American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

Gharib, Hossein; Papini, Enrico; Paschke, Ralf; Duick, Daniel S.; Valcavi, Roberto; Hegedűs, László; Vitti, Paolo

doi:10.4158/10024.gl

Cited by 836 publications

(928 citation statements)

References 202 publications

(287 reference statements)

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“…Vol. 14,No. 5 HRM analysis can identify, with high sensitivity, samples harboring mutations, irrespective of the substitution type.…”

Section: Discussionmentioning

confidence: 99%

“…Fine-needle aspiration biopsy (FNAB) has emerged over the past 30 years as an accurate and cost-effective procedure for the preoperative screening of thyroid nodules, representing the gold standard for differential diagnosis of benign and malignant nodules. 4 Under recent guidelines, 5,6 cytological smears are classified in five categories for the diagnostic report: Thy 1, nondiagnostic; Thy 2, benign or negative for malignant cells; Thy 3, all follicular lesions (including atypia/ follicular lesion of undetermined significance and follicular neoplasm or suspicious for follicular neoplasm); Thy 4, suspicious; and Thy 5, diagnostic for malignancy.…”

mentioning

confidence: 99%

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A High-Resolution Melting Protocol for Rapid and Accurate Differential Diagnosis of Thyroid Nodules

Mancini

Pinzani

Pupilli

et al. 2012

The Journal of Molecular Diagnostics

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Thyroid cancer is the most common malignancy of the endocrine system, accounting for approximately 1% of all malignancies in Western countries. 1 The incidence of thyroid cancer has increased 2.6-fold in the last 30 years. This change is attributed not only to an increment in papillary thyroid carcinoma, 2 but also to more wisely conducted medical surveillance and improvements in diagnostic tools. 3 The large majority of thyroid nodules, as discovered with the use of new diagnostic imaging techniques, are asymptomatic and benign. In this context, diagnostic studies are becoming essential to identify the small fraction of thyroid nodules that harbor malignant disease and to predict when surgery is indicated. Fine-needle aspiration biopsy (FNAB) has emerged over the past 30 years as an accurate and cost-effective procedure for the preoperative screening of thyroid nodules, representing the gold standard for differential diagnosis of benign and malignant nodules. 4 Under recent guidelines, 5,6 cytological smears are classified in five categories for the diagnostic report: Thy 1, nondiagnostic; Thy 2, benign or negative for malignant cells; Thy 3, all follicular lesions (including atypia/ follicular lesion of undetermined significance and follicular neoplasm or suspicious for follicular neoplasm); Thy 4, suspicious; and Thy 5, diagnostic for malignancy.Although the overall accuracy of FNAB is considered excellent, approximately 30% of cytological aspirates do not allow definitive diagnosis of malignancy, because of intrinsic and unavoidable characteristics of samples. 7 The major limitations of FNAB procedures are linked to inadequate and indeterminate specimens and, in that sense, are also linked respectively to the nondiagnostic or follicular lesions categories. 8,9 Thus, a clinical need emerges for the characterization of aspirates with suspicious features but with unsatisfactory cellularity, to allow accurate distinction of benign from malignant forms of follicular lesions.Several somatic mutations have been identified in thyroid cancer, stimulating the search for genetic alterations in FNAB that could increase the diagnostic accuracy of traditional cytology. Numerous studies have demonstrated that identification of specific mutations in cytological specimens can assist in the diagnosis by FNAB and in the clinical decision to excise the nodule and to intensify the follow-up. 10 -16 In most cases, genetic alterations are represented by activating mutations of oncogenes that are mutually exclusive and linked to distinct histological subtypes, with a demonstrated pathogenic role in thyroid cell transformation as effectors of the RAS/RAF/ MAPK signaling cascade.The presence of BRAF mutations, a frequent alteration in papillary carcinoma (PTC), evolves into an unregulated activation of the intracellular MAPK pathway that can promote tumorigenesis and tumor progression. The main mutation of BRAF, identified exclusively in PTC, affects

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“…Vol. 14,No. 5 HRM analysis can identify, with high sensitivity, samples harboring mutations, irrespective of the substitution type.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A High-Resolution Melting Protocol for Rapid and Accurate Differential Diagnosis of Thyroid Nodules

