Follicular lesions of thyroid

Greaves, Timothy S.; Olvera, Maria; Florentine, Barbara D.; Raza, Anwar; Cobb, Camilla J.; Tsao-Wei, Denise D.; Groshen, Susan; Сингер, Петер; LoPresti, Jonathan S.; Martin, Sue Ellen

doi:10.1002/1097-0142(20001225)90:6<335::aid-cncr3>3.0.co;2-l

Cited by 159 publications

(20 citation statements)

References 7 publications

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“…Although some authors report no correlation between atypia and malignancy [5, 22, 23], other studies show, conversely, that atypia alone or in association with a follicular patterned FNAC can be linked to a higher risk of malignancy [12, 14, 16, 20, 24, 25]. …”

Section: Discussionmentioning

confidence: 99%

Subclassification of the “Grey Zone” of Thyroid Cytology; A Retrospective Descriptive Study with Clinical, Cytological, and Histological Correlation

Bonzanini

Amadori

Morelli

et al. 2011

Journal of Thyroid Research

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Undetermined thyroid cytology precludes any definitive distinction between malignant and benign lesions. Recently several classifications have been proposed to split this category into two or more cytological subcategories related to different malignancy risk rates. The current study was performed retrospectively to investigate the results obtained separating “undetermined” cytologic reports into two categories: “follicular lesion” (FL) and “atypia of undetermined significance” (AUS). Biochemical, clinical, and echographic features of each category were also retrospectively analyzed. Altogether, 316 undetermined fine-needle aspirated cytologies (FNACs) were reclassified as 74 FL and 242 AUS. Histological control leads to a diagnosis of carcinomas, adenomas, and nonneoplastic lesions, respectively, in 42.2%, 20%, and 37.8% of AUS and in 8.3%, 69.4%, and 22.2% of FL. Among biochemical, clinical, cytological, and echographic outcomes, altered thyroid autoantibodies, multiple versus single nodule, AUS versus FL, and presence of intranodular vascular flow were statistically significant to differentiate adenoma from carcinoma and from nonneoplastic lesions, whereas no significant differences were found between carcinomas and nonneoplastic lesions for these parameters. The results of this retrospective study show that undetermined FNAC category can further be subclassified in AUS and FL, the former showing higher malignancy rate. Further prospective studies are needed to confirm our results.

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Section: Discussionmentioning

confidence: 99%

Subclassification of the “Grey Zone” of Thyroid Cytology; A Retrospective Descriptive Study with Clinical, Cytological, and Histological Correlation

Bonzanini

Amadori

Morelli

et al. 2011

Journal of Thyroid Research

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“…Greaves et al . [15] reviewed 96 FNAC cases of “follicular lesion” and reported a 30% malignancy rate, whereas 23% malignancy rate was reported by Ersoz et al . [16] who examined 56 cases of “solitary cellular nodules” and “cellular microfollicular lesions”.…”

Section: Discussionmentioning

confidence: 99%

A cell pattern approach to interpretation of fine needle aspiration cytology of thyroid lesions: A cyto-histomorphological study

Bommanahalli

Bhat

Rupanarayan

2010

J Cytol

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Aim:Our study aimed at a cell pattern approach to interpret thyroid cytology and to demonstrate diagnostic accuracy of fine needle aspiration cytology (FNAC) with an emphasis on diagnostic pitfalls.Materials and Methods:A total number of 218 goitre cases, from the year 2000 to 2004, were reviewed retrospectively from the cytology files, without considering the previous cytological diagnosis. Four cases with inadequate aspirate were excluded. The predominant cell pattern, such as macro/normofollicular, microfollicular, papillary, syncytial, dispersed and cystic pattern, was noted in each case. The final diagnosis was arrived by observing the cellular details and background elements. Cytological diagnosis was correlated with histopathology in 75 cases. The sensitivity and specificity were computed.Results:Normo/macrofollicular pattern was seen in 71.96% of nodular goitre and 6.9% of follicular neoplasms. Around 86.2% of follicular neoplasms and 17.6% of papillary carcinoma had microfollicular pattern. The papillary pattern was seen in 47% of papillary carcinoma. Syncytial pattern was noticed in 72.3% of chronic lymphocytic thyroiditis and 29.4% of papillary carcinoma. Cytological diagnosis was concordant with histopathological diagnosis in 65 cases. Overall sensitivity and specificity of FNAC in diagnosing neoplastic lesions of thyroid were 83.33 and 95.55%, respectively.Conclusion:FNAC is more sensitive and specific in triaging neoplastic from non-neoplastic thyroid lesions. Identification of the predominant cell pattern would be complementary to analysis of cell morphology and background details in cytological diagnosis of thyroid lesions. This approach helps to diagnose follicular neoplasm and follicular variant of papillary thyroid carcinoma.

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“…Cytologic evaluation of FNAs can usually render a diagnosis, but 15 to 30% of FNAs are indeterminate. 1–3 These patients require surgery for a definitive diagnosis. Many groups are trying to improve the diagnostic capabilities of FNAs; molecular markers such as galectin-3, HBME-1, as well as microRNA and gene expression profiles have all shown promise but are not yet accurate enough to be used clinically.…”

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confidence: 99%

Predictive Value of Cytologic Atypia in Indeterminate Thyroid Fine-Needle Aspirate Biopsies

et al. 2011

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Background Fine-needle aspiration (FNA) biopsies are the most accurate method for diagnosis of thyroid nodules. Unfortunately, biopsies are indeterminate 15–30% of the time and surgery is thus required for a definitive diagnosis. We aimed to determine whether specific descriptors of cytologic atypia mentioned in indeterminate FNA reports were associated with malignancy on final histopathology. Methods Retrospective review of 1000 surgery patients identified 466 indeterminate FNA lesions that underwent either a hemi- or total thyroidectomy between 1998 and 2009. We screened FNA reports for specific descriptors of nuclear atypia. Univariate and multivariate analyses were performed to evaluate the independent effect of cytologic atypia descriptors on the risk of malignancy. Results Nuclear atypia on FNA conferred a risk of malignancy of 42% (P <0.0001). Risk of malignancy increased from 17% for zero descriptors to 81.2% when four or more descriptors of atypia were described. Nuclear grooves and inclusions together conferred a risk of malignancy, specificity, and false positive rate of 79.3%, 98.2% and 1.8% respectively. Conclusions The presence of four or more descriptors of cytologic atypia or the presence of both nuclear inclusions and grooves together confers a high risk of malignancy on final histopathology and a low false positive rate. These findings should be taken into consideration when interpreting FNA reports and total thyroidectomy should be considered for those patients at higher risk.

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Follicular lesions of thyroid

Cited by 159 publications

References 7 publications

Subclassification of the “Grey Zone” of Thyroid Cytology; A Retrospective Descriptive Study with Clinical, Cytological, and Histological Correlation

Subclassification of the “Grey Zone” of Thyroid Cytology; A Retrospective Descriptive Study with Clinical, Cytological, and Histological Correlation

A cell pattern approach to interpretation of fine needle aspiration cytology of thyroid lesions: A cyto-histomorphological study

Predictive Value of Cytologic Atypia in Indeterminate Thyroid Fine-Needle Aspirate Biopsies

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