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Thyroid FNA

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https://www.readbyqxmd.com/read/28537891/multiplex-pcr-approach-to-simultaneously-identify-several-mutations-in-fine-needle-cytology-thyroid-samples
#1
Emilia Vuttariello, Marco Borra, Elvira Mauriello, Celeste Calise, Barbara D'Andrea, Anna Capiluongo, Franco Fulciniti, Anna Cipolletta, Mario Monaco, Luciano Pezzullo, Gennaro Chiappetta
The most frequent initial manifestation of thyroid cancer is the appearance of a nodule. More than 20% of the general population has a palpable thyroid nodule and the percentage rises to 70% based on ultrasound identification. In 95% of cases the nodule is simply a hyperplastic or benign lesion. The most reliable diagnostic test for thyroid nodules is fine needle aspiration (FNA), but cytological discrimination between malignant and benign follicular neoplasms remains difficult. Cytological analysis is now, almost routinely, being combined with molecular genetics to enable the pathologist to make a more objective diagnosis...
May 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28537807/next-generation-sequencing-identifies-gene-mutations-that-are-predictive-of-malignancy-in-residual-needle-rinses-collected-from-fine-needle-aspirations-of-thyroid-nodules
#2
Maren Y Fuller, Dina Mody, April Hull, Kristi Pepper, Heather Hendrickson, Randall Olsen
CONTEXT: - Thyroid nodules have a prevalence of approximately 70% in adults. Fine-needle aspiration (FNA) is a minimally invasive, cost-effective, standard method to collect tissue from thyroid nodules for cytologic examination. However, approximately 15% of thyroid FNA specimens cannot be unambiguously diagnosed as benign or malignant. OBJECTIVE: - To investigate whether clinically actionable data can be obtained using next-generation sequencing of residual needle rinse material...
May 24, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28534687/role-of-molecular-markers-in-thyroid-nodule-management-then-and-now
#3
Yuri E Nikiforov
OBJECTIVE: To describe the evolution and clinical utility of molecular testing for thyroid nodules and cancer achieved over the last two decades. METHODS: Scientific reports on thyroid cancer genetics and molecular diagnostics in thyroid nodules. RESULTS: Over the last two decades, our understanding of the genetic mechanisms of thyroid cancer has dramatically expanded, such that most thyroid cancers now have known gene driver events. This knowledge provides the basis for establishing and further improving molecular tests for thyroid nodules and cancer and for the introduction of new entities such as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)...
May 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28523498/maldi-msi-analysis-of-cytological-smears-the-study-of-thyroid-cancer
#4
Niccolò Mosele, Andrew Smith, Manuel Galli, Fabio Pagni, Fulvio Magni
Fine needle aspiration (FNA) biopsies are the current gold-standard for the preoperative evaluation of thyroid nodules. However, a significant number of them (15-30%) are unable to be affirmatively diagnosed and are given an "indeterminate for malignancy" final report, meaning that the malignant nature of the thyroid nodule remains unknown and the recommended therapeutic approach is total thyroidectomy. Furthermore, cytomorphological evaluation of biopsies taken post-surgery indicates that approximately 80% of nodules within this group of patients are in fact benign, and the total thyroidectomy unwarranted...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28521616/a-10-gene-classifier-for-indeterminate-thyroid-nodules-development-and-multicenter-accuracy-study
#5
Hernan E Gonzalez, Jose R Martínez, Sergio Vargas, Antonieta Solar, Loreto Pamela Véliz, Francisco Cruz, Tatiana Arias, Soledad Loyola, Eleonora Horvath, Hernán Tala, Eufrosina Traipe, Manuel Meneses, Luis Marin, Nelson Wohllk, Rene Eduardo Diaz, Jesús Véliz, Pedro Pineda, Patricia Arroyo, Natalia Mena, Milagros Bracamonte, Giovanna Miranda, Elsa Bruce, Soledad Urra
BACKGROUND: In most of the world, diagnostic surgery remains as the most frequent approach for indeterminate thyroid cytology. Although several molecular tests are available for central-lab testing in the US, there are no available kits for local laboratory testing. The aim of this study was to develop a prototype in-vitro diagnostic (IVD) gene classifier for diagnosis of indeterminate thyroid cytology. METHODS: In a first stage, the expression of 18 genes was determined by qPCR in a broad histopathological spectrum of fresh tissue biopsies (114)...
