Diagnosis of Follicular Neoplasm in Thyroid Nodules by Fine Needle Aspiration Cytology

Marhefka, Gregary D.; McDivitt, Jonathan D.; Shakir, K.M. Mohamed; Drake, Almond J.

doi:10.1159/000325378

Cited by 22 publications

(7 citation statements)

References 23 publications

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“…The rate of such an interpretation in our study is very low compared to that reported in the literature; however, there is a wide range of frequency of such an interpretation [31]. In their recent meta-analysis review about the BSRTC, Bongiovanni et al [29] reported that the range of this particular interpretation is 1.2-25.3% with a mean of 10.1%.…”

Section: Discussioncontrasting

confidence: 68%

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: Phase I Pilot Retrospective Analysis

et al. 2013

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We analyzed and evaluated our adequacy rate and the classification of our thyroid aspirates using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). All thyroid fine needle aspirates that were collected or referred to our institution were reviewed and reclassified according to the BSRTC. The results were tabulated and analyzed. Those with histological resection were correlated with our revised cytopathological evaluation using the BSRTC. A total of 205 thyroid aspirates from 186 patients were reviewed. There were 149 females (80%) and 37 males (20%) ranging in age from 23 to 81 (average age 48) years. All slides were reclassified using the BSRTC. The previous interpretations were not consistent with any apparent standards. The nondiagnostic rate was found to be 22%. Five cases were considered false negative and were upgraded to a more serious category with higher risk of malignancy. The high unsatisfactory rates can be reduced by an adequacy interpretation at the time of the procedure. The risk of malignancy in our cohort increased with each increase in the BSRTC category (I-VI). Communication about and awareness of the BSRTC and its implications by all our clinicians is a prime target of this study and is still work in progress. Hopefully, this study will increase the awareness of the BSRTC and its intended benefits in our region.

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Section: Discussioncontrasting

confidence: 68%

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: Phase I Pilot Retrospective Analysis

et al. 2013

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“…However, there is wide variation in the reported malignancy rates for these categories. Typical reported malignancy rates in the literature for follicular neoplasm cytology range between 16 and 35% [10,11,12,13,14] and for AUS/FLUS cytology between 4.5 and 22.5% [10,11,12,15,16,17,18,19], but with malignancy rates as high as 27-48% reported by some authors [20,21,22,23]. …”

Section: Discussionmentioning

confidence: 99%

Outcome of Subclassification of Indeterminate (Thy-3) Thyroid Cytology into Thy-3a and Thy-3f

et al. 2015

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Objectives: The British Thy system is a widely used classification system for reporting thyroid fine-needle aspiration (FNA) cytology. The Royal College of Pathologists in 2009 recommended the subdivision of the Thy-3 (indeterminate) category into Thy-3a (atypia) and Thy-3f (follicular neoplasm). Our objective was to examine the malignancy rates of Thy-3a and Thy-3f cases at our institution and to investigate whether the risk of malignancy in Thy-3a cases is reduced by FNA on a different occasion showing benign cytology. Methods: This is a retrospective study of 748 thyroid nodules undergoing 1,032 FNAs, with indeterminate (Thy-3) cytology subdivided into Thy-3a and Thy-3f. Cases were correlated with final histology in surgical cases. Incidental carcinomas occurring outside the biopsied nodule were discounted. Results: A total of 109 nodules had a final cytological diagnosis of Thy-3a, of which 67 underwent surgery, with an incidence of malignancy of 13.4% (9/67); 90 nodules had a final cytological diagnosis of Thy-3f, of which 84 underwent surgery, with an incidence of malignancy of 17.9% (15/84). The difference in malignancy rates was not significant (p = 0.51). The incidence of malignancy in nodules with benign and Thy-3a cytology on separate occasions was not significantly different from cases with a single Thy-3a cytology. Conclusions: Thyroid nodules with Thy-3a cytology have a slightly lower risk of malignancy than Thy-3f cases. However, the difference is not significant and does not appear to be reduced by FNA on a separate occasion showing benign cytology. Management decisions for patients with Thy-3a cytology should be taken carefully to avoid missing cancers.

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“…By the same token, the category of follicular lesion/atypia of undetermined significance remains the most controversial category due to heterogeneity in its use among institutions and follow-up. This is due to the fact that it is nearly impossible to establish distinct morphologic criteria for diagnosing atypia among cytopathologists [9,10,11,12,13,14,15,16]. It is has been shown that the best way to implement TBSRTC in a pathology laboratory and to convince the clinicians of its validity and robustness is to compare the outcome data prior to and after the implementation of TBSRTC.…”

Section: Introductionmentioning

confidence: 99%

The Bethesda System for Reporting Thyroid Cytopathology: A Meta-Analysis

et al. 2012

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Objective: We aimed to investigate the validity of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) through meta-analysis. Study Design: All publications between January 1, 2008 and September 1, 2011 that studied TBSRTC and had available histological follow-up data were retrieved. To calculate the sensitivity, specificity and diagnostic accuracy, the cases diagnosed as follicular neoplasm, suspicious for malignancy and malignant which were histopathologically confirmed as malignant were defined as true-positive. True-negative included benign cases confirmed as benign on histopathology. The nondiagnostic category was excluded from the statistical calculation. The correlations between the 6 diagnostic categories were investigated. Results: The publications review resulted in a case cohort of 25,445 thyroid fine-needle aspirations, 6,362 (25%) of which underwent surgical excision; this group constituted the basis of the study. The sensitivity, specificity and diagnostic accuracy were 97, 50.7 and 68.8%, respectively. The positive predictive value and negative predictive value were 55.9 and 96.3%, respectively. The rates of false negatives and false positives were low: 3 and 0.5%, respectively. Conclusions: Theresults of meta-analysis showed high overall accuracy, indicating that TBSRTC represents a reliable and valid reporting system for thyroid cytology.

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Diagnosis of Follicular Neoplasm in Thyroid Nodules by Fine Needle Aspiration Cytology

Cited by 22 publications

References 23 publications

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: Phase I Pilot Retrospective Analysis

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: Phase I Pilot Retrospective Analysis

Outcome of Subclassification of Indeterminate (Thy-3) Thyroid Cytology into Thy-3a and Thy-3f

The Bethesda System for Reporting Thyroid Cytopathology: A Meta-Analysis

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