Follicular or Hu ̈rthle cell neoplasm of the thyroid: Can clinical factors be used to predict carcinoma and determine extent of thyroidectomy?

McHenry, Christopher R.; Thomas, Stephanie R.; Slusarczyk, Sandra J.; Khiyami, Amer

doi:10.1016/s0039-6060(99)70138-8

Cited by 93 publications

(89 citation statements)

References 13 publications

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“…12,21 In an attempt to avoid unnecessary surgery of thyroid nodules with follicular neoplasm, some authors have further stratified the indeterminate thyroid aspirates into high-and low-risk groups for a malignancy based on clinical parameters. [24][25][26] Baloch et al 24 reported male sex, age >40 years, and a nodule size >3 cm to be significantly associated with a higher likelihood of a malignancy. Similarly, Davis et al 25 added a history of neck irradiation to those parameters associated with a risk of a malignancy, including size >3 cm and age >50 years; however, sex and family history of goiter or neoplasm were not predisposing factors.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Davis et al 25 added a history of neck irradiation to those parameters associated with a risk of a malignancy, including size >3 cm and age >50 years; however, sex and family history of goiter or neoplasm were not predisposing factors. On the other hand, McHenry et al 26 reported that these clinical factors were not helpful in predicting a carcinoma in patients with a follicular neoplasm. With respect to the cytologic features, cellular atypia has been found to be associated with a higher risk of malignancy by some investigators 27,28 but not others.…”

Section: Discussionmentioning

confidence: 99%

“…With respect to the cytologic features, cellular atypia has been found to be associated with a higher risk of malignancy by some investigators 27,28 but not others. 26,29 Markers of a malignancy-in particular HBME-1, galectin-3, and Ret proto-oncogene-even in a small thyrocyte population, may improve the diagnostic accuracy of FNA of thyroid nodules in the future. 26,30 Despite the improved aspiration technique and US guidance, up to 20% of initial aspirations are nondiagnostic.…”

Section: Discussionmentioning

confidence: 99%

“…26,29 Markers of a malignancy-in particular HBME-1, galectin-3, and Ret proto-oncogene-even in a small thyrocyte population, may improve the diagnostic accuracy of FNA of thyroid nodules in the future. 26,30 Despite the improved aspiration technique and US guidance, up to 20% of initial aspirations are nondiagnostic. 7,9,21 The highest proportion of nondiagnostic specimens occur in nodules with a large cystic content, and malignancy has been observed in 5-10% of cases with nondiagnostic aspirates.…”

Section: Discussionmentioning

confidence: 99%

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Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Lee

Kim

et al. 2007

J of Clinical Ultrasound

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Purpose. To analyze the discrepancies between the cytologic results of sonographically (US)-guided fine needle aspiration (FNA) of thyroid nodules and final histopathologic results and to discuss the limitations of US-guided FNA.Materials and Methods. The results of US-guided FNAs performed by a single experienced radiologist in 315 thyroid nodules in 292 patients (246 women, 46 men aged 12-79 years) were retrospectively correlated with their surgical pathologic results. The FNA results were classified as nondiagnostic, indeterminate, negative, or positive, whereas final pathologic diagnoses were classified as malignant or benign.Results. The FNA results were nondiagnostic in 31 cases (9.8%), indeterminate in 97 cases (30.8%), and determinate in 187 cases (59.4%). Of the 187 conclusive cases, 169 (90.4%) were concordant with the final pathologic results, whereas 18 (9.6%) were discordant with 14 false-positive and 4 false-negative results. These discrepancies were caused by atypical nuclear features. Among the 97 indeterminate and 31 nondiagnostic cases, a malignancy was found in 14 (14.4%) and 8 (25.8%) cases, respectively. In addition, 10 papillary carcinomas, which were not visualized on sonograms, were detected incidentally in thyroidectomy specimens.Conclusion. The diagnostic accuracy of US-guided FNA of thyroid nodule has limitations that should be minimized by careful interpretation of the cytologic findings and accurate sampling. V V C 2007 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sonographically guided fine needle aspiration of thyroid nodule: Discrepancies between cytologic and histopathologic findings

Lee

Kim

et al. 2007

J of Clinical Ultrasound

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“…1,2 In addition, clinical predictors of malignancy in patients with follicular neoplasms and HCN have been intensely studied, with varied results. [3][4][5][6][7][8] The cytomorphologic features of Hurthle cell nodules of the thyroid in FNAB have been described by multiple investigators, but there is limited agreement regarding the usefulness of specific features for the cytologic diagnosis of HCN. 9 -19 Kini et al 13 described a set of widely used criteria for the cytologic diagnosis of HCN that include cytoarchitecture, monomorphism, and macronucleoli.…”

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confidence: 99%

Fine-needle aspiration biopsy of Hurthle cell lesions of the thyroid gland

Elliott

Pitman

Bloom

et al. 2006

Cancer

109

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The aim of this study was twofold. The first aim was to estimate the diagnostic reliability of urinary cytology for detection and management of urothelial neoplasms by using a specific preserving fluid for sample collection, and the liquid‐based thin layer method for specimen preparation, the estimate was based on the correlation between the cytological findings of 10,000 non‐hospitalized patients, and their histological diagnoses. A second aim was to compare the reliability of two instruments for thin‐layer preparation, i.e., TP2000, TP3000, capable of processing the specimens at very different rates. The preservation of cell structure is ameliorated by the procedure of sample collection and treatment here described. This allows a more accurate reading of LBC slides as shown by: (a) the significant concordance between cytological and histological diagnosis (92%); (b) the significant number of low‐grade urothelial carcinomas (20.5%) revealed by urinary cytology and validated by histologic diagnosis; (c) the low rate (8%) of misjudgement of cytological diagnosis reached in this study. The quality of performances of the two instruments tested for thin‐layer preparation, i.e., TP2000 and TP3000, is statistically comparable. We recommend the procedure that makes use of preserving fluid for sample collection (cytolyt™) and treatment (preservcyt ™) as here described. We also recommend the use of thin‐layer method for specimen preparation since it allows a more uniform distribution of the cells on the support with reduction of overlapping phenomena. Finally, economic considerations suggest the preferential use of Thin Prep 3000. Diagn. Cytopathol. 2012. © 2011 Wiley Periodicals, Inc.

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