May 18, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28488195/differences-in-clinical-features-between-subcategories-of-atypia-follicular-lesion-of-undetermined-significance
#6
Seong Dong Kim, Seung Hoon Han, Woo-Jin Jeong, Hyojin Kim, Soon Hyun Ahn
Within the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), category III (atypia or follicular lesion of undetermined significance (AUS/FLUS)) comprises specimens with heterogeneous features and the need for subcategorization has been reported. We compared the clinical features of two subgroups from within the category of AUS/FLUS to determine precise guidelines for clinicians who explain the results of fine-needle aspiration (FNA) to patients. Retrospective review was performed including data from all patients who underwent FNA with results reported as AUS/FLUS at a single tertiary hospital from January 2010 to August 2014...
May 9, 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28472764/comparative-analysis-of-diagnostic-performance-feasibility-and-cost-of-different-test-methods-for-thyroid-nodules-with-indeterminate-cytology
#7
Salvatore Sciacchitano, Luca Lavra, Alessandra Ulivieri, Fiorenza Magi, Gian Paolo De Francesco, Carlo Bellotti, Leila B Salehi, Maria Trovato, Carlo Drago, Armando Bartolazzi
Since it is impossible to recognize malignancy at fine needle aspiration (FNA) cytology in indeterminate thyroid nodules, surgery is recommended for all of them. However, cancer rate at final histology is <30%. Many different test-methods have been proposed to increase diagnostic accuracy in such lesions, including Galectin-3-ICC (GAL-3-ICC), BRAF mutation analysis (BRAF), Gene Expression Classifier (GEC) alone and GEC+BRAF, mutation/fusion (M/F) panel, alone, M/F panel+miRNA GEC, and M/F panel by next generation sequencing (NGS), FDG-PET/CT, MIBI-Scan and TSHR mRNA blood assay...
April 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28470780/intra-institutional-second-opinion-diagnosis-can-reduce-unnecessary-surgery-for-indeterminate-thyroid-fna-a-preliminary-report-on-34-cases
#8
C Bellevicine, I Migliatico, E Vigliar, N Serra, G Troncone
INTRODUCTION: Indeterminate diagnoses are rendered on 15%-30% of thyroid fine-needle aspirates (FNA). Thus, a second diagnostic opinion given by an outside expert pathologist is a common practice that facilitates a more appropriate clinical management. Conversely, the role of an intra-institutional second opinion diagnosis (iSOD), which is usually informally performed in-house, has not been well established. METHODS: To assess the contribution of iSOD, a retrospective series of 34 thyroid FNA diagnosed as follicular neoplasm/suspicious follicular neoplasm (FN/SFN) with matched histological follow-up and a malignancy rate of 17...
May 3, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/28463597/cytology-ultrasonography-risk-stratification-scoring-system-based-on-fine-needle-aspiration-cytology-and-the-korean-thyroid-imaging-reporting-and-data-system
#9
Min Ji Hong, Dong Gyu Na, Jung Hwan Baek, Jin Yong Sung, Ji-Hoon Kim
BACKGROUND: The malignancy risk of a cytology diagnosis may depend on the ultrasonography (US) patterns of thyroid nodules, and management should be determined by the combined malignancy risk of fine-needle aspiration (FNA) cytology and US patterns. This study was performed to develop a clinically applicable cytology-ultrasonography (CU) scoring system for malignancy risk stratification based on FNA cytology and US patterns, according to the Korean-Thyroid Imaging Reporting and Data System (K-TIRADS)...
May 19, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28463595/selection-of-atypia-follicular-lesion-of-unknown-significance-patients-for-surgery-versus-active-surveillance-without-using-genetic-testing-a-single-institute-experience-prospective-analysis-and-recommendations
#10
Oded Cohen, Sharon Tzelnick, Yonatan Lahav, Doron Schindel, Doron Halperin, Moshe Yehuda
Atypia/follicular lesion of unknown significance (AUS/FLUS) has variable rates of malignancy. The recommended management includes active surveillance (AS), repeated fine needle aspiration (RFNA), diagnostic surgery or genetic testing for malignancy. The objective of this study was to assess the management of AUS/FLUS patients in a dedicated thyroid clinic without implementing genetic testing. This is a single institute cohort study of all patients aged 18 years and above who underwent ultrasound-guided FNA (USGFNA) thyroid biopsies between January 2009 and January 2013 and were followed until January 2016...
