Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology

Abstract

Design: Fine-needle aspiration biopsy (FNAB) is the most reliable diagnostic tool in the diagnosis of thyroid nodules. A cytologic diagnosis of follicular neoplasm with atypical cells of undetermined significance (FN/AUS) implies that the selection of patients between surgery and follow-up is difficult. In this setting immunocytochemical stainings might be helpful. The efficacy of a panel made up of HBME-1 and Galectin-3 antibodies is evaluated in cases processed by liquid-based cytology (LBC). Methods: Out of 7091 thyroid FNAB processed by LBC method, 120 cases undergoing surgery successively were selected. These cases were classified as benign lesion (BL, eight cases), FN, including the ACUS category of the Bethesda classification (FN/AUS, 50 cases), suspicious for malignancy (SM, 59 cases), and malignant neoplasm (MN, three cases). Immunostains for HBME-1 and Galectin-3 were carried out on the LBC slides. Results: All MN and BL were histologically confirmed. FN/AUS and SM showed a malignancy risk of 24 and 72.9% respectively. The complete immunocytochemical panel was positive in 83.3% of the cases resulting in malignancy and negative in 87.5% of cases resulting in benign histology. Among the FN/AUS, the complete positive immunocytochemical panel was detected in 76.9% of cases resulting as malignant and the complete negative immunocytochemical panel was observed in 96.8% of cases resulting as benign at histology. Conclusions: The expression of HBME-1 and Galectin-3 in cases classified as FN/AUS on LBC-processed FNABs can effectively distinguish lesions, which need immediate surgery (high risk or FNH or Thy 3h) from those which can be followed-up (low risk or FNL or Thy 3l).

Diagnostic and prognostic value of immunocytochemistry and BRAF mutation analysis on liquid-based biopsies of thyroid neoplasms suspicious for carcinoma

“…Our diagnostic everyday approach was reflected in the application of the ICC panel for every SM case achieving a sub-classification in high-and low-risk thyroid lesions (29). This evidence also reflected the present results, where the ICC-positive panel was statistically correlated with a malignant outcome (PZ0.0007), highlighted also by the ICC-negative panel in all the seven benign lesions and 86.6% positive malignancies (26 out of 30 cases).…”

“…A recent review article by Correia-Rodrigues et al (30) and other papers have highlighted the increasing application of ancillary techniques to thyroid cytology focusing on immunocytochemical panels as a good choice to discriminate between low-and highmalignant risk lesions that result in an overall diagnostic accuracy spanning from 81 through 92% with the concordant positive panel (3,5,29,30,31).…”

The cytologic category of oncocytic (Hurthle) cell neoplasm mostly includes low-risk lesions at histology: an institutional experience

“…Concerning the use of immunocytochemistry, in particular Galectin-3, contradictory results were reported in the literature and also in our personal experience ascribed to different technical procedures used to reveal the immunomarker expression in the oncocytic/Hurthle cells which are rich in endogenous biotin (29,32,38).…”

“…Among the 150 OCNs, histology revealed four PTC as three cases of oncocytic/Hurthle variant of PTC and one macrofollicular variant of PTC, which are both difficult diagnoses. For the latter, the cytological features may sometimes show misdiagnosed nuclear and cytoplasm malignant details as stated by Alaedeen et al Yang et al and Fadda et al (9,31,32). For the former, Renshaw (33) referred to some difficulties in defining the cytological diagnosis of the oncocytic variant of PTC apart from Hurthle cell neoplasms as emerged in his detection of only three oncocytic/Hurthle lesions out of 18 with nuclear features of PTC.…”

Surgical and pathological changes after radiofrequency ablation of thyroid nodules

“…In one case HBME-1 staining, which is considered a good marker of malignancy [16,17], was also performed and evaluated. Although molecular biology analyses had already been performed on the FNA of all Thy3 nodules before RFA, they were repeated on the surgically resected nodules.…”