Mancini

Pinzani

Pupilli

et al. 2012

The Journal of Molecular Diagnostics

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“…Nodular thyroid disease is a very common finding in clinical practice, discovered by ultrasound (US) in about 50 % of the general population, with higher prevalence in women and in the elderly [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, current guidelines do not recommend its routine use in clinical practice, suggesting its usefulness in some cases only [3,4].…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

Garberoglio

Aliberti

Appetecchia³

et al. 2015

J Ultrasound

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Nodular thyroid disease is a very common finding in\ud clinical practice, discovered by ultrasound (US) in about\ud 50 % of the general population, with higher prevalence in\ud women and in the elderly [1–4].\ud Whereas therapeutic flowchart is quite established and\ud shared for malignant lesions, multiple options are now\ud available for patients presenting with benign thyroid nod-\ud ules, ranging from simple clinical and US follow-up to\ud thyroid surgery. The majority of thyroid nodules, benign by\ud fine-needle aspiration, are asymptomatic, stable, or slow-\ud growing over time and require no treatmen

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“…The major limit of CNB in neck mass resides in heterogeneity of mesenchymal tumors, so large lesions may result not adequately sampled by thin core needle. On the other hand CNB is informative in a great number of cases and it was recommended as diagnostic strategy for neck masses in international guidelines [14]. With relation to the case report we are presenting, some aspects can be of interest concerning the role of CNB.…”

Section: Discussionmentioning

confidence: 92%

Neck schwannoma diagnosed by core needle biopsy: a case report

et al. 2014

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Here we present a case of a 58 year old man referred to our hospital to undergo neck and thyroid ultrasonography (US) following palpable neck mass. US revealed a solid hypoechoic nodule in right thyroid lobe, and a solid lesion on the right laterocervical neck region with ultrasound suspicious features of neoplastic lymph node. In order to achieve a diagnosis of the neck mass and to get a proper evaluation of the thyroid nodule, we decided to perform a fine-needle aspiration (FNA) of both lesions. At cytopathologic examination the thyroid nodule appeared as benign, while cytologic sampling of the neck lesion was inadequate for a proper evaluation. Thus, we performed core needle biopsy (CNB) of the neck lesion like recently proposed for thyroid lesions; also, to definitively exclude malignancy of thyroid nodule, this also underwent CNB. Histologic report of CNB confirmed benign thyroid nodule, while the neck lesion revealed a proliferation of neuronal type consistent with schwannoma. The patient has been addressed to clinical and ultrasonographic follow-up. CNB appears as a safe and minimally-invasive approach to diagnose indeterminate neck masses and avoid unnecessary diagnostic surgery.Riassunto Presentiamo il caso di un uomo di 58 anni che si sottoponeva ad ecotomografia del collo per una massa palpabile in sede laterocervicale destra. L'esame ecotomografico ha mostrato la presenza di una lesione solida nella regione laterocervicale destra del collo, con caratteristiche ecografiche sospette per linfonodo neoplastico. Contestualmente, si riscontrava un nodulo solido ipoecogeno del lobo destro della tiroide. Allo scopo di un'ulteriore definizione diagnostica, si è pertanto deciso di procedere ad esecuzione di agoaspirato ecoguidato di entrambe le lesioni, inviando per esame citologico il materiale ottenuto. Il nodulo tiroideo ha mostrato caratteri di benignità, mentre il prelievo eseguito sulla formazione del collo non è apparso adeguato per la valutazione citologica. Abbiamo così deciso di procedere a core needle biopsy della lesione del collo, eseguendo la medesima procedura anche sul nodulo tiroideo, per una conferma diagnostica. L'esame istologico ha confermato la benignità del nodulo tiroideo e la lesione del collo è risultata una proliferazione di tipo neuronale compatibile con schwannoma. Il paziente è stato quindi indirizzato a follow-up clinico ed ecografico. In conclusione, nel caso clinico da noi presentato la core needle biopsy è apparsa una procedura sicura e mini-invasiva nell'inquadramento diagnostico di una massa del collo di incerto significato all'esame ecotomografico, senza necessità di ulteriori approcci chirurgici.

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American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

Cited by 836 publications

References 202 publications

A High-Resolution Melting Protocol for Rapid and Accurate Differential Diagnosis of Thyroid Nodules

A High-Resolution Melting Protocol for Rapid and Accurate Differential Diagnosis of Thyroid Nodules

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

Neck schwannoma diagnosed by core needle biopsy: a case report

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