May 2, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28454525/influence-of-presence-absence-of-thyroid-gland-on-the-cutoff-value-for-thyroglobulin-in-lymph-node-aspiration-to-detect-metastatic-papillary-thyroid-carcinoma
#11
Huan Zhao, Yong Wang, Min-Jie Wang, Zhi-Hui Zhang, Hai-Rui Wang, Bing Zhang, Hui-Qin Guo
BACKGROUND: Thyroglobulin measurement with fine-needle aspiration (Tg-FNA) is a sensitive method for detecting metastatic papillary thyroid carcinoma (PTC). However, the diagnostic threshold is not well established and the influence of the thyroid gland on the cutoff value is also controversial. In this study, patients were classified into two groups according to the presence or absence of thyroid tissue, to determine an appropriate cutoff value for clinical practice. METHODS: Patients with a history of thyroid nodules or surgery for PTC and with enlarged cervical lymph nodes on an FNA examination were enrolled for Tg-FNA detection...
April 28, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28447904/fine-needle-aspiration-versus-frozen-section-in-the-evaluation-of-malignant-thyroid-nodules-in-patients-with-the-diagnosis-of-suspicious-for-malignancy-or-malignancy-by-fine-needle-aspiration
#12
Qin Ye, Jennifer S Woo, Qunzi Zhao, Ping Wang, Pintong Huang, Lirong Chen, Xin Li, Kanlun Xu, Ying Yong, Stephanie Sung-Eun Yang, Jianyu Rao
CONTEXT: - The Bethesda System for Reporting Thyroid Cytopathology recommends against the use of intraoperative frozen section (FS) during lobectomy of a thyroid nodule with a fine-needle aspiration (FNA) diagnosis of malignant. Bethesda recommendations for FS in the FNA category of suspicious for malignancy (SFM) is less well-defined. In some institutions in China, FS examination is performed during lobectomy even for FNA-proven malignant cases. OBJECTIVE: - -To compare the efficacy of FNA versus FS in the evaluation of malignant thyroid lesions...
May 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28425211/importance-of-cytological-subclassification-of-thyroid-nodules-with-bethesda-category-iii-cytology-aus-flus-into-architectural-atypia-only-and-nuclear-atypia-a-prospective-study
#13
Pedro Weslley Rosario, Maria Regina Calsolari
BACKGROUND: The objective of this study was to compare two cytological subcategories of thyroid nodules with Bethesda category III initial cytology. METHODS: This was a prospective study. All patients with thyroid nodules > 1 cm were eligible and 98 patients with category III cytology were selected. Cytology was subcategorized into architectural atypia only (AA, n = 45) and nuclear atypia (NA, n = 53). All patients underwent a second fine-needle aspiration (FNA)...
April 19, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28423960/the-role-of-molecular-diagnostic-testing-in-the-management-of-thyroid-nodules
#14
Maureen D Moore, Suraj Panjwani, Katherine D Gray, Brendan M Finnerty, Rasa Zarnegar, Thomas J Fahey
Fine needle aspiration (FNA) with cytologic examination remains the standard of care for investigation of thyroid nodules. However, as many as 30% of FNA samples are cytologically indeterminate for malignancy, which confounds clinical management. To reduce the burden of repeat diagnostic testing and unnecessary surgery, there has been extensive investigation into molecular markers that can be detected on FNA specimens to more accurately stratify a patient's risk of malignancy. Areas covered: In this review, the authors discuss recent evidence and progress in molecular markers used in the diagnosis of thyroid cancer highlighting somatic gene alterations, molecular technologies and microRNA analysis...
