Fine needle aspiration cytology of follicular tumor, proposal for our subclassification

Fujisawa, Toshimichi; Morimitsu, Eri; Hiraki, T; Takahashi, Masaharu; Tamura, Megumi; Sasaki, Eiji; Kameyama, Kaori; Tamai, Susumu; Toriya, Kunio; Ito, Koichi

doi:10.5795/jjscc.49.42

Cited by 5 publications

(3 citation statements)

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“…Only 47.2% (93/197 cases) were surgically treated and there were 54 (58.0%) with favor benign, 10 (10.8%) cases with borderline, 20 (21.5%) cases with favor malignant diagnoses. The rates of malignancy were 16.7% (6FTCs and 3PTCs) in favor benign, 50% (5 FTCs) in borderline and 60% (10 FTCs and 2 others) in favor malignant [59]. These observations confirmed that cytological subclassification of follicular neoplasms successfully stratifies patients for risks of malignancy.…”

Section: Clinical Management For the Indeterminate Categorysupporting

confidence: 74%

“…It has to be mentioned that false-negative results for those FTC patients did not create any problems such as a delay in treatment or litigation because the patients were advised to undergo diagnostic surgery due to high-risk findings obtained from other clinical tests, such as ultrasound examination, despite the fact of a benign cytological report [10,11,26,49,59,60,70,71]. Kawai et al analyzed 643 surgically treated patients, who simultaneously had 866 accessory nodules in addition to the main nodules.…”

Section: False-negative Results In Thyroid Fna Cytologymentioning

confidence: 99%

“…From Japan, Fujisawa et al analyzed 93 surgically treated patients for thyroid nodule with follicular neoplasm among 4505 patients who were examined with FNA cytology in 2006 at Ito Hospital, Tokyo, Japan [59]. Only 47.2% (93/197 cases) were surgically treated and there were 54 (58.0%) with favor benign, 10 (10.8%) cases with borderline, 20 (21.5%) cases with favor malignant diagnoses.…”

Section: Clinical Management For the Indeterminate Categorymentioning

confidence: 99%

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Introducing the reporting system for thyroid fine-needle aspiration cytology according to the new guidelines of the Japan Thyroid Association [Review]

et al. 2014

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Abstract. The Japan Thyroid Association (JTA) recently published new guidelines for clinical management of thyroid nodules. This paper introduces their diagnostic system for reporting thyroid fine-needle aspiration cytology. There are two points where the new reporting system that differs from existing internationally-accepted ones. The first is the subclassification of the so-called indeterminate category, which is divided into 'follicular neoplasm' and 'others'. The second is the subclassification of follicular neoplasm into 'favor benign', 'borderline' and 'favor malignant'. It is characterized by self-explanatory terminologies as to histological type and probability of malignancy to establish further risk stratification as well as to facilitate communication between clinicians and cytopathologists. The different treatment strategies adopted for thyroid nodules is deeply influenced by the particular diagnostic system used for thyroid cytology. In Western countries all patients with follicular neoplasms are advised to have immediate diagnostic surgery while patients in Japan often undergo further risk stratification without immediate surgery. The JTA diagnostic system of reporting thyroid cytology is designed for further risk stratification of patients with indeterminate cytology. If a surgeon applies diagnostic lobectomy to all patients with follicular neoplasm unselectively, this subclassification of follicular neoplasm has no practical meaning and is unnecessary. Cytological risk stratification of follicular neoplasms is optional and cytopathologists can choose either a simple 6-tier system without stratification of follicular neoplasm or a complicated 8-tier system depending on their experience in thyroid cytology and clinical management.

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Section: Clinical Management For the Indeterminate Categorysupporting

confidence: 74%