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https://www.readbyqxmd.com/read/29091573/the-2017-bethesda-system-for-reporting-thyroid-cytopathology
#1
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
https://www.readbyqxmd.com/read/29040691/differential-growth-rates-of-benign-vs-malignant-thyroid-nodules
#2
Trevor E Angell, Chirag M Vyas, Marco Medici, Zhihong Wang, Justine A Barletta, Carol B Benson, Edmund S Cibas, Nancy L Cho, Gerard M Doherty, Peter M Doubilet, Mary C Frates, Atul A Gawande, Howard T Heller, Matthew I Kim, Jeffrey F Krane, Ellen Marqusee, Francis D Moore, Matt A Nehs, Ann Marie Zavacki, P Reed Larsen, Erik K Alexander
Context: Thyroid nodule growth was once considered concerning for malignancy, but data showing that benign nodules grow questioned the use of this paradigm. To date, however, no studies have adequately evaluated whether growth rates differ in malignant vs. benign nodules. Objective: To sonographically evaluate growth rates in benign and malignant thyroid nodules ≥1 cm. Design: Prospective, cohort study of patients with tissue diagnosis of benign or malignant disease, with repeated ultrasound evaluation six or more months apart...
December 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28914983/suggesting-the-cytologic-diagnosis-of-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features-niftp-a-retrospective-analysis-of-atypical-and-suspicious-nodules
#3
Kyle C Strickland, Brooke E Howitt, Justine A Barletta, Edmund S Cibas, Jeffrey F Krane
BACKGROUND: The term "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) has replaced a subset of follicular variant of papillary thyroid carcinoma due to the indolent behavior of such tumors. NIFTPs are most often classified in an "indeterminate" diagnostic category. In the current study, the authors sought to identify cytologic features helpful in distinguishing NIFTP from other entities in these categories, particularly benign nodules. METHODS: The authors retrospectively evaluated a consecutive cohort of 130 thyroid fine-needle aspiration (FNA) specimens with an indeterminate diagnosis and available histopathologic follow-up...
September 15, 2017: Cancer
https://www.readbyqxmd.com/read/28902465/a-modified-reporting-approach-for-thyroid-fna-in-the-niftp-era-a-1-year-institutional-experience
#4
Jeffrey K Mito, Erik K Alexander, Trevor E Angell, Justine A Barletta, Matthew A Nehs, Edmund S Cibas, Jeffrey F Krane
BACKGROUND: The reclassification of noninvasive follicular variant of papillary thyroid carcinoma as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has created diagnostic and management issues for thyroid fine-needle aspiration (FNA). In response to these challenges, the authors' laboratory adopted a NIFTP policy including 1) stringent criteria (requiring pseudo-inclusions, papillae, and/or psammoma bodies) for a malignant diagnosis of papillary carcinoma to limit false-positive results due to NIFTP and 2) the use of explanatory notes in cases with cytomorphologic features suggestive of possible NIFTP to encourage lobectomy over thyroidectomy...
November 2017: Cancer
https://www.readbyqxmd.com/read/28271380/the-flip-side-of-niftp-an-increase-in-rates-of-unfavorable-histologic-parameters-in-the-remainder-of-papillary-thyroid-carcinomas
#5
Kristine S Wong, Kyle C Strickland, Trevor E Angell, Matthew A Nehs, Erik K Alexander, Edmund S Cibas, Jeffrey F Krane, Brooke E Howitt, Justine A Barletta
The term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently proposed to replace noninvasive follicular variant of papillary thyroid carcinoma (FVPTC) both to promote more conservative management of these tumors and spare patients the psychological burden of a cancer diagnosis. This reclassification will lower the incidence of papillary thyroid carcinoma (PTC). In addition, it could result in an increase in the rates of unfavorable histologic prognosticators for PTC overall because NIFTPs had previously accounted for many of the PTCs without these features...