April 28, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28422844/ultrasound-is-helpful-to-differentiate-bethesda-class-iii-thyroid-nodules-a-prisma-compliant-systematic-review-and-meta-analysis
#15
REVIEW
Lu-Ying Gao, Ying Wang, Yu-Xin Jiang, Xiao Yang, Ru-Yu Liu, Xue-Hua Xi, Shen-Ling Zhu, Rui-Na Zhao, Xing-Jian Lai, Xiao-Yan Zhang, Bo Zhang
BACKGROUND: Fine-needle aspiration (FNA) is the most dependable tool to triage thyroid nodules for medical or surgical management. However, Bethesda class III cytology, namely "follicular lesion of undetermined significance" (FLUS) or "atypia of undetermined significance" (AUS), is a major limitation of the US-FNA in assessing thyroid nodules. As the most important imaging method, ultrasound (US) has a high efficacy in diagnosing thyroid nodules. This meta-analysis aimed to assess the role of US in evaluating Bethesda class III thyroid nodules...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28418784/a-fresh-cadaver-model-for-the-instruction-of-ultrasound-guided-fine-needle-aspiration-of-thyroid-nodules
#16
Hilary C McCrary, Erynne A Faucett, Audriana N Hurbon, Tijana Milinic, Jose A Cervantes, Sean L Kent, William J Adamas-Rappaport
Objective The aim of our study is to determine if a fresh cadaver model (FCM) for the instruction of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules is a practical method for instruction. Study Design Pre- and postinstruction assessment of medical students' ability to perform US-guided FNA of artificially created thyroid nodules placed adjacent to the thyroid gland of a fresh cadaver. Setting University-based fresh cadaver laboratory. Subjects and Methods Study participants included a total of 17 first- and second-year medical students with minimal US training...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28417935/diagnostic-limitation-of-fine-needle-aspiration-fna-on-indeterminate-thyroid-nodules-can-be-partially-overcome-by-preoperative-molecular-analysis-assessment-of-ret-ptc1-rearrangement-in-braf-and-ras-wild-type-routine-air-dried-fna-specimens
#17
Young Sin Ko, Tae Sook Hwang, Ja Yeon Kim, Yoon-La Choi, Seung Eun Lee, Hye Seung Han, Wan Seop Kim, Suk Kyeong Kim, Kyoung Sik Park
Molecular markers are helpful diagnostic tools, particularly for cytologically indeterminate thyroid nodules. Preoperative RET/PTC1 rearrangement analysis in BRAF and RAS wild-type indeterminate thyroid nodules would permit the formulation of an unambiguous surgical plan. Cycle threshold values according to the cell count for detection of the RET/PTC1 rearrangement by real-time reverse transcription-polymerase chain reaction (RT-PCR) using fresh and routine air-dried TPC1 cells were evaluated. The correlation of RET/PTC1 rearrangement between fine-needle aspiration (FNA) and paired formalin-fixed paraffin-embedded (FFPE) specimens was analyzed...
April 12, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28407624/risk-of-malignancy-and-risk-of-neoplasia-in-the-bethesda-indeterminate-categories-study-on-4-532-thyroid-fine-needle-aspirations-from-a-single-institution-in-india
#18
Swati Mahajan, Radhika Srinivasan, Arvind Rajwanshi, Bishan Radotra, Naresh Panda, Pranab Dey, Nalini Gupta, Raje Nijhawan
OBJECTIVES: To determine the frequency of category 3 (atypia of undetermined significance [AUS]/follicular lesion of undetermined significance [FLUS]), category 4 (follicular neoplasm), and category 5 (suspicious for malignancy) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), the risk of malignancy (ROM) and the risk of neoplasia (RON) in these categories. STUDY DESIGN: A retrospective 6-year audit of 4,532 thyroid fine-needle aspirations (FNA) reported as per the TBSRTC from a single institution with cytohistological correlation in 335 cases...
2017: Acta Cytologica
https://www.readbyqxmd.com/read/28397450/bethesda-system-in-the-evaluation-of-thyroid-nodules-review
#19
REVIEW
Marta Wesoła, Michał Jeleń
Fine needle aspiration (FNA) biopsy is an important and widely accepted method used in the diagnosis of patients with thyroid nodules.The lack of consistency in reporting FNA taken from the thyroid gland has led to divergences in the calculation of the sensitivity and specificity of the method. Discrepancies depend on what was considered to be true or false negative/positive. This resulted in confusion among doctors, who had to decide how to manage the patient with constantly changing positive or negative results of the FNA...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28388017/adequacy-criteria-for-thyroid-fna-evaluated-by-thinprep-slides-only
#20
Marina Vivero, Andrew A Renshaw, Jeffrey F Krane
BACKGROUND: Adequacy criteria for thyroid fine-needle aspiration (FNA) recommended by The Bethesda System for Reporting Thyroid Cytopathology (TBS) were developed with smears, but they are commonly applied to ThinPreps (TPs). This study evaluated adequacy in TPs at different diagnostic thresholds. METHODS: All FNA procedures performed between 2010 and 2015 with matched surgical specimens were analyzed. Cell counts and cytological features were evaluated in all initially nondiagnostic (ND) cases...
April 7, 2017: Cancer
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