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Thyroid cytopathology

Safa Alshaikh, Zainab Harb, Eman Aljufairi, S Ali Almahari
Background: Fine-needle aspiration cytology (FNAC) of thyroid is the initial screening test for thyroid nodules. The Bethesda system classifies thyroid FNAC into six categories. Each category is linked to a malignancy risk and has a recommended clinical management. The aim of this study is to analyze the thyroid cytology smears by Bethesda system and to correlate the diagnosis of cytopathology with histopathology, whenever surgery was done. Materials and Methods: This study presents our experience with the Bethesda system in 681 thyroid FNAs from 632 patients in the period between January 2013 and December 2016...
2018: CytoJournal
Ozgen Arslan Solmaz
Background: Palpable thyroid nodules can be found in 4%-7% of the adult population; however, <5% of thyroid nodules are malignant. Immunohistochemical markers, such as CD56, can be used to make a differential diagnosis between benign and malignant lesions. To increase the accuracy of the diagnosis and distinguish the malignant aspirates from the benign ones, chose to evaluate CD56, which is normally found in benign thyroid tissue. Methods: A total of 53 fine-needle aspirate samples from patients diagnosed with suspected papillary thyroid carcinoma (PTC) were included prospectively...
2018: CytoJournal
Polycarp Erivwo, Chandrani Ghosh
INTRODUCTION: The rates of atypia of undetermined significance (AUS) by fine-needle aspiration (FNA) and malignant outcomes have been estimated at < 7% and 5-15%, respectively. Initial AUS diagnosis is followed up clinically with serial ultrasounds, repeat FNA, molecular testing, or direct surgery. We investigated the incidence, follow-up modalities, and final outcomes of AUS in Newfoundland. METHODS: All cases of AUS diagnosed at the Eastern Health Cytology Laboratory between 1 January 2010 and 31 December 2013 were identified...
February 27, 2018: Acta Cytologica
Andrey Bychkov, Chan Kwon Jung, Zhiyan Liu, Kennichi Kakudo
The introduction of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was initiated and promoted by pathologists. Recent Asian studies added new knowledge to the existing literature to aid a better understanding of NIFTP. Our original data and the results of a meta-analysis suggest that the initial rate of NIFTP has been overestimated, averaging 9.1% (95% confidence interval [CI] 6.0-12.7%) of all papillary thyroid cancers worldwide. The incidence of NIFTP in the Asian population (1...
February 23, 2018: Endocrine Pathology
Claudio Bellevicine, Roberta Sgariglia, Ilaria Migliatico, Elena Vigliar, Melania D'Anna, Maria Antonia Nacchio, Nicola Serra, Umberto Malapelle, Massimo Bongiovanni, Giancarlo Troncone
BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology category of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) includes fine-needle aspiration (FNA) specimens that cannot straightforwardly be classified as benign or malignant. To determine whether morphological subcategorization based on atypia qualifiers and molecular testing could improve malignancy risk stratification of AUS/FLUS patients, this study assessed the correlation between these qualifiers and the molecular alterations commonly harbored by thyroid neoplasms...
February 22, 2018: Cancer Cytopathology
Giovanni Guido Pompili, Silvia Tresoldi, Anna Ravelli, Alessandra Primolevo, Giovanni Di Leo, Gianpaolo Carrafiello
Purpose: The purpose of this study was to validate the role of the total malignancy score (TMS) in identifying thyroid nodules suspicious for malignancy through the sum of their ultrasound features. Methods: The local ethical committee approved this prospective observational study. We examined 231 nodules in 231 consecutive patients (164 females and 67 males; age range, 20 to 87 years; median age, 59 years; interquartile range, 48 to 70 years) who underwent ultrasound followed by fine-needle aspiration cytology (FNAC)...
January 6, 2018: Ultrasonography
Isabel Amendoeira, Tiago Maia, M Sobrinho-Simões
The 2017 edition of the WHO book on Classification of Tumours of Endocrine Organs includes a new section entitled "Other encapsulated follicular-patterned thyroid tumours", in which the newly created NIFTP (Non-invasive follicular thyroid neoplasm with papillary-like nuclear features) is identified and detailed described. Despite deleting the word "carcinoma" from its name, NIFTP is not a benign tumor either, and is best regarded as a neoplasm with "very low malignant potential"...
