Flow cytometric, gene rearrangement, and karyotypic analyses of 110 cases of primary thyroid lymphoma: a single-institutional experience in Japan

Suzuki, Ayana; Hirokawa, Mitsuyoshi; Higashiyama, Takuya; Fukata, Shuji; Takada, Nami; Hayashi, Toshitetsu; Kuma, Seiji; Miyauchi, Akira

doi:10.1507/endocrj.ej18-0348

Cited by 10 publications

(16 citation statements)

References 44 publications

(40 reference statements)

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“…Interestingly, of all the PTLs, while DLBCL was the most frequent (71.9%; including DLBCL transformed from low-grade NHL) subtype in western literature, MALT lymphoma was the commonest (41.1%) in Asian studies. Some recent studies have subclassified DLBCL into germinal and post-germinal center type (12,14,18,26). Other rare subtypes of PTL reported include follicular lymphoma (FL), chronic 2).…”

Section: Prevalence and Spectrum/classification Of Ptlmentioning

confidence: 99%

“…A study from Asia compared the cytomorphology of PTL on LBC with that of conventional smears. This study was not included in the analysis in this review because of overlapping study period with another study published from the same institute (14). The authors reported that on LBC large elongated swollen nuclei act as a clue to differentiate PTL from non-neoplastic lymphoid cells and that lymphoglandular bodies are not reliable for diagnosing PTL (49).…”

Section: Fnacmentioning

confidence: 99%

“…Flowcytometry (FC) is a reliable method for evaluation of patients suspected to have PTL. The National Cancer Institute (NCI)-sponsored Thyroid Fine Needle Aspiration State of the Science Conference concluded that FC is useful for immunophenotyping of clinically suspected cases of PTL ( 52), as has also been documented in some Asian and Western studies (14,15,17,28,29,(39)(40)(41)43,45). Hirokawa et al tried to establish a diagnostic algorithm based on findings of USG, FNAC and FC.…”

Section: Ancillary Techniquesmentioning

confidence: 99%

“…Two studies, one from the USA (43) and the other from Japan ( 14) have documented use of tissue samples in FC for PTL management. While the former used frozen specimens for FC (43), the latter have just mentioned resection specimens as the material used (14). Suzuki et al performed FC on a large number of aspirated and resected materials and found nearly similar detection rates (73.7% and 69.2% respectively) of light chain restriction from both types of materials (14).…”

Section: Ancillary Techniquesmentioning

confidence: 99%

“…Molecular testing: use of molecular methods as an ancillary technique in PTL diagnosis and management has also been discussed in some studies (11,14,15,17,26,28,29,39,40,43,44,46), more commonly in those from the West (Table 3). Majority of these methods were performed from surgical tissue specimens except two studies where FNA material was used (29,40).…”

Section: Ancillary Techniquesmentioning

confidence: 99%

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Thyroid lymphoproliferative lesions in Asia

2020

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Primary thyroid lymphomas (PTLs) are rare and most commonly present as rapidly enlarging thyroid mass causing obstructive symptoms. Due to worldwide differences in clinical practices related to thyroid malignancy, this review was conducted to compare the clinicopathological and diagnostic modalities related to PTL and their similarities and differences between the Asian and Western countries. Using the search engine PubMed, published data on thyroid lymphomas was collected and reviewed. A total of 18 Asian and 22 Western studies were included. Most of PTLs were B-cell Non-Hodgkin lymphomas (NHL). While mucosa-associated lymphoid tissue (MALT) lymphoma was the commonest (41.1%) among Asians, diffuse large B cell lymphoma (DLBCL) (71.9%) predominated in the Western population. Some rare subtypes of PTL were also identified. Majority of all patients in Asian as well as Western studies presented with early stage (stage I/II) disease. Interestingly, when compared with Asian patients, a larger proportion of patients from the West presented with higher stage (stage III/IV) disease (12.2% vs. 3%). Ultrasonography (USG) and fine needle aspiration cytology (FNAC) in addition to histological examination usually by core needle biopsy and in some by open procedures were used for the diagnosis of PTL in both the cohorts. The various ancillary techniques used were immunocytochemistry (ICC), flowcytometry (FC), immunohistochemistry (IHC), and molecular testing. The use of ancillary techniques for PTL diagnosis was more common in the West compared to Asia and markedly increased the sensitivity of cytology to diagnose PTL. Treatment and prognosis largely depend upon the subtype of PTL and stage at presentation. To conclude, from the available published literature, there is an apparent difference between Asian and Western cohorts in the histological type and stage of presentation of PTL, but the results may be affected by publication and selection bias. Also, advanced ancillary techniques are more commonly adopted in the West.

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Section: Prevalence and Spectrum/classification Of Ptlmentioning

confidence: 99%

Section: Fnacmentioning

confidence: 99%

Section: Ancillary Techniquesmentioning

confidence: 99%

Section: Ancillary Techniquesmentioning

confidence: 99%

Section: Ancillary Techniquesmentioning

confidence: 99%

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Thyroid lymphoproliferative lesions in Asia

2020

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Application of deep learning as an ancillary diagnostic tool for thyroid FNA cytology

Hirokawa

Niioka

Suzuki

et al. 2022

Cancer Cytopathology

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Background: Several studies have used artificial intelligence (AI) to analyze cytology images, but AI has yet to be adopted in clinical practice. The objective of this study was to demonstrate the accuracy of AI-based image analysis for thyroid fine-needle aspiration cytology (FNAC) and to propose its application in clinical practice. Methods:In total, 148,395 microscopic images of FNAC were obtained from 393 thyroid nodules to train and validate the data, and EfficientNetV2-L was used as the image-classification model. The 35 nodules that were classified as atypia of undetermined significance (AUS) were predicted using AI training. Results:The precision-recall area under the curve (PR AUC) was >0.95, except for poorly differentiated thyroid carcinoma (PR AUC = 0.49) and medullary thyroid carcinoma (PR AUC = 0.91). Poorly differentiated thyroid carcinoma had the lowest recall (35.4%) and was difficult to distinguish from papillary thyroid carcinoma, medullary thyroid carcinoma, and follicular thyroid carcinoma. Follicular adenomas and follicular thyroid carcinomas were distinguished from each other by 86.7% and 93.9% recall, respectively. For two-dimensional mapping of the data using t-distributed stochastic neighbor embedding, the lymphomas, follicular adenomas, and anaplastic thyroid carcinomas were divided into three, two, and two groups, respectively. Analysis of the AUS nodules showed 94.7% sensitivity, 14.4% specificity, 56.3% positive predictive value, and 66.7% negative predictive value. Conclusions:The authors developed an AI-based approach to analyze thyroid FNAC cases encountered in routine practice. This analysis could be useful for the clinical management of AUS and follicular neoplasm nodules (e.g., an online AI platform for thyroid cytology consultations).

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