June 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28152275/qualifiers-of-atypia-in-the-cytologic-diagnosis-of-thyroid-nodules-are-associated-with-different-afirma-gene-expression-classifier-results-and-clinical-outcomes
#6
Sylvan C Baca, Kristine S Wong, Kyle C Strickland, Howard T Heller, Matthew I Kim, Justine A Barletta, Edmund S Cibas, Jeffrey F Krane, Ellen Marqusee, Trevor E Angell
BACKGROUND: Thyroid nodules with atypia of undetermined significance (AUS) on fine-needle aspiration (FNA) have a low risk of malignancy that appears to vary based on specific features described in the AUS diagnosis. The Afirma gene expression classifier (GEC) is a molecular test designed to improve preoperative risk stratification of thyroid nodules, but its performance for different patterns of AUS has not been defined. The objective of this study was to assess GEC results and clinical outcomes in AUS nodules with architectural atypia (AUS-A), cytologic atypia (AUS-C) or both (AUS-C/A)...
May 2017: Cancer Cytopathology
https://www.readbyqxmd.com/read/28114855/noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features-accounts-for-more-than-half-of-carcinomas-harboring-ras-mutations
#7
Vera A Paulson, Priyanka Shivdasani, Trevor E Angell, Edmund S Cibas, Jeffrey F Krane, Neal I Lindeman, Erik K Alexander, Justine A Barletta
BACKGROUND: Molecular testing of thyroid nodules is increasingly being utilized to guide clinical management decisions. RAS mutations are the most frequent mutations detected in the context of an indeterminate fine-needle aspiration (FNA) diagnosis. The term "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) was recently introduced to promote conservative management of tumors previously classified as noninvasive follicular variant of papillary thyroid carcinoma (FVPTC)...
April 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27788511/the-bethesda-system-for-reporting-thyroid-cytopathology-ii
#8
Syed Z Ali, Edmund S Cibas
No abstract text is available yet for this article.
2016: Acta Cytologica
https://www.readbyqxmd.com/read/27689252/clinical-sonographic-and-pathological-characteristics-of-ras-positive-versus-braf-positive-thyroid-carcinoma
#9
Sujay Kakarmath, Howard T Heller, Caroline A Alexander, Edmund S Cibas, Jeffrey F Krane, Justine A Barletta, Neal I Lindeman, Mary C Frates, Carol B Benson, Atul A Gawande, Nancy L Cho, Matthew Nehs, Francis D Moore, Ellen Marqusee, Mathew I Kim, P Reed Larsen, Norra Kwong, Trevor E Angell, Erik K Alexander
CONTEXT: Mutations in the BRAF and RAS oncogenes are responsible for most well-differentiated thyroid cancer. Yet, our clinical understanding of how BRAF-positive and RAS-positive thyroid cancers differ is incomplete. OBJECTIVE: We correlated clinical, radiographic, and pathological findings from patients with thyroid cancer harboring a BRAF or RAS mutation. DESIGN: Prospective cohort study. SETTING: Academic, tertiary care hospital...
December 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27501280/features-and-outcome-of-autonomous-thyroid-nodules-in-children-31-consecutive-patients-seen-at-a-single-center
#10
Samantha Ly, Mary C Frates, Carol B Benson, Hope E Peters, Frederick D Grant, Laura A Drubach, Stephan D Voss, Henry A Feldman, Jessica R Smith, Justine Barletta, Monica Hollowell, Edmund S Cibas, Francis D Moore, Biren Modi, Robert C Shamberger, Stephen A Huang
CONTEXT: Most thyroid nodules are benign and their accurate identification can avoid unnecessary procedures. In adult patients, documentation of nodule autonomy is accepted as reassurance of benign histology and as justification to forgo biopsy or thyroidectomy. In contrast, the negative predictive value of nodule autonomy in children is uncertain. Some recent publications recommend surgical resection as initial management, but few address the degree of TSH suppression or the specific scintigraphic criteria used to diagnose autonomy...
October 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27457786/preoperative-cytologic-diagnosis-of-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features-a-prospective-analysis
#11
Kyle C Strickland, Marina Vivero, Vickie Y Jo, Alarice C Lowe, Monica Hollowell, Xiaohua Qian, Tad J Wieczorek, Christopher A French, Lisa A Teot, Peter M Sadow, Erik K Alexander, Edmund S Cibas, Justine A Barletta, Jeffrey F Krane
BACKGROUND: The term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has been proposed to replace noninvasive follicular variant of papillary thyroid carcinoma (FVPTC) in recognition of the indolent behavior of this tumor. The ability to differentiate NIFTP from classical papillary thyroid carcinoma (cPTC) by fine-needle aspiration (FNA) would facilitate conservative management for NIFTP. The aim of this study was to determine if NIFTP can be distinguished prospectively from cPTC...
