Follicular Growth Pattern Disease on Thyroid Fine-needle Aspiration Biopsy

Taştekin, Ebru; Canberk, Şule; Schmidt, Fernando C

doi:10.4274/balkanmedj.galenos.2022.2022-5-17

Cited by 2 publications

(2 citation statements)

References 99 publications

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“…The vascular or capsular invasion should be demonstrated to diagnose follicular carcinoma. These cannot be seen in an FNAB material, and the material is defined as “FN.” Nodules defined as FNs are in the suspicious group for malignancy [ 15 ]. Surgical treatment is recommended for these patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Thyroid Nodules in Patients With Fine-Needle Aspiration Biopsy

Turkkan,

Uzum

2023

Cureus

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Background: The incidence of thyroid nodules has increased in the last 50 years due to the widespread use of imaging methods and incidental detection of small thyroid nodules. Thyroid fine-needle aspiration biopsy (FNAB) is the most accurate, reliable, and cost-effective test to evaluate thyroid nodules. Aim: In this research, we aimed to elucidate thyroid fine-needle aspiration cytology (FNAC) to understand how suspicious cases predict malignancy. Materials and methods: Within this research’s scope, 411 patients over 16 years old who were evaluated in Izmir Katip Celebi University, Ataturk Training and Research Hospital Internal Medicine (Izmir, Turkey) outpatient clinic for thyroid nodules between 2018 and 2022 and underwent thyroid FNAC followed by thyroid surgery were analyzed retrospectively. The age, gender, thyroid FNAC, operation type, and histopathology of all the patients were reviewed. Individuals with a history of head and neck cancer were excluded from the analysis. Results: No statistically significant relationship between the pathology results and demographic characteristics was found. A statistically significant correlation existed between the pathology and FNAB results (p<0.05) . Although 84.5% of the patients were diagnosed as benign, 14.7% as suspicious, and 0.8% as malignant in FNAC, all of these cases were diagnosed as benign in final histopathology results. Similarly, 21.9% of the patients were diagnosed as benign, 58.8% as suspicious, and 19.4% as malignant in FNAC and all of these cases were diagnosed as malignant in final histopathology results. A correlation was determined between the two measurements (Cohen’s kappa (κ)=0.557; p<0.001). The test’s sensitivity was 47%, and the specificity was 99.1%. According to the FNAC results, the rate of being diagnosed with malignancy (positive predictive value (PPV)) was 93.9%, and the rate of being diagnosed as benign (negative predictive value (NPV)) was 85.8% for the individuals initially diagnosed as benign. Conclusion: Although FNAB remains the most important diagnostic tool to identify benign cases with a high accuracy rate, the operation decision is not clear in suspicious atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) cytology findings. In conclusion, this study highlights the importance of FNA results and helps in surgical decision-making by emphasizing that the possibility of malignancy in the post-operative final histopathology report is higher, especially in the presence of suspicious FNAC results.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Thyroid Nodules in Patients With Fine-Needle Aspiration Biopsy

Turkkan,

Uzum

2023

Cureus

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“…In most cases, benign and malignant classes show high diagnostic accuracy [ 6 , 7 ]. However, FNA has some limitations; in fact, approximately 70% of nodules are diagnosed as benign and 5–10% as malignant; therefore, the remaining 15–30% are classified as “indeterminate nodules” [ 8 , 9 ]. The differential diagnosis among indeterminate classes, composed mostly of follicular-architecture tumors (benign, pre-malignant, and frankly malignant), is very challenging [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Indeterminate Thyroid Nodules: From Cytology to Molecular Testing

Vignali,

Macerola,

Poma

et al. 2023

Diagnostics

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Thyroid cancer is the most common malignancy of the endocrine system. Fine-needle aspiration (FNA) biopsy of thyroid nodules has become the gold standard procedure, in terms of cost and efficacy, for guiding clinicians towards appropriate patients’ management. One challenge for cytopathologists is to accurately classify cytological specimens as benign or malignant based on cytomorphological features. In fact, with a frequency ranging from 10% to 30%, nodules are diagnosed as indeterminate. In recent years, the mutational landscape of thyroid tumors has been extensively described, and two molecular profiles have been identified: RAS-like (NRAS, HRAS, and KRAS mutations; EIF1AX mutations; BRAF K601E mutation; and PPARG and THADA fusions) and BRAFV600E-like (including BRAFV600E mutation and RET and BRAF fusions). The purpose of this review is to discuss the latest molecular findings in the context of indeterminate thyroid nodules, highlighting the role of molecular tests in patients’ management.

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Follicular Growth Pattern Disease on Thyroid Fine-needle Aspiration Biopsy

Cited by 2 publications

References 99 publications

Evaluation of Thyroid Nodules in Patients With Fine-Needle Aspiration Biopsy

Evaluation of Thyroid Nodules in Patients With Fine-Needle Aspiration Biopsy

Indeterminate Thyroid Nodules: From Cytology to Molecular Testing

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