Amyloid goiter diagnosis by <scp>ultrasound‐guided</scp> fine needle aspiration performed by interventional pathologist

Celis-Pinto, Juan Carlos; Rivas, Héctor Enrique Torres; Fernández, Luis Manuel Fernández; Zarra, Karen Villar; Gutiérrez, María de la Paz González

doi:10.1002/dc.24625

Cited by 5 publications

(2 citation statements)

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“…There are reported cases of amyloid goiter diagnosed by ultrasound-guided FNA in patients with systemic amyloidosis. [35][36][37] In salivary gland aspirates, amyloid can be easily misinterpreted for chondromyxoid stroma or mucinous material, leading to the misdiagnosis of pleomorphic adenoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma. 38,39 It is easy to misinterpret the acellular dense material as cyst contents or sometimes as nondiagnostic specimen.…”

Section: Discussionmentioning

confidence: 99%

“…There are exceedingly rare cases of amyloid goiter and it refers to nodular or diffuse deposition of amyloid in the thyroid gland. There are reported cases of amyloid goiter diagnosed by ultrasound‐guided FNA in patients with systemic amyloidosis 35–37 . In salivary gland aspirates, amyloid can be easily misinterpreted for chondromyxoid stroma or mucinous material, leading to the misdiagnosis of pleomorphic adenoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma 38,39 .…”

Section: Discussionmentioning

confidence: 99%

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Fine‐needle aspiration of amyloidoma: A critical analysis

Ramani,

Krishnan

2024

Cancer Cytopathology

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BackgroundAmyloid, presenting as a mass, is termed amyloidoma. Among the reported cases, fine‐needle aspiration (FNA) of amyloid is often misinterpreted as acellular nondiagnostic material.MethodsA computer search of all FNAs was performed and cases diagnosed as amyloidoma were identified.ResultsAmong 11,956 cases and 20,634 FNAs, there were six cases and 12 FNAs of amyloidoma. One case with mucin/myxoid matrix was misinterpreted as amyloid, which on our review was Congo red negative. All five other cases of amyloidoma were adequate for evaluation. The smears showed most of the aspirated contents in the middle of the slide and it did not spread when smeared. The amyloid was present as large chunks of waxy, smooth, orangophilic/cyanophilic fragments on Papanicolaou stain and as basophilic fragments on Diff‐Quik stain in a clean background. In cases with lymphoma/myeloma, there were admixed lymphocytes and/or plasma cells. Unlike fibrous tissue, amyloid aspirates well and provides adequate material for interpretation. The clean background distinguishes it from mucin/myxoid matrix. Congo red stain was positive with apple green birefringence in all five cases. Further subtyping by mass spectrometry showed AL (κ) type in three patients and AIns (insulin) type in one patient. In one patient with lymphoma, the subtyping was not done.ConclusionFNA of amyloidoma is rare (0.04%), but an optimal method for diagnosis and subtyping, avoiding unwanted surgical interventions. Although mistaken for fibrous tissue, which aspirates poorly, abundant acellular orangophilic/cyanophilic material on FNA should raise a suspicion for amyloid. Unlike mucin/myxoid matrix, amyloid does not smear the background.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fine‐needle aspiration of amyloidoma: A critical analysis

Ramani,

Krishnan

2024

Cancer Cytopathology

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Interventional pathology: One small step for the pathologist, one big leap for the speciality

Llanos

Zarra

2022

Revista Española de Patología

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Ultrasound-Guided Fine-Needle Aspiration of Superficial Lymphadenopathy Performed by Interventional Pathologists: The Applicability of the Sydney System from 2 Years of Experience and 363 Cases

et al. 2021

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Introduction: The Sydney system proposal for the study and reporting of lymphadenopathy by fine-needle aspiration (FNA) constitutes one of the first attempts to standardize this procedure. Here, we review its applicability. Materials and Methods: A retrospective study in which all ultrasound-guided FNAs (USFNAs) of superficial lymphadenopathy (palpable or not) performed by interventional pathologists in 2 specialized hospital centers were quantified over 2 years. The procedure was systematized, and the diagnoses were reclassified according to the Sydney system categories. Results: We analyzed 363 USFNAs of lymphadenopathies. The distribution of cases by categories was as follows: insufficient (n = 13; 3.58%), benign (n = 208; 57.30%), atypia of uncertain significance (n = 7; 1.93%), suspicious (n = 21; 5.79), and malignant (n = 114; 31.40%). The risks of malignancy calculated for categories I, II, III, IV, and V were 27%, 3%, 50%, 100%, and 100%, respectively. Conclusion: The implementation of the Sydney system allows the systematization and standardization of the lymph node FNA methodology, with increased efficacy and efficiency. Assimilating the recommendations enables the qualification of the diagnostic procedure.

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Amyloid goiter diagnosis by ultrasound‐guided fine needle aspiration performed by interventional pathologist

Cited by 5 publications

References 13 publications

Fine‐needle aspiration of amyloidoma: A critical analysis

Fine‐needle aspiration of amyloidoma: A critical analysis

Interventional pathology: One small step for the pathologist, one big leap for the speciality

Ultrasound-Guided Fine-Needle Aspiration of Superficial Lymphadenopathy Performed by Interventional Pathologists: The Applicability of the Sydney System from 2 Years of Experience and 363 Cases

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