October 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27219469/noninvasive-follicular-variant-of-papillary-thyroid-carcinoma-and-the-afirma-gene-expression-classifier
#12
Kristine S Wong, Trevor E Angell, Kyle C Strickland, Erik K Alexander, Edmund S Cibas, Jeffrey F Krane, Justine A Barletta
BACKGROUND: It is now recognized that noninvasive follicular variant of papillary thyroid carcinoma (NFVPTC) is a distinct subset of FVPTC with an exceedingly indolent clinical course. The Afirma gene-expression classifier (GEC) helps guide clinicians in the management of thyroid nodules with indeterminate fine-needle aspiration (FNA) results. Thyroid surgery is recommended for nodules with a suspicious Afirma result, whereas observation is deemed reasonable for most nodules with a benign result...
July 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/26563459/bethesda-categorization-of-thyroid-nodule-cytology-and-prediction-of-thyroid-cancer-type-and-prognosis
#13
Xiaoyun Liu, Marco Medici, Norra Kwong, Trevor E Angell, Ellen Marqusee, Matthew I Kim, P Reed Larsen, Nancy L Cho, Matthew A Nehs, Daniel T Ruan, Atul Gawande, Francis Moore, Justine Barletta, Jeffrey F Krane, Edmund S Cibas, Tao Yang, Erik K Alexander
BACKGROUND: Since its inception, the Bethesda System for Reporting Thyroid Cytopathology (TBS) has been widely adopted. Each category conveys a risk of malignancy and recommended next steps, though it is unclear if each category also predicts the type and extent of malignancy. If so, this would greatly expand the utility of the TBS by providing prognostic information in addition to baseline cancer risk. METHODS: All patients prospectively enrolled into the authors' thyroid nodule database from 1995 to 2013 with histologically proven malignancy were analyzed...
February 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/26465395/the-influence-of-patient-age-on-thyroid-nodule-formation-multinodularity-and-thyroid-cancer-risk
#14
Norra Kwong, Marco Medici, Trevor E Angell, Xiaoyun Liu, Ellen Marqusee, Edmund S Cibas, Jeffrey F Krane, Justine A Barletta, Matthew I Kim, P Reed Larsen, Erik K Alexander
INTRODUCTION: Although advancing age is known to influence the formation of thyroid nodules, the precise relationship remains unclear. Furthermore, it is uncertain whether age influences the risk that any thyroid nodule may prove cancerous. AIM: The aim was to determine the impact of patient age on nodule formation, multinodularity, and risk of thyroid malignancy. METHOD: We conducted a prospective cohort analysis of consecutive adults (ages 20-95 y) who presented for evaluation of nodular disease from 1995 to 2011...
December 2015: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/26353010/afirma-benign-thyroid-nodules-show-similar-growth-to-cytologically-benign-nodules-during-follow-up
#15
Trevor E Angell, Mary C Frates, Marco Medici, Xiaoyun Liu, Norra Kwong, Edmund S Cibas, Matthew I Kim, Ellen Marqusee
CONTEXT: The Afirma gene expression classifier (GEC) is a molecular diagnostic test that has a high negative predictive value for ruling out malignancy in thyroid nodules with indeterminate cytology. Many patients with a cytologically indeterminate and GEC benign (Cyto-I/GEC-B) nodule undergo monitoring instead of diagnostic surgery, but few data describe their follow-up. OBJECTIVE: The objective of the study was to determine the sonographic changes and clinical outcomes for patients with Cyto-I/GEC-B nodules compared with patients with cytologically benign (Cyto-B) nodules...
