Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

Kayilioglu, Selami Ilgaz; Dinç, Tolga; Sozen, Isa; Şenol, Kazım; Katar, Kagan; Karabeyoğlu, Melih; Tez, Mesut; Çoşkun, Faruk

doi:10.7314/apjcp.2014.15.23.10307

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…This cytological description constitutes 1-27% of FNAB results (19). The cancer risk in Bethesda category III is reported to be between 5% and 15%, although many studies have reported that cancer rates vary between 17-39% (4,(20)(21)(22)(23)(24)(25)(26)(27). In our study, the incidence of thyroid cancer was 20.3% in patients with category III cytology.…”

Section: Resultsmentioning

confidence: 48%

Results of the Bethesda System in Patients Undergoing Thyroidectomy-A Single-Center Experience

Ocak¹,

Bük²,

Yemez³

2019

eamr

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To compare preoperative fine needle aspiration biopsy (FNAB) and postoperative histopathological findings in patients undergoing thyroidectomy and to validate the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Methods: Data from 366 patients who underwent thyroidectomy between 2014-2016 were analyzed retrospectively and the variables related to thyroid cancer were investigated. Results: Of 366 patients, 44 (12%) were male and 322 (88%) were female. Regarding FNAB results according to TBSRTC, 23 (6.3%) patients had category I, 79 (21.6%) had category II, 128 (35%) had category III, 113 (30.9%) had category IV, nine (3.8%) patients had category V and 14 (2.5%) had category VI cytology. Histopathological examination revealed thyroid cancer in 65 (17.7%) patients. The Bethesda System was found to have a sensitivity of 73.9% and a specificity of 96%. There was no association between thyroid cancer and other variables except male gender. Conclusion: Although TBSRTC has an acceptable sensitivity and specificity, the risk of malignancy in category III and IV patients may vary. Therefore, multidisciplinary approach should be considered during treatment planning and surgical treatment option should be kept in mind.

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Section: Resultsmentioning

confidence: 48%

Results of the Bethesda System in Patients Undergoing Thyroidectomy-A Single-Center Experience

Ocak¹,

Bük²,

Yemez³

2019

eamr

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“…Valderrabano et al 25 have reported a malignancy rate up to 30% in the resection specimens of AUS/FLUS category. Kayılıoğlu et al 26 observed 35% malignant diagnosis in this group of patients.…”

Section: Discussionmentioning

confidence: 50%

Thyroid cytology in Pakistan: An institutional audit of the atypia of undetermined significance/follicular lesion of undetermined significance category

et al. 2020

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Introduction Fine needle aspiration cytology (FNAC), along with thyroid ultrasound, is an important tool in evaluation of thyroid nodules that helps in further management of these patients in making a decision of surgical intervention vs follow‐up. The Bethesda System for Reporting Thyroid Cytopathology category III of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) has risk of malignancy (ROM) ranging from 5% to 15%. The aim of the present study was to describe the frequency of AUS/FLUS in thyroid gland FNACs and the surgical outcomes of these cases. Methods The integrated laboratory management system retrieved the thyroid FNACs from 2010 to 2018 and subsequent surgical pathology specimens. For the AUS/FLUS cases, data regarding patient demographics, cytology and histological diagnoses were recorded. The results were tabulated as the overall frequency of AUS/FLUS in thyroid FNACs, cytohistological correlation (benign and malignant) and ROM. Results Over a period of 9 years, 256 (10.9%) cases out of 2342 thyroid FNACs were reported as AUS/FLUS at our institution. Mean age was 43.5 years. The majority (70.3%) of patients were female. Seventy‐two of 104 resection specimens (69.2%) were reported as benign and 32 cases (30.7%) had malignant diagnosis. Upper‐bound ROM was 30.7% (32 cases with malignant diagnosis out of 104 resection specimens). Lower‐bound ROM was calculated as 12.5% (32 cases with malignant diagnosis out of 256 total AUS diagnosis). Conclusion The AUS/FLUS category of thyroid cytology and associated ROM remain an evolving area. Individual institutions should monitor the frequency and include ROM in the dashboard indicators to remain within the recommended range.

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“…However, this rate is reported as 28.3% for FLUS and 32% for AUS patients in the above mentioned studies [3]. In a similar study of ours, we found that 35% of patients who undergone surgical resection due to AUS/ FLUS were diagnosed malignant [4]. Initial presentation of the Bethesda System was based on 7% diagnosing rate and around 5-15% malignancy rate; however, clinical practice does not seem to tone with these expectations.…”

Section: Introductionmentioning

confidence: 51%

The Gray Zone in Thyroid Nodules: Atypia of Undetermined Signifi cance/ Follicular Lesion with Unknown Signifi cance

Kayilioglu¹,

Göktuğ²,

Dinç³

2017

Open J Thyroid Res

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Major purpose of the management of thyroid nodules is to distinguish between malignant nodules and the benign ones. Nodules with the cytology result Atypia of Undetermined Signifi cance or Follicular Lesion of Undetermined Signifi cance are still a diagnostic challenge. Initial presentation of the Bethesda System was based on 7% diagnosing rate and around 5-15% malignancy rate for these nodules; however, clinical practice presents with higher rates for both variables. Recent studies showed that when these nodules are grouped by cytological features; compared with the architectural atypia group, the cytological atypia group has a signifi cantly higher risk of malignancy. Cytological sub-classifi cation, ultrasonographic evaluation and genetic tests in selected cases should be used in the management of these nodules.

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Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

Cited by 7 publications

References 23 publications

Results of the Bethesda System in Patients Undergoing Thyroidectomy-A Single-Center Experience

Results of the Bethesda System in Patients Undergoing Thyroidectomy-A Single-Center Experience

Thyroid cytology in Pakistan: An institutional audit of the atypia of undetermined significance/follicular lesion of undetermined significance category

The Gray Zone in Thyroid Nodules: Atypia of Undetermined Signifi cance/ Follicular Lesion with Unknown Signifi cance

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