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Fine needle aspiration and thyroglobulin

Alicia Algeciras-Schimnich
The post-operative management of patients with differentiated thyroid carcinoma (DTC) relies on serial measurements of serum thyroglobulin. Current methodologies for thyroglobulin quantitation vary in their analytical and clinical performance. For years, thyroglobulin radioimmunoassays (RIA) and immunometric assays (IMA) have been used despite analytical interferences from anti-thyroglobulin autoantibodies (TgAb) as well as heterophile antibodies (HAb). TgAb interference limits Tg utility as a tumor marker in ∼30% of TgAb-positive patients...
March 16, 2018: Critical Reviews in Clinical Laboratory Sciences
Yonghua Liu, Lin Yuan, Daohua Yang, Yubiao Jin
Medullary thyroid carcinoma (MTC) is potentially lethal. A prompt and accurate diagnosis is the prerequisite for the treatment of MTC. Fine-needle aspiration (FNA) is a reliable diagnostic tool in the assessment of thyroid nodules. However, cytologic assessment of MTC based on FNA has several drawbacks due to morphological variants. We present a case of MTC diagnosed through FNA cytology, which was eventually histologically confirmed as a mixed medullary-follicular carcinoma with negative serum calcitonin expression...
March 10, 2018: Diagnostic Cytopathology
Jamila A Benmoussa, Karin Chen, Saleh Nijjar, Megan Applewhite, James Warshaw
No abstract text is available yet for this article.
March 2, 2018: Endocrine Practice
Samantha Epstein, Rachel McEachern, Rachita Khot, Shetal Padia, James T Patrie, Jason N Itri
OBJECTIVES: To assess the yield of neck ultrasound (US) when serum thyroglobulin (Tg) is undetectable (<0.1 ng/mL) compared to elevated serum Tg in patients with differentiated papillary thyroid carcinoma (PTC) treated with thyroidectomy and radioactive iodine 131 (RAI) ablation. METHODS: A retrospective chart review was conducted from 2010 through 2015 at an academic institution evaluating US results in patients with serum Tg levels obtained within 6 months of a neck US examination after thyroidectomy and RAI...
March 2, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Na Lae Eun, Eun Ju Son, Jeong-Ah Kim, Hye Mi Gweon, Jung-Hyun Kang, Ji Hyun Youk
PURPOSE: To evaluate the diagnostic performances of ultrasonographic (US) findings, computed tomography (CT) findings and fine needle aspiration cytology (FNAC) for the prediction of cervical lymph node (LN) metastases of papillary thyroid carcinoma (PTC) to determine which LN should be dissected. METHODS: 376 LNs in 302 patients who underwent both US-guided skin surface LN markings and CT before LN dissection were analyzed retrospectively. Indications for LN dissection were suspicious US findings of LN metastases (n = 300), suspicious CT findings (n = 67) or surgeon's request (n = 9)...
January 11, 2018: International Journal of Surgery
Marta Amaro da Silveira Duval, André Borsatto Zanella, Ana Patrícia Cristo, Carlo Sasso Faccin, Marcia Silva Graudenz, Ana Luiza Maia
Background: Thyroglobulin measurements in the washout of fine needle aspiration (FNA-Tg) are an excellent tool to detect lymph node (LN) metastases of differentiated thyroid carcinoma (DTC). Nevertheless, how to define the best cutoffs and the influence of potential confounders are still being discussed. Objective: To evaluate the accuracy of FNA-Tg measurement to detect DTC metastases and the influence of thyroid status and anti-thyroglobulin antibodies (TgAb)...
November 2017: European Thyroid Journal
Haihui Liao, Ashraf Khan, Patricia M Miron, Kristine M Cornejo
Mammary analogue secretory carcinoma (MASC) harboring ETV6 gene rearrangements was first described in the salivary gland with a relatively favorable prognosis and a possible molecular therapeutic target with pan-Trk inhibitors. Recently, primary MASC of the thyroid gland has been reported. We report a case of a 4.0 cm MASC arising from the left thyroid of a 58-year-old female with extrathyroidal extension. Initially, it was diagnosed by fine needle aspiration as suspicious for papillary thyroid carcinoma (PTC) and subsequently called a poorly differentiated carcinoma on resection...
