Differential Diagnosis of Fine Needle Aspiration Smears of Thyroid Nodules

Khan, Enam Murshed; Pandey, Rakesh

doi:10.1159/000334008

Cited by 9 publications

(10 citation statements)

References 7 publications

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“…Since then, this finding has been confirmed by several other groups [22][23][24][25][26][27][28][29][30]. The widespread application of the technique has been hindered by the relatively wide overlap between AgNOR values of the benign and malignant groups [31]. In the present study, we show that there is a close correlation between the proliferative activity of single cells determined by AgNOR and the growth potential of the whole nodule.…”

Section: Variablesupporting

confidence: 86%

Evaluation of the Long-term Growth Potential of Benign Non-toxic Thyroid Nodules by the AgNOR Method; an 11-year Follow-up Study

Solymosi¹,

Gál²,

Bodó³

et al. 2015

J Cytol Histol

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Objective: The classification of benign thyroid nodules as stable or as fast growing may have clinical and economical relevance. The proliferative activity of thyroid cells determined by argyrophilic staining of the nucleolar organizer region (AgNOR) displays significant differences between benign and malignant thyroid lesions. We tested if that parameter can predict the growth potential of benign nodules. Methods:On cytological samples of 106 benign nodules of 89 euthyroid patients, the mean AgNOR number per cell (AgNORc), the mean AgNOR area per cell (AgNORa) and the mean nuclear area were determined. The mean follow-up period was 11.9 years. The initial (V1) and the final (V2) nodule volumes and respective TSH values (TSH1 and TSH2) were determined.Results: 66 nodules (62.2%) increased in volume. The median of V2/V1 was 1.31. V2/V1 correlated significantly with AgNORa, AgNORc, nuclear area and TSH-1. There was no significant correlation between V2/V1 and either age, duration of follow-up or TSH-2. No correlation was found between V2 and any of the parameters. We found on both forward and backward stepwise analysis that AgNORc values and initial TSH levels were significant determinates of the increase in volume size, i.e. both higher AgNORc values and higher initial TSH levels carry a greater risk for nodule growth. Conclusions:The determination of AgNORc during FNA evaluation may contribute to the estimation of growth potential of thyroid nodules. Further studies using other enzyme techniques or new molecular methods are justified to achieve a better discrimination between stable and growing nodules.

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Section: Variablesupporting

confidence: 86%

Evaluation of the Long-term Growth Potential of Benign Non-toxic Thyroid Nodules by the AgNOR Method; an 11-year Follow-up Study

Solymosi¹,

Gál²,

Bodó³

et al. 2015

J Cytol Histol

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“…Khan EM et al in their study also did not find a cut-off point to differentiate between non-neoplastic and neoplastic lesions based on mean AgNOR count due to overlapping. 11 Although this study found a higher mean AgNOR count in follicular carcinoma (4.84 ± 1.42) than in follicular adenoma (3.5 ± 0.27) and there was no overlapping in AgNOR counts between the two, cut-off point could not be established because the number of cases was too small. Karmaker T et al observed a significant difference in AgNOR counts in follicular carcinoma and follicular adenoma, but they too had a small number of cases in their study.…”

Section: After Histopathological Confirmation Of the Diagnoses It Wasmentioning

confidence: 54%

Argyrophilic nucleolar organizer regions of thyroid lesions on fi ne needle aspiration smears

Chalise

Thapa²,

Sayami³

et al. 2013

J Pathol Nep

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Background: Argyrophilic nucleolar organizer region is higher in malignant nuclei as compared to reactive and benign nuclei. The main objective of this study was to evaluate the role of Argyrophilic nucleolar organizer region and its extent in differentiating benign and malignant lesions, particularly with respect to follicular neoplasms of the thyroid. Materials and Methods:This was a prospective, cross sectional study which included 110 patients presenting with thyroid swelling. The fi ne needle aspiration smears were studied by conventional methods and silver staining for Argyrophilic nucleolar organizer region. In 50 cases, diagnosis was confi rmed by histopathology. The Argyrophilic nucleolar organizer region count was done and the mean Argyrophilic nucleolar organizer region count per nucleus was calculated along with pattern of distribution.Results: Mean Argyrophilic nucleolar organizer region count was higher in neoplastic as compared to non-neoplastic and infl ammatory lesions. Papillary carcinoma had the highest mean Argyrophilic nucleolar organizer region count (5.40 ± 0.86) and the lowest count was seen in Hashimoto's thyroiditis (2.10 ± 0.36). Higher mean Argyrophilic nucleolar organizer region count was recorded in follicular carcinoma (4.84 ± 1.42) as compared to follicular adenoma (3.5 ± 0.27) which was found to be statistically signifi cant (P<0.05). Argyrophilic nucleolar organizer region dots were arranged in clusters in colloid goiter whereas scattered discrete black dots were seen in neoplastic lesions. Conclusion:Argyrophilic nucleolar organizer region study of thyroid can be used as an additional diagnostic adjunct with cytomorphological features to differentiate benign and malignant follicular neoplasms.

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“…The cytologic findings of adenomatous colloid goiter and follicular adenoma were described in detail in many papers. 10,11,12,14,[16][17][18] Tissue fragments with microfollicles and acinar formations seen in the above two conditions were not noticed in FVPTC. Rare colloid balls have been seen in colloid goiters but not in follicular adenoma.…”

Section: Discussionmentioning

confidence: 99%