Are all thyroid papillae malignant? An unusual pitfall in FNAC

Powari, Manish; John, A. St; Jones, H.

doi:10.1111/j.1365-2303.2007.00379.x

Cited by 4 publications

(12 citation statements)

References 5 publications

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“…Several case reports and smaller series have also reported cytological and histological findings similar to those found in our study . Faser et al described 3 FNAB cases of BTN‐PH with surgical follow‐up.…”

Section: Discussionsupporting

confidence: 90%

“…To the best of our knowledge, this represents the largest reported analysis of FNAB findings in surgically resected BTN‐PH. BTN‐PH can pose a diagnostic challenge in cytology as well as in surgical pathology by mimicking classical PTC, particularly when papillary hyperplasia comprises the majority of the nodule. In this study, we have shown that FNAB interpretations of BTN‐PH can encompass all 6 diagnostic categories of the BSRTC.…”

Section: Discussionmentioning

confidence: 99%

“…Their cases were diagnosed as S‐PTC (n = 1) and S‐FN (n = 2), although no nuclear grooves or pseudoinclusions were identified . Powari et al described a single case of BTN‐PH diagnosed as Thy5, consistent with PTC on FNAB and treated by total thyroidectomy . Baloch et al studied 3 pediatric cases of BTN‐PH (including 2 with evidence of hyperfunction) and 8 cases in adults .…”

Section: Discussionmentioning

confidence: 99%

“…Thyroid fine‐needle aspiration biopsy (FNAB) plays a central role in the initial evaluation of thyroid nodules, helping to guide subsequent clinical management by triaging patients into diagnostic categories with a defined risk of malignancy . Although thyroid FNAB is highly accurate for the diagnosis of papillary thyroid carcinoma (PTC), certain cytologic features, including those associated with “papillary hyperplasia” (PH), may be misdiagnosed as suspicious for PTC (S‐PTC) or PTC itself …”

Section: Introductionmentioning

confidence: 99%

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FNAB of benign thyroid nodules with papillary hyperplasia: A cytological and histological evaluation

Pusztaszeri

Krane

Cibas

et al. 2014

Cancer Cytopathology

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BACKGROUND: Benign thyroid nodules with papillary hyperplasia (BTN-PH) are sometimes misinterpreted cytologically as papillary thyroid carcinoma (PTC). We evaluated a fine-needle aspiration biopsy (FNAB) series of BTN-PH to identify the causes of diagnostic error and to better define its cytologic criteria. METHODS: A total of 48 FNAB cases of histologically confirmed BTN-PHs from 44 patients were identified from our archives. The available cytological and histological slides were reviewed and scored for 10 cytomorphological features. Fifteen FNAB cases of classical PTC were also reviewed for comparison. RESULTS: The FNAB diagnoses for the 48 BTN-PHs were: benign, 18; suspicious for malignancy (S-PTC), 12); atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 10; follicular neoplasm, 5; malignant (PTC), 2; and nondiagnostic, 1. The extent of PH in the corresponding histology was highest in FNAB cases diagnosed as S-PTC/PTC versus all other categories (54% vs 27%; P 5.0084). Papillary cytoarchitectural features were present in 53% of FNAB cases overall and in 89% of cases diagnosed as S-PTC/PTC (P 5.0093). Nuclei were smaller in FNABs of BTN-PH compared with PTC (mean diameter/range, 8.2/6-12 vs 14.2/7-26 lm, respectively; P 5.0001).Twenty-six percent of BTN-PHs contained cytoplasmic pigment. All FNAB cases diagnosed as S-PTC/PTC had focal nuclear atypia including grooves (87.5%), enlargement and crowding (75%), and chromatin pallor and pseudoinclusions (25%); however, the extent of nuclear atypia was significantly less than in the control group of PTCs (P <.0001). CONCLU-SIONS: BTN-PH represents a significant pitfall in thyroid FNABs in which it can be misinterpreted as S-PTC/PTC. Cytologic clues to this pitfall include limited and variable nuclear atypia, small nuclear size, and cytoplasmic pigment. Cancer (Cancer Cytopathol) 2014;122:666-77.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

FNAB of benign thyroid nodules with papillary hyperplasia: A cytological and histological evaluation

Pusztaszeri

Krane

Cibas

et al. 2014

Cancer Cytopathology

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show abstract

“…Hürthle cell neoplasms have consistently round nuclei, lower nuclear‐to‐cytoplasmic ratios and cytoplasmic granularity. The chromatin is not clear and nucleoli are larger than in PTC 18,19 …”

Section: Discussionmentioning

confidence: 92%