December 1, 2017: International Journal of Surgical Pathology
Wenwu Dong, Ping Zhang, Jian Li, Liang He, Zhihong Wang, Ting Zhang, Liang Shao, Hao Zhang
BACKGROUND: Carcinoma showing thymus-like differentiation (CASTLE) is a rare malignant tumor of the thyroid. It is difficult to diagnose, and there is no universally recognized therapeutic regimen. This study aims to define the clinicopathological features and discuss the optimal management of CASTLE. METHODS: We retrospectively analyzed six patients with CASTLE who accepted surgery at the First Hospital of China Medical University between January 2010 and December 2015...
November 13, 2017: World Journal of Surgery
Pedro Weslley Rosario, Gabriela Franco Mourão, Luís Fernando Faria Oliveira, Maria Regina Calsolari
The objective was to determine whether negative assessment after surgery is a predictor of no relevant change of the results in subsequent evaluations in patients with noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Six months after surgery, "absence of persistent disease" was defined when concentration of thyroglobulin (Tg) is ≤2 ng/ml in patients undergoing total thyroidectomy and ≤10 ng/ml in those undergoing lobectomy, in the absence of antithyroglobulin antibodies (TgAb), and neck ultrasonography (US) without abnormalities...
November 9, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Shinya Satoh, Hiroyuki Yamashita, Kennichi Kakudo
In Japan, fine-needle aspiration (FNA) cytology is the most important diagnostic modality for triaging patients with thyroid nodules. A clinician (endocrinologist, endocrine surgeon, or head and neck surgeon) generally performs FNA cytology at the outpatient clinic, and ultrasound (US)-guided FNA is widespread because US is extremely common and most clinicians are familiar with it. Although almost all FNA thyroid samples are examined by certified cytopathologists and pathologists, some clinicians assess cytological specimens themselves...
November 2017: Journal of Pathology and Translational Medicine
Yizeng Wang, Yuanchao Liu, Xiaoning Wang, Xin Li, Ruoyu Jiang, Xianghui He
BACKGROUND: Among patients with papillary thyroid carcinoma (PTC), 30%-80% have cervical lymph node (LN) metastases, which are most commonly located in the central compartment. However, preoperative ultrasonography identifies malignant central compartment LNs in only 20%-30% of cases. We aimed to evaluate the diagnostic value of intraoperative thyroglobulin (Tg) measurement in fine-needle aspirates (FNA-Tg) of suspicious metastatic LNs. METHODS: In total, 75 patients (75 LNs) with PTC or suspected PTC were enrolled in this study...
2017: OncoTargets and Therapy
Mohsen Kolahdouzan, Mehdi Sadeghi, Behrooz Kalidari, Behnam Sanei, Elyas Mostafapour, Ashraf Aminorroaya
BACKGROUND: Some studies have shown that a preoperative high concentration of thyroglobulin (Tg) in wash out of fine-needle aspiration cytology of cervical lymph nodes mandate therapeutic lymph node dissection. However, there is disagreement about the minimum concentration of Tg which could have diagnostic value. Hence, according to our literature review, this study is the first one which designed to do intraoperatively. Therefore, this study was conducted and aimed to determine the clinical diagnostic value of Tg lymph nodes in the diagnosis of metastatic thyroid cancer...
2017: Advanced Biomedical Research
Francesco Boi, Fabiana Pani, Stefano Mariotti
The association between Hashimoto thyroiditis (HT) and papillary thyroid carcinoma (PTC) has been originally suggested by retrospective pathological studies and has recently been re-evaluated and proposed on the basis of several fine-needle aspiration cytology (FNAC) studies. In FNAC studies, the association between HT and PTC is based on the comparison of anti-thyroid autoantibodies (ATA) (anti-thyroperoxidase [TPOAb] and anti-thyroglobulin [TgAb]), thyroid function (TSH), and cytology with histology of thyroid nodules and lymphocytic thyroid infiltration (LTI) of operated thyroid glands...
July 2017: European Thyroid Journal
Michelle Melany, Sardius Chen
Ultrasound is critical in detection, diagnosis, and management of thyroid nodules. Ultrasound detection of regional nodal metastatic disease is based on abnormal nodal morphology rather than size and is critical to initial surgical and long-term management of thyroid cancer. Fine-needle aspiration biopsy is the gold standard for malignancy diagnosis in thyroid cancer. Thyroglobulin assay of nodal aspirates improves accuracy in diagnosis of metastases. Reporting lexicons assign risk levels to thyroid nodules with the goal of improving and standardizing patient management...
