The <scp>B</scp>ethesda system for reporting thyroid cytopathology: an institutional experience of the outcome of indeterminate categories

Önder, Sevgen; Firat, Pınar; Özdemir, Deniz

doi:10.1111/cyt.12091

Cited by 55 publications

(80 citation statements)

References 24 publications

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“…Others do not support such observations [13][14]. In our material FLUS-O diagnoses were rarely formulated (2.5% of all FLUS), and only six nodules were verified with histopathological examination that revealed one cancer (16.7%).…”

Section: Prace Oryginalnecontrasting

confidence: 64%

“…As a consequence of the above-mentioned factors the risk of malignancy in FLUS nodules as assessed on the basis of postoperative histopathological examination ranges from 4% up to as much as 50% [12,[22][23][24][25][26][27][28][30][31][32][33][34][35][36][37][38][39][40][41], so it exceeds by several times the values suggested by NCI recommendations. Many authors indicate that the final malignancy results were observed several times more frequently in AUS than in FLUS [7][8][9][10][11][12][13][14]. In our material, in 1 of 3 cases of FLUS with features of nuclear atypia a papillary cancer was found in postoperative examination.…”

Section: Prace Oryginalnementioning

confidence: 41%

“…Another assumption was that FLUS diagnosis would not be a direct indication for surgical treatment, in contrast to other ISC categories (SFN and SM). However, numerous reports indicate that FLUS may be related to higher than assumed risk of malignancy [7][8][9][10][11][12][13][14]. It is also unclear whether implementation of the new FLUS category does not significantly affect the malignancy risk related to other ISC categories (SFN and SM).…”

mentioning

confidence: 99%

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Analiza znaczenia klinicznego niejednoznacznych wyników biopsji tarczycy ze szczególnym uwzględnieniem kategorii ZPBN na podstawie 5 lat stosowania nowej klasyfikacji rozpoznań cytologicznych

Słowińska-Klencka

Wojtaszek-Nowicka

Sporny

et al. 2016

Endokrynologia Polska

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Introduction: The diagnostic category of follicular lesion of undetermined significance (FLUS) was intended to allow selection of cases with low risk of malignancy from all smears with indeterminate, suspicious cytology (ISC), which can potentially take advantage from repeat fine-needle aspiration (rFNA). Aim of the study was a comparison of the risk of malignancy related to FLUS nodules and other nodules with ISC: suspected follicular neoplasm (SFN) and suspected malignancy (SM), as well as analysis of the usefulness of assessing ultrasonographic malignancy risk features (UMRF) in nodules with ISC. Material and methods: We analysed UMRF, rFNA, and results of histopathological examination (H) in 441 FLUS, 135 SFN, and 72 SM nodules. Results: The frequency of exposing cancer in H in FLUS nodules was 5.9%, and when cytological follow up was also included it was 2.9%. rFNAs made the diagnosis more precise in 72.7% of FLUS, and in 5.2% it was diagnosis/suspicion of cancer. The incidence of cancer in SFN nodules was 8.2%, in SM nodules with suspicion of papillary cancer -61.1%, and in nodules with suspicion of other or unspecified malignancy -53.8% (p < 0.0001 FLUS vs. both groups). The presence of calcifications is the only independent UMRF for nodules with ISC (OR 4.7). Features of importance are also microcalcifications (OR 3.8), especially in the SM group, and taller-than-wide-shape (OR 2.2). FLUS and SFN nodules are characterised by particularly low value of assessing suspicious margins; analysis of hypoechogenicity is of low value in SFN nodules, like suspected vascularisation in SFN and SM nodules. Conclusions: The risk of cancer in FLUS and SFN nodules is lower than in SM nodules. rFNAs of FLUS nodules make the diagnosis more precise in more than 70% of cases and are effective in revealing cancers. UMRFs present variable diagnostic value depending on the subcategory of ISC. (Endokrynol Pol 2016; 67 (1): 23-34)

