Thyroid

Jayaram, Gita; Orell, S. R.

doi:10.1016/b978-0-7020-3151-9.00006-2

Cited by 14 publications

(8 citation statements)

References 195 publications

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“…In recent years, several series have reported the cytomorphological features of parathyroid lesions. [ 5 7 ] The role of FNAC in parathyroid lesions is limited as a diagnostic modality because of better imaging modalities and localizing scans such as methoxy isobutyl isonitrile (MIBI) and technetium 99. In the presence of clinical evidence of hyperparathyroidism, high-frequency sonography is an accurate and noninvasive means of localizing the enlarged parathyroid glands.…”

Section: Discussionmentioning

confidence: 99%

Utility of fine-needle aspiration cytology in the identification of parathyroid lesions

Kumari

Mishra

Pradhan

et al. 2016

J Cytol

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Objectives:Fine-needle aspiration cytology (FNAC) is a first-line investigation in the evaluation of neck nodules. In an attempt to search for reliable cytomorphological criteria for parathyroid lesions, we systematically evaluated cytomorphology of FNAC of parathyroid lesions.Study Design:FNAC of 15 parathyroid and 15 hyperplastic thyroid nodules with histological confirmation were reviewed for following features: Cellularity, follicles, bare nuclei, cohesiveness, vascular profiles, cytoplasmic granularity, intracytoplasmic vacuolation, mitosis, macrophages, and colloid.Results:Vascular proliferation, bare nuclei, intracytoplasmic fat vacuolation, absence of colloid, and high cellularity showed significant association with parathyroid lesions (P ≤ 0.05). Intracytoplasmic fat vacuolation was 53.3% sensitive and 100% specific for parathyroid. Follicular pattern and papillaroid clusters were also important; however, they achieved nearly significant statistical difference (P = 0.05 and P = 0.06, respectively). The combination of vascular proliferation and intracytoplasmic fat vacuolation were significantly associated with parathyroid (P = 0.006) whereas the absence of bare nuclei and the presence of background colloid were associated with thyroid cytomorphology (P = 0.03).Conclusion:No single cytological feature is helpful in differentiating parathyroid from thyroid lesion. Vascular proliferation, bare nuclei, intracytoplasmic fat vacuolation, high cellularity, and the absence of colloid were significantly associated with the parathyroid origin. The combination of at least two features — vascular proliferation and intracytoplasmic fat vacuoles — were highly suggestive of parathyroid origin.

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Section: Discussionmentioning

confidence: 99%

Utility of fine-needle aspiration cytology in the identification of parathyroid lesions

Kumari

Mishra

Pradhan

et al. 2016

J Cytol

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“…Psammoma bodies, “chewing gum” colloid, and metaplastic squamous cells may also be present. [ 4 5 ] Cellular swirls have been recently described as a useful diagnostic clue for PTC. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

“…The various cytologic features of classic PTC are well-documented in literature and include high cellularity, papillary fronds with anatomical edges, enlarged oval nucleus with longitudinal intranuclear grooves, nuclear crowding and overlapping, cellular swirls, and chewing gum colloid. [ 4 5 6 ] Several histologic variants of PTC described in the literature include follicular, oncocytic, tall cell, columnar cell, diffuse sclerosing, cribriform–morular, etc. Cytologic diagnosis of these variants is clinically significant as some of them are associated with poor prognosis such as tall cell, columnar cell, and diffuse sclerosing variants.…”

Section: Introductionmentioning

confidence: 99%

Cytomorphologic diversity of papillary thyroid carcinoma

Monappa

Kudva

2017

J Cytol

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Introduction:Cytologic features of papillary thyroid carcinoma (PTC) have been extensively documented in literature. However, PTC variants can prove to be diagnostically challenging on fine needle aspiration cytology (FNAC).Aims:To study the FNAC features of PTC and its variants and explore the causes for misdiagnosis.Materials and Methods:This is a retrospective study. All cases of histopathologically (HP) confirmed cases of PTC during a 2-year period (January 2012 to December 2013) with presurgical FNAC were included. The cytologic findings and FNAC diagnosis of each case were documented and compared with the HP report. The misdiagnosed cases were reviewed to look for any cytological clues and reasons for misdiagnosis.Results:A total of 58 cases were included. The overall diagnostic accuracy was 55.6% which improved to 64.8% on including suspicious for PTC cases. Follicular variant was the most misdiagnosed variant; 41.2% of the cases were called follicular neoplasm. Oncocytic variant showed cells with abundant eosinophilic cytoplasm along with bizarre giant cells. Warthin tumor-like variant showed cells with moderate eosinophilic cytoplasm with close apposition of lymphocytes in a background of reactive lymphocytes and lymphoid tangles. Cystic variant was paucicellular. Columnar cell variant showed tall columnar cells with nuclear stratification. Cribriform–morular variant showed syncytial sheets of cells and hyaline globules.Conclusions:PTC variants have distinct cytomorphological features. In some variants (follicular, columnar cell), nuclear grooves and inclusions may not be apparent, contributing to the diagnostic confusion. Benign nodule adjacent to the tumor can dominate the FNAC smear and lead to misdiagnosis.

