Diagnostic Accuracy of Fine Needle Aspiration Cytology of the Thyroid

Solymosi, Tamás; Tóth, Gyula Lukács; Bodó, M

doi:10.1159/000328285

Cited by 30 publications

(10 citation statements)

References 17 publications

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“…The low prevalence (4.16%) of diffuse hypoechogenic enlargement of thyroid gland in comparison to previous studies (18.5–95%) [8,19] may also be due to relatively small number of patients in our study group. The USG helps not only in diagnosis of the condition but also in selecting the patients with suspicious nodules for work up for malignancy [20]. In the present study no neoplastic lesion was found amongst the cases studied.…”

Section: Discussionmentioning

confidence: 43%

Lymphocytic thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters

et al. 2007

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BackgroundClinical, biochemical, ultrasonographic, radionuclide and cytomorphological observations in Lymphocytic thyroiditis (LT), to define the cytological grading criteria on smears and correlation of grades with above parameters.MethodsThis prospective study was conducted on 76 patients attending the Fine needle aspiration cytology clinic of a tertiary care institute in North India. The various parameters like patients' clinical presentation, thyroid antimicrosomal antibodies, hormonal profiles, radionuclide thyroid scan and thyroid ultrasound were studied. Fine needle aspiration of thyroid gland and grading of thyroiditis was done on smears. The grades were correlated with above parameters and the correlation indices were evaluated statistically.ResultsMost of the patients were females (70, 92.11%) who presented with a diffuse goiter (68, 89.47%). Hypothyroid features (56, 73.68%) and elevated TSH (75, 98.68%) were common, but radioiodide uptake was low or normal in majority of patients. Thyroid antimicrosomal antibody was elevated in 46/70 (65.71%) patients. Cytomorphology in fine needle aspirates was diagnostic of lymphocytic thyroiditis in 75 (98.68%) patients. Most of them had grade I/II disease by cytology. No correlation was observed between grades of cytomorphology and clinical, biochemical, ultrasonographic and radionuclide parameters.ConclusionDespite the availability of several tests for diagnosis of LT, FNAC remains the gold standard. The grades of thyroiditis at cytology however do not correlate with clinical, biochemical, radionuclide and ultrasonographic parameters.

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Section: Discussionmentioning

confidence: 43%

Lymphocytic thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters

et al. 2007

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“…Here, guided FNAC is more useful to aspirate from solid lesion. [212] In our study, incidence of cystic neoplasms was 12.5% (2/16). Misinterpretation of cystic papillary carcinoma in cytology was mainly because of less cellularity and absence of characteristic nuclear features.…”

Section: Discussionmentioning

confidence: 46%

“…The low frequency of “unsatisfactory for diagnosis” would result from a combination of a good aspiration technique and immediate examination of specimen adequacy by the cytopathologist. [12] The key to interpretation of thyroid FNAC is largely dependent on recognition of various cellular patterns, details of follicular cells and background elements like colloid and cyst macrophages.…”

Section: Discussionmentioning

confidence: 99%

A cell pattern approach to interpretation of fine needle aspiration cytology of thyroid lesions: A cyto-histomorphological study

Bommanahalli

Bhat

Rupanarayan

2010

J Cytol

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Aim:Our study aimed at a cell pattern approach to interpret thyroid cytology and to demonstrate diagnostic accuracy of fine needle aspiration cytology (FNAC) with an emphasis on diagnostic pitfalls.Materials and Methods:A total number of 218 goitre cases, from the year 2000 to 2004, were reviewed retrospectively from the cytology files, without considering the previous cytological diagnosis. Four cases with inadequate aspirate were excluded. The predominant cell pattern, such as macro/normofollicular, microfollicular, papillary, syncytial, dispersed and cystic pattern, was noted in each case. The final diagnosis was arrived by observing the cellular details and background elements. Cytological diagnosis was correlated with histopathology in 75 cases. The sensitivity and specificity were computed.Results:Normo/macrofollicular pattern was seen in 71.96% of nodular goitre and 6.9% of follicular neoplasms. Around 86.2% of follicular neoplasms and 17.6% of papillary carcinoma had microfollicular pattern. The papillary pattern was seen in 47% of papillary carcinoma. Syncytial pattern was noticed in 72.3% of chronic lymphocytic thyroiditis and 29.4% of papillary carcinoma. Cytological diagnosis was concordant with histopathological diagnosis in 65 cases. Overall sensitivity and specificity of FNAC in diagnosing neoplastic lesions of thyroid were 83.33 and 95.55%, respectively.Conclusion:FNAC is more sensitive and specific in triaging neoplastic from non-neoplastic thyroid lesions. Identification of the predominant cell pattern would be complementary to analysis of cell morphology and background details in cytological diagnosis of thyroid lesions. This approach helps to diagnose follicular neoplasm and follicular variant of papillary thyroid carcinoma.

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“…Since the incidence is less, more and more studies are required to confirm the exact sequence of occurrence among the two entities. In cases of co‐existence of two, it is possible that if FNAC is taken from the peritumoral thyroiditis area alone, it will seem only as HT . Few authors consider it as the chief reason for the underreporting of this condition in the literature.…”

Section: Discussionmentioning

confidence: 99%

Medullary thyroid carcinoma co‐existent with Hashimoto's thyroiditis diagnosed by a comprehensive cytological approach

Malpani

Tandon

Panwar

et al. 2019

Diagnostic Cytopathology

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Fine‐needle aspiration cytology (FNAC) is a preliminary test for the diagnosis of thyroid lesions. We hereby report a rare case of medullary thyroid carcinoma (MTC) co‐existing with Hashimoto's thyroiditis (HT). This case was substantiated with ancillary tests on cytology material to give a novel insight. A 60‐year‐old female presented clinically with diffuse enlargement of the thyroid, and right‐side nodule on ultrasonography. FNAC of the isthmic area showed features of HT, while cytology of right‐side nodule displayed sheets of plasmacytoid cells and frequent scattered large bizarre and pleomorphic cells, lymphoglandular bodies and pale eosinophilic material. The differential diagnosis of MTC with co‐existent HT or high‐grade lymphoma was considered. To establish the diagnosis, serum calcitonin and ancillary studies on aspirated material were carried out. High serum calcitonin (7251 pg/mL), Congophilia on smears, and CD 45−ve; CD56+ve expression of tumor cells on flowcytometric analysis established the diagnosis of MTC over lymphoma. This diagnosis was further confirmed upon histopathology. Ancillary studies on aspirated material established the diagnosis of MTC and excluded the diagnosis of lymphoma. Establishing the correct diagnosis was cardinal in such a scenario as these diseases have extremely diverse management.

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Diagnostic Accuracy of Fine Needle Aspiration Cytology of the Thyroid

Cited by 30 publications

References 17 publications

Lymphocytic thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters

Lymphocytic thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters

A cell pattern approach to interpretation of fine needle aspiration cytology of thyroid lesions: A cyto-histomorphological study

Medullary thyroid carcinoma co‐existent with Hashimoto's thyroiditis diagnosed by a comprehensive cytological approach

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