Fine Needle Aspiration Cytology of the Thyroid

Jogai, Sanjay; Al-Jassar, Aisha; Dey, Pranab; Adesina, Aaron O.; Amanguno, Henney G.

doi:10.1159/000326192

Cited by 32 publications

(14 citation statements)

References 18 publications

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“…Previous studies have stressed the importance of identifying thyroid neoplasm that may be disguised by a background of H/LT on FNA of the thyroid. Several of these studies have also sought to identify specific cytologic criteria that would help differentiate between thyroid neoplasm versus changes due to H/LT [16,17]. We have taken a similar approach, in our current study, to identify specific cytologic criteria that may prevent the overdiagnosis of thyroid neoplasm because of cytologic changes associated with H/LT.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Pitfalls of Hashimoto’s/Lymphocytic Thyroiditis on Fine-Needle Aspirations and Strategies to Avoid Overdiagnosis

2012

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Objective: The importance of identifying papillary carcinoma or lymphoma amidst background Hashimoto’s/lymphocytic thyroiditis (H/LT) is well documented. However, avoidance of overdiagnosing neoplasms on thyroid fine-needle aspiration (FNA) with only H/LT has not been adequately addressed. Study Design: This study aimed to identify cytomorphologic features leading to overdiagnosing neoplasms within background H/LT. Nine thyroid FNAs classified as suspicious or positive for neoplasm with subsequent thyroidectomy specimens having only H/LT were identified. Cytologic features of these cases were compared to 8 control cases from the same time period and FNAs from both groups were reevaluated for features from the cytology literature. Results: Features leading to overdiagnosing papillary carcinoma were: powdery chromatin, occasional nuclear grooves or holes, and paucity of background lymphocytes. One feature differentiating H/LT from neoplasm noted in most cases was lymphocytes infiltrating follicular groups. In contrast, true papillary carcinomas displayed characteristic features in multiple cell clusters. These clusters were devoid of infiltrating lymphocytes or displayed only rare lymphocytes at their periphery. A microfollicular pattern with paucity of background lymphocytes was the major pitfall in overdiagnosing follicular neoplasm. Conclusions: Features suspicious for neoplasm are often seen in FNA of H/LT, leading to unnecessary surgery. Recognizing this pitfall and its differentiating features should avert overdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Pitfalls of Hashimoto’s/Lymphocytic Thyroiditis on Fine-Needle Aspirations and Strategies to Avoid Overdiagnosis

2012

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“…If aspirates contain more than 75% Hurthle cells, the possibility of a Hurthle cell neoplasm should be considered, in the absence of which non-neoplastic lesions are to be suspected. [1011]…”

Section: Discussionmentioning

confidence: 99%

“…Cytological differentiation is very difficult in these cases due to overlapping cytological features. [791012]…”

Section: Discussionmentioning

confidence: 99%

Application of pattern analysis in fine needle aspiration of solitary nodule of thyroid

Lngegowda

Muddegowda

Rajesh

et al. 2010

J Cytol

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Background:Various methods are used to arrive at a conclusive diagnosis of thyroid lesions on fine needle aspiration cytology (FNAC). Systemic pattern analysis is one such that can be used to analyze the lesions and divide them into individual categories.Aims:To study the application of pattern analysis in the interpretation of solitary thyroid nodule (STN).Materials and Methods:Two hundred and nineteen cases of fine needle aspiration cytology of STN were reviewed along with histopathological correlation. Smears were classified based on primary and secondary patterns. Predominant pattern (primary) was identified and lesion categorized. This was followed by identifying the next dominant pattern (secondary) and recategorization. Cytological diagnosis based on primary and secondary patterns was correlated with the histopathological diagnosis.Results:Based on pattern analysis, the study had a sensitivity of 66.7% and specificity of 98.9%. The positive predictive value and negative predictive value were 88.9% and 96% respectively and the overall diagnostic accuracy was 95.4%.Conclusions:The present study demonstrates the feasibility and applicability of pattern analysis in diagnosing thyroid lesions by FNAC, which could be easily reproducible.

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“…[1][2][3][4] However, in certain situations there may be problems in diagnosis. The cells may be present in groups obscured by blood, or darkly stained overlapped cells clusters may make interpretation difficult or impossible.…”

Section: Discussionmentioning

confidence: 99%