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Section: Prace Oryginalnecontrasting

confidence: 64%

Section: Prace Oryginalnementioning

confidence: 41%

mentioning

confidence: 99%

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Analiza znaczenia klinicznego niejednoznacznych wyników biopsji tarczycy ze szczególnym uwzględnieniem kategorii ZPBN na podstawie 5 lat stosowania nowej klasyfikacji rozpoznań cytologicznych

Słowińska-Klencka

Wojtaszek-Nowicka

Sporny

et al. 2016

Endokrynologia Polska

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“…A high malignancy rate may be the result of many factors, including heterogeneity of AUS, or differences in interpretation of the cytological results by pathologists. [9] In our study, papillary carcinoma was the most frequently seen malignancy. Previous studies have reported that incidence rate of papillary carcinoma and follicular carcinoma were similar and that the follicular variant of papillary carcinoma was the most frequently seen.…”

Section: Discussionmentioning

confidence: 50%

“…[7,8] There is a 5% to 15% risk of malignancy in these cases. [9] Since it is difficult to determine whether atypia detected in cytological examination is benign or malignant, other clinical characteristics should be taken into consideration.…”

Section: Introductionmentioning

confidence: 99%

Atypia of Undetermined Significance on Thyroid Fine Needle Aspiration Cytology: Pathological Evaluation and Risk Factors for Malignancy

Akın¹

2017

South Clin Ist Euras

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Objective:This study was performed to analyze the surgical pathology results of thyroid fine-needle aspiration (FNA) cytology categorized as atypia of undetermined significance (AUS). Results: A total of 44 female patients and 11 male patients were included in this study. Among the 55 cases, 27 (49.1%) had final diagnosis of malignancy and 28 (50.9%) had benign lesions according to pathological evaluation. Both univariate and multivariate analysis revealed that only ultrasonographic finding of suspected malignancy was associated with malignant pathology. Conclusion:The risk for malignancy should be determined in the initial stage and high-risk patients with cytology classified as AUS should be recommended for surgery. In this study, the patients had a high preoperative risk of malignancy; thus, our pathological results had a high rate of malignancy.

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The value of second opinion in thyroid cytology: A review

Gerhard

Boerner

2014

Cancer Cytopathology

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BACKGROUND: Second-opinion diagnosis (SOD) on pathological material is an accepted practice before definitive therapy is considered for referred patients. The thyroid gland is an anatomical site prone to diagnostic disagreement between pathologists. We performed a review of the literature that addressed the role of interinstitutional SOD on thyroid fineneedle aspirations (FNAs). METHODS: Nine studies comprising second opinions on thyroid FNAs were selected. The parameters analyzed included: discordances between the initial diagnoses (IDs) and SODs; cytohistologic correlation; changes in the clinical management of the patients with thyroid nodules after SOD. The same parameters were applied to the "indeterminate" diagnostic category comprising cases initially reported as "atypia," "atypia of undetermined significance/follicular lesion of undetermined significance," "suspicious for a follicular neoplasm," "follicular neoplasm," "suspicious," and "suspicious for malignancy." RESULTS: A total of 7154 thyroid FNAs were retrieved, showing an overall discordance rate between ID and SOD of 28.6%. In general, SOD was better supported by clinical follow-up and histologi-

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The Bethesda system for reporting thyroid cytopathology: an institutional experience of the outcome of indeterminate categories

Cited by 55 publications

References 24 publications

Analiza znaczenia klinicznego niejednoznacznych wyników biopsji tarczycy ze szczególnym uwzględnieniem kategorii ZPBN na podstawie 5 lat stosowania nowej klasyfikacji rozpoznań cytologicznych

Analiza znaczenia klinicznego niejednoznacznych wyników biopsji tarczycy ze szczególnym uwzględnieniem kategorii ZPBN na podstawie 5 lat stosowania nowej klasyfikacji rozpoznań cytologicznych

Atypia of Undetermined Significance on Thyroid Fine Needle Aspiration Cytology: Pathological Evaluation and Risk Factors for Malignancy

The value of second opinion in thyroid cytology: A review

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