February 9, 2018: Endocrine-related Cancer
Jean L Oosthuizen, Blair Walker, Emilija Todorovic, Hamid Masoudi, Sam M Wiseman
BACKGROUND: The objective of this study was to evaluate the influence of papillary features on risk of malignancy (ROM) within the Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance (AUS-FLUS) Bethesda System for Reporting Thyroid Cytopathology (BSRTC) diagnostic category. METHODS: A Retrospective review of cases with an AUS-FLUS diagnosis that underwent a thyroidectomy was carried out, and cases were subcategorized based upon the presence of papillary features...
January 5, 2018: American Journal of Surgery
Pragati Awasthi, Garima Goel, Ujjawal Khurana, Deepti Joshi, Kaushik Majumdar, Neelkamal Kapoor
Objectives: Fine-needle aspiration cytology (FNAC) has emerged as an indispensable tool to discriminate thyroid lesions into benign or malignant for appropriate management. The need for simplicity of communication and standardization of terminology for thyroid FNAC reporting led to introduction of "The Bethesda system for reporting Thyroid Cytopathology" (TBSRTC) in a conference held at the National Cancer Institute in 2007. This study aims at establishing the reproducibility of TBSRTC for diagnosing thyroid lesions...
January 2018: Journal of Cytology
Jae Yeon Seok, Jungsuk An, Hyun Yee Cho
BACKGROUND: Various efforts have been made to improve the diagnostic accuracy of thyroid fine needle aspiration (FNA) cytology. We changed the diagnostic system by reducing the number of pathologists responsible for the thyroid FNA cytology in the routine work, and analyzed the effect on the pathologist's diagnostic performance. METHODS: Since March 1, 2015, 3 pathologists have been responsible for diagnostic thyroid FNA, previously undertaken by 9 equally. We compared the prechange period (three months, 319 nodules) and the postchange period (12 months, 1194 nodules)...
January 22, 2018: Diagnostic Cytopathology
Lili Zhang, Yujiang Liu, Xiaoqu Tan, Xi Liu, Hong Zhang, Linxue Qian
OBJECTIVES: To compare the adequacy of 23-, 25-, and 27-gauge needles in the fine-needle aspiration biopsy of thyroid nodules to develop guidelines for the collection of better specimens for cytologic diagnosis. METHODS: This randomized prospective study included 156 consecutively enrolled patients with 156 nodules. Each nodule was aspirated with a needle of each size. The obtained specimens were analyzed independently by 2 cytopathologists, and adequacy rates were calculated...
December 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Mara Y Roth, Robert L Witt, David L Steward
Thyroid nodules affect nearly two-thirds of the world population. Fine-needle biopsy with cytologic evaluation remains the diagnostic test of choice to distinguish benign from malignant thyroid nodules yet fails to discriminate as benign or malignant in up to one-third of cases. This review discusses the limitation of current cytopathologic evaluation, the development of thyroid molecular testing, and the strengths and limitations of commercially available tests. Initial cytomolecular testing sought to identify specific gene mutations associated with thyroid cancer...
December 26, 2017: Cancer
Yin P Hung, Justine A Barletta
The term non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently introduced to replace a subset of follicular variant of papillary thyroid carcinoma (FVPTC). The goal of this change was to promote more conservative management of these tumours and spare patients the psychological burden of a cancer diagnosis. The histological diagnosis of NIFTP is stringent: the tumour needs to demonstrate encapsulation or circumscription, a purely follicular architecture and the presence of nuclear features of papillary thyroid carcinoma, while lacking capsular and vascular invasion, a significant component of solid growth and high-grade features (increased mitotic activity and necrosis)...
January 2018: Histopathology
Weihong Li, Andrew Sciallis, Madelyn Lew, Judy Pang, Xin Jing
BACKGROUND: Noninvasive encapsulated follicular variant of papillary thyroid carcinoma (PTC) has recently been reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Implementation of the new terminology may alter the implied risk of malignancy (ROM) across the six categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). METHODS: The study cohort consisted of thyroid fine needle aspiration (FNA) cases which were assessed between January 2011 and June 2016 and led to surgical resections...