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“…Cell block cytology shows the structural details of the thyroid lesions very well and, with the help of immunohistochemical staining, can distinguish benign and malignant thyroid nodules with high diagnostic accuracy (20,21). Also cell block studies were found to be helpful in the diagnosis of papillary thyroid carcinoma and nodules that are suspicious for malignancy, since they show the configuration and nuclear features better.…”

Section: Discussionmentioning

confidence: 99%

The contribution of vacuum-assisted modified Menghini type needle to diagnosis of US-guided fine needle aspiration biopsy of the thyroid

Birgi¹,

Ergün²,

Türkmenoğlu³

et al. 2016

Diagn Interv Radiol

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T hyroid gland nodules are common findings and palpable nodule prevalence is reported as 3%-7% in the literature (1-3). Nonpalpable thyroid nodules that cannot be detected clinically are seen on ultrasonography (US) in 13%-50% of the population (4). The most important issue in detection of a nodule is how to distinguish between benign and malignant nodules, so that unnecessary surgical procedures on benign nodules can be prevented and surgical removal of malignant nodules can be ensured.Fine needle aspiration biopsy (FNAB) is a minimally invasive and safe diagnostic method to distinguish benign and malignant thyroid nodules, especially when performed under US guidance. The diagnostic accuracy of FNAB in experienced centers is very high; the sensitivity and specificity were reported to be approximately 85% and 99%, respectively (5).According to the literature, FNAB may provide insufficient results in 2%-20% of the nodules (average 15%) based on whether it has been performed under US guidance or not (3). In addition to operator experience, lesion characteristics, lesion and needle localization, guiding method, number of aspirations, needle size, aspiration technique, and accompanying pathologist are among the factors affecting the results of FNAB (6). An insufficient FNAB cytology result leads to a waste of time not only for patients, but also for clinicians, radiologists, and pathologists. Moreover, repeated biopsy procedures increase the cost and the patient anxiety.In this prospective study, we aimed to determine the contribution of 21G vacuum-assisted modified Menghini type needle to diagnosis of US-guided FNAB of the thyroid evaluated by a pathologist at the bedside. Additionally, we aimed to investigate the effect of the needle on patient comfort and examine the relation between the number of aspirations, nodule characteristics, and sufficient material obtainability. PURPOSEWe aimed to determine the contribution of vacuum-assisted modified Menghini type needle to diagnosis of ultrasound-guided fine needle aspiration biopsy (FNAB) of the thyroid evaluated by a pathologist at the bedside. METHODSA total of 147 thyroid nodules in 138 patients (122 women, 16 men) were included in this prospective study. Sonographic features of nodules, number of aspirations, pain and pain severity during the process, hemorrhage, and presence of sample obtained for cell block analysis were recorded and analyzed with the results of aspiration biopsy. RESULTSUsing the 21G modified Menghini type needle, a diagnosis could not be reached in 14.3% of nodules. Adequate samples for cell block analysis were obtained in 47 nodules (32%), 17 of which contributed to the diagnosis. While the difference between diagnostic cytopathology results and the contribution of the cell block were statistically significant, obtainability of cell block samples was not significantly correlated with the number of aspirations or the presence of a cystic component in the nodule. CONCLUSIONFNAB with 21G vacuum-assisted modified Menghini type needle is a safe ...

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Thyroid

Cited by 14 publications

References 195 publications

Utility of fine-needle aspiration cytology in the identification of parathyroid lesions

Utility of fine-needle aspiration cytology in the identification of parathyroid lesions

Cytomorphologic diversity of papillary thyroid carcinoma

The contribution of vacuum-assisted modified Menghini type needle to diagnosis of US-guided fine needle aspiration biopsy of the thyroid

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