC-processed FNABs can effectively distinguish lesions, which need immediate surgery (high risk or FNH or Thy 3h) from those which can be followed-up (low risk or FNL or Thy 3l).

show abstract

“…For example, diagnostic cells are famously smaller in TP. [3][4][5] In thyroid cytology, several alterations have been reported, including reduction and alteration in colloid, decreased pseudo-inclusions in cases of papillary cancer, and difficulty recognizing Hashimoto thyroiditis in TP compared with CPs. 3,6 Despite these alterations, several large studies have proven that TP is at least equivalent to CPs in diagnostic accuracy and is a safe alternative to CPs in thyroid cytology.…”

mentioning

confidence: 99%

“…[3][4][5] In thyroid cytology, several alterations have been reported, including reduction and alteration in colloid, decreased pseudo-inclusions in cases of papillary cancer, and difficulty recognizing Hashimoto thyroiditis in TP compared with CPs. 3,6 Despite these alterations, several large studies have proven that TP is at least equivalent to CPs in diagnostic accuracy and is a safe alternative to CPs in thyroid cytology. 7,8 Settings or specific diagnoses in which background material is critical to establishing the diagnosis (some sarcomas, salivary gland tumors, mucinous tumors) may be more difficult to accurately diagnose with TP.…”

mentioning

confidence: 99%

Analysis of ThinPrep cytology in establishing the diagnosis of small cell carcinoma of lung

Kim

Owens

2009

Cancer Cytopathology

View full text Add to dashboard Cite

BACKGROUND:ThinPrep liquid‐based cytology (TP) preparations are being used increasingly in nongynecologic specimens. To the authors' knowledge, few studies to date have evaluated TP cytology in the setting of small cell carcinoma of the lung (SCCL). Accurately differentiating SCCL from other lung tumors has important clinical and therapeutic implications. Herein, the authors evaluated the diagnostic utility and cytomorphology of TP in the setting of SCCL.METHODS:All cases of SCCL with prior or concurrent TP cytologic specimens were identified via computer search. The cytodiagnoses were tabulated. When available, cytologic material was reviewed. Performance parameters of the various cytologic modalities processed with TP were calculated.RESULTS:In 121 patients with SCCL, 261 TP specimens were identified. The cytodiagnoses were: SCCL (119 specimens), suspicious for SCCL (45 specimens), atypical cells‐not otherwise specified (22 specimens), negative/nondiagnostic (63 specimens), and nonsmall cell carcinoma (4 specimens). During the same period of time, 3 cases of false‐positive diagnoses of SCCL were identified. The positive predictive value for a cytodiagnosis of SCCL on TP was 97.5%, and the sensitivity was 62.8%. Bronchial brush was the most sensitive cytologic modality (78.3%). Immunostaining was found to be contributory to the diagnosis in 10 of the 11 cases in which it was attempted.CONCLUSIONS:TP is a sound alternative to conventional preparations for the cytodiagnosis of SCCL. Cytomorphology of SCCL is altered in TP with less molding, less cell fragility, more discohesion, and tumor cell shrinkage artifact. Immunohistochemical staining of cellblocks is a useful adjunct in challenging cases. A positive cytodiagnosis of SCCL on TP can be used to initiate definitive therapy when biopsy is not possible. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.

show abstract

Cytologic artifacts and pitfalls of thyroid fine-needle aspiration using ThinPrep®

Abstract: presented in poster form at the United States

Cited by 97 publications

References 12 publications

Liquid‐based FNAC of the thyroid

Liquid‐based FNAC of the thyroid

Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology

Analysis of ThinPrep cytology in establishing the diagnosis of small cell carcinoma of lung

Contact Info

Product

Resources

About