February 2018: Diagnostic Cytopathology
Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov
Thyroid carcinoma is one of the leading malignancies in Thailand increasingly prevalent in the female population. Fine-needle aspiration (FNA) cytology is a widely used diagnostic tool for evaluation of thyroid nodules and thyroid cancer. Thyroid FNA is a routine procedure universally performed in Thai hospitals by a variety of clinical specialists. Manual guidance is the first-line choice complemented by ultrasound assistance in selected cases. Despite national guidelines recommendations, the diagnostic criteria and terminology of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was slowly adopted in the local settings...
November 2017: Journal of Pathology and Translational Medicine
Pablo Valderrabano, Laila Khazai, Zachary J Thompson, Susan C Sharpe, Valentina D Tarasova, Kristen J Otto, Julie E Hallanger-Johnson, J Trad Wadsworth, Bruce M Wenig, Christine H Chung, Barbara A Centeno, Bryan McIver
BACKGROUND: Indeterminate categories of thyroid cytopathology (categories B-III and B-IV of the Bethesda system) are integrated by a heterogeneous spectrum of cytological scenarios that are generally clustered for analysis and management recommendations. It has been suggested that aspirates exhibiting nuclear atypia have a higher risk of malignancy. This study aimed to assess whether cytologically indeterminate thyroid nodules with nuclear atypia have a significantly higher cancer risk than those without nuclear atypia...
February 2018: Thyroid: Official Journal of the American Thyroid Association
R Yashaswini, T N Suresh, A Sagayaraj
Introduction: Fine needle aspiration (FNA) of the thyroid gland is an effective diagnostic method. The Bethesda system for reporting thyroid cytopathology classifies them into six categories and gives implied risk for malignancy and management protocol in each category. Though the system gives specific criteria, diagnostic dilemma still exists. Using nuclear morphometry, we can quantify the number of parameters, such as those related to nuclear size and shape. The evaluation of nuclear morphometry is not well established in thyroid cytology...
October 2017: Journal of Cytology
Sogol Mostoufi-Moab, Emmanuel Labourier, Lisa Sullivan, Virginia LiVolsi, Yimei Li, Rui Xiao, Sylvie Beaudenon-Huibregtse, Ken Kazahaya, N Scott Adzick, Zubair Baloch, Andrew J Bauer
BACKGROUND: Thyroid nodules are less common in pediatric patients (i.e., those ≤18 years) than they are in adults. The Bethesda System for Reporting Thyroid Cytopathology allows for individual risk stratification, but a significant number of nodules are indeterminate. Incorporating gene mutation panels and gene expression classifiers may aid in preoperative diagnosis. The overall aim of this study was to assess the prevalence of oncogene alterations in a representative pediatric population and across a broad-spectrum of thyroid tumor diagnoses...
January 2018: Thyroid: Official Journal of the American Thyroid Association
Edmund S Cibas, Syed Z Ali
The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) established a standardized, category-based reporting system for thyroid fine-needle aspiration (FNA) specimens. The 2017 revision reaffirms that every thyroid FNA report should begin with one of six diagnostic categories, the names of which remain unchanged since they were first introduced: (i) nondiagnostic or unsatisfactory; (ii) benign; (iii) atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS); (iv) follicular neoplasm or suspicious for a follicular neoplasm; (v) suspicious for malignancy; and (vi) malignant...
November 2017: Thyroid: Official Journal of the American Thyroid Association
Chae Jung Park, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Youngjean Park, Jin Young Kwak
OBJECTIVE: The purpose of this study was to evaluate the malignancy rate of nodules with nondiagnostic cytologic results based on the American Thyroid Association (ATA) ultrasound (US) patterns and to suggest management guidelines for these nodules. MATERIALS AND METHODS: From January 2013 to December 2014, 441 nodules (≥ 1 cm) were found in 437 patients with nondiagnostic results of ultrasound (US)-guided fine-needle aspiration biopsy (nondiagnostic nodules)...
November 1, 2017: AJR. American Journal of Roentgenology
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