September 2017: Endocrinology and Metabolism Clinics of North America
Gaetano Achille, Vito M Garrisi, Sabino Russo, Edoardo Guastamacchia, Vito A Giagulli, Laura Schirosi, Antonella Daniele, Antonio Tufaro, Vito Cafagna, Marilena Centrone, Giovanni Simone, Ines Abbate, Vincenzo Triggiani
BACKGROUND: Differentiated thyroid carcinomas (DTCs) account for about 1% of all human malignancies. Cervical lymph nodes metastases and recurrences in the thyroid bed frequently occur. Furthermore, about 10-15% of patients develop distant metastases. Therefore, patients must undergo life-long follow-up. OBJECTIVE: The aim of this study was to evaluate the usefulness of Thyroglobulin measurement in FNAB washout (FNAB-Tg) in the detection of local metastasis in patients affected by or evaluated for thyroid cancer...
2017: Endocrine, Metabolic & Immune Disorders Drug Targets
Alexander M Nixon, Xeni Provatopoulou, Eleni Kalogera, George N Zografos, Antonia Gounaris
Differentiated thyroid cancer (DTC) is the most common malignancy of the endocrine system. There has been a significant increase in its incidence over the past two decades attributable mainly to the use of more sensitive diagnostic modalities. Ultrasound-guided fine needle aspiration cytology is the mainstay of diagnosis of benign disorders and malignancy. However, approximately 20% of lesions cannot be adequately categorized as benign or malignant. In the postoperative setting, monitoring of thyroglobulin (Tg) levels has been employed for the detection of disease recurrence...
August 2017: Clinical Endocrinology
Sadegh Shirian, Maryam Maghbool, Azita Aledavood, Shahrzad Negahban, Bijan Khademi, Yahya Daneshbod
BACKGROUND: Adenoid cystic carcinoma (ACC) of the larynx and trachea is very rare. CASE: A 45-year-old man with ACC of the larynx presenting as a thyroid mass is reported in this study. Physical examination revealed a large solid thyroid nodule in the left lobe without any lymphadenopathy. A technetium thyroid scan showed multinodular goiter with cold nodules in the left lobe, isthmus, and functioning nodules in the right lobe. A large thyroid mass originating from the left side of the larynx, mostly the left vocal cord and the infraglottic part, was seen using enhanced magnetic resonance imaging after rupture of the thyroid cartilage on the left side...
2017: Acta Cytologica
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
Fanny Piotrkowski-Viale, Adriana Reyes, Alicia Dios, Fabian Pitoia, Alicia Lowenstein, Patricia Glikman
OBJECTIVE: To evaluate two variables affecting Thyroglobulin stability in the washout of fine needle aspiration biopsies of thyroid nodules and metastatic lymph nodes. MATERIALS AND METHODS: Thyroglobulin stability after storage at -20 °C up to 14 days was studied in washout performed with normal saline solution and further dilutions with normal saline solution from five metastatic thyroid nodes and six benign thyroid nodules. We also studied thyroglobulin stability in diluents compared with normal saline solution: 4% bovine serum albumin in normal saline solution and diluents free from thyroglobulin or Calcitonin or parathyroid hormone in paired and simultaneous thyroglobulin measurements of washout dilutions from 5/6 benign thyroid nodules and 2/5 metastatic lymph nodes...
June 2017: Endocrine
Florence Boux de Casson, Valérie Moal, Anne-Sophie Gauchez, Marie-Pierre Moineau, Corinne Sault, Marie-Hélène Schlageter, Catherine Massart
The aim of this study was to evaluate the pre-analytical factors contributing to uncertainty in thyroglobulin measurement in fluids from fine-needle aspiration (FNA) washout of cervical lymph nodes. We studied pre-analytical stability, in different conditions, of 41 samples prepared with concentrated solutions of thyroglobulin (FNA washout or certified standard) diluted in physiological saline solution or buffer containing 6% albumin. In this buffer, over time, no changes in thyroglobulin concentrations were observed in all storage conditions tested...
April 1, 2017: Annales de Biologie Clinique
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