November 2015: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/26253102/the-variable-phenotype-and-low-risk-nature-of-ras-positive-thyroid-nodules
#16
Marco Medici, Norra Kwong, Trevor E Angell, Ellen Marqusee, Matthew I Kim, Mary C Frates, Carol B Benson, Edmund S Cibas, Justine A Barletta, Jeffrey F Krane, Daniel T Ruan, Nancy L Cho, Atul A Gawande, Francis D Moore, Erik K Alexander
BACKGROUND: Oncogenic mutations are common in thyroid cancers. While the frequently detected RAS-oncogene mutations have been studied for diagnostic use in cytologically indeterminate thyroid nodules, no investigation has studied such mutations in an unselected population of thyroid nodules. No long-term study of RAS-positive thyroid nodules has been performed. METHODS: We performed a prospective, blinded cohort study in 362 consecutive patients presenting with clinically relevant (>1 cm) thyroid nodules...
August 7, 2015: BMC Medicine
https://www.readbyqxmd.com/read/26137287/comparison-of-two-different-standards-of-care-in-detecting-malignant-thyroid-nodules-using-thyroid-fine-needle-aspiration
#17
Xiaoyun Liu, Lijun Zhu, Zhixiao Wang, Dai Cui, Huanhuan Chen, Ling Wei, Yunsong Wu, Rong Rong, Yan Wu, Qing Yao, Zhihong Zhang, Edmund S Cibas, Erik K Alexander, Tao Yang
The aim of the present study was to verify the optimal method to obtain enough fine-needle aspiration (FNA) materials for detecting thyroid malignancy. A prospective study was performed by comparing two different regional standards of care. In one group a traditional FNA method mainly used in Asian countries, including China, was performed in which a single pass of a 22-G needle was applied with or without aspiration. In the other group, the method mainly used in Western countries was performed in which three passes of a 25-G needle with non-aspiration were undertaken for thyroid nodules...
May 2015: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/26114752/the-impact-of-noninvasive-follicular-variant-of-papillary-thyroid-carcinoma-on-rates-of-malignancy-for-fine-needle-aspiration-diagnostic-categories
#18
Kyle C Strickland, Brooke E Howitt, Ellen Marqusee, Erik K Alexander, Edmund S Cibas, Jeffrey F Krane, Justine A Barletta
BACKGROUND: Increased recognition of the indolent nature of noninvasive follicular variant of papillary thyroid carcinoma (NFVPTC) along with greater insight into the molecular alterations of these tumors has prompted endocrine pathologists to question whether these tumors warrant a diagnosis of carcinoma. However, a change in terminology would affect the rates of malignancy of fine-needle aspiration (FNA) diagnostic categories. Therefore, the aim of this study was to determine the percentage decrease in associated risk of malignancy for each FNA diagnostic category if NFVPTCs were no longer termed carcinomas...
September 2015: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/25926393/molecular-analysis-of-residual-thinprep-material-from-thyroid-fnas-increases-diagnostic-sensitivity
#19
Jeffrey F Krane, Edmund S Cibas, Erik K Alexander, Ralf Paschke, Markus Eszlinger
BACKGROUND: Molecular testing for genetic alterations associated with malignancy is a potential triage approach for thyroid fine-needle aspiration (FNA) samples with indeterminate cytology. Because liquid-based FNA material allows for efficient RNA extraction, the authors analyzed residual material for common point mutations and rearrangements. METHODS: Thyroid FNAs were classified according to The Bethesda System for Reporting Thyroid Cytopathology after routine ThinPrep slide preparation...
June 2015: Cancer Cytopathology
https://www.readbyqxmd.com/read/25369542/fine-needle-aspiration-biopsy-of-secondary-neoplasms-of-the-thyroid-gland-a-multi-institutional-study-of-62-cases
#20
MULTICENTER STUDY
Marc Pusztaszeri, He Wang, Edmund S Cibas, Celeste N Powers, Massimo Bongiovanni, Syed Ali, Kamal K Khurana, Paul J Michaels, William C Faquin
BACKGROUND: Secondary neoplasms of the thyroid gland (SNTGs) are uncommon, and it is important to recognize them in thyroid fine-needle aspiration biopsy (FNAB). METHODS: The authors report a cohort of 62 SNTGs from 7 institutions in the United States and Europe. Patients were identified retrospectively by searching through medical records of the respective institutions. All initial diagnoses were rendered by FNAB. RESULTS: SNTGs represented 0...
January 2015: Cancer Cytopathology
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