Distinguishing parathyroid and thyroid lesions on ultrasound‐guided fine‐needle aspiration: A correlation of clinical data, ancillary studies, and molecular analysis

Abstract

Lesions with follicular lesion of undetermined significance-like or oncocytic features are prone to misdiagnosis. The current study identified distinct cytologic patterns in parathyroid lesions suggestive of parathyroid origin, which, together with PTH immunostains or assay, molecular studies, or sestamibi scans, aid in distinguishing parathyroid from thyroid lesions. Cancer Cytopathol 2017;125:674-82. © 2017 American Cancer Society.

Analytical performance of the ThyroSeq v3 genomic classifier for cancer diagnosis in thyroid nodules

“…They include not only most common papillary and follicular thyroid cancer types but also Hurthle cell cancers through the exploitation of the common occurrence of widespread CNAs, which result in a nearly homozygous genome in these tumors . Furthermore, the ThyroSeq v3 GC retains the accurate detection of medullary thyroid cancers and parathyroid nodules demonstrated by the previous version of the test …”

“…12 Furthermore, the ThyroSeq v3 GC retains the accurate detection of medullary thyroid cancers and parathyroid nodules demonstrated by the previous version of the test. 16,23 An important parameter of the performance of each diagnostic test is its specificity for cancer detection. However, the existence of borderline tumors makes the assessment of specificity of tests for thyroid nodules more complex.…”

Clinical validation of the ThyroSeq v3 genomic classifier in thyroid nodules with indeterminate FNA cytology

“…The latter version of this test not only used DNA and RNA for detecting point mutations/indels and gene fusions found in approximately 90% of papillary carcinomas, but also used a limited gene expression panel to monitor the cellularity and cell lineage of the tested samples. This allowed an overall high positive predictive value (PPV) and negative predictive value (NPV) for cancer detection in TBSRTC categories III and IV nodules and facilitated the detection of parathyroid nodules and medullary carcinomas . More recent advances in the genetic science related to the molecular mechanisms of less common types of thyroid cancer, and particularly Hurthle cell carcinomas, offered an opportunity for the even more comprehensive and accurate detection of all main types of thyroid cancer, which led to the creation of the latest version of the ThyroSeq test.…”

Cured primary hyperparathyroidism after fine-needle aspiration biopsy-induced parathyroid disappearance

“…Furthermore, parathyroid cytology has very low diagnostic value even when FNAB is coupled to US (US-FNAB) (2, 4). For these reasons, in clinical practice, the measurement of intact PTH within the washing fluid (wPTH) obtained by US-FNAB, increases the US positive-predictive value for the detection of parathyroid lesions and is recommended as an ancillary study in order to distinguish parathyroid from thyroid lesions on US-guided FNAB (4, 5). …”