Histologic alterations in the thyroid gland after fine-needle aspiration

Abstract

To evaluate the histologic alterations due to the fine‐needle aspiration (FNA), a comparative study between 20 aspirated and 20 nonaspirated thyroidectomy specimens was performed. The most common findings in the aspirated group were hemorrhage (80%) and vascular proliferation and/or vascular thrombosis (45%). In one of the aspirated cases with the cytologic diagnosis of follicular neoplasm, histologic sections revealed prominent vascular and endothelial proliferation. Fibrosis, cystic degeneration, and infarction were other histologic findings in the aspirated group. Hemorrhage was seen in 45% and cystic degeneration in 25% of the nonaspirated cases. Fifty percent of the nonaspirated cases did not have any additional findings. In conclusion, knowledge of previous FNA application and awareness of possible histologic alterations due to the needling is necessary while evaluating the histologic sections of the thyroidectomy specimens. Diagn. Cytopathol. 16:230–232, 1997. © 1997 Wiley‐Liss, Inc.

Diagnostic Aspiration of Parathyroid Adenomas Causes Severe Fibrosis Complicating Surgery and Final Histologic Diagnosis

“…Alwaheeb et al (7) have recently described reactive changes seen after FNA of parathyroid glands that can be mistaken for signs of malignancy. This has been well described following FNA of thyroid, salivary gland, and breast tissues (11)(12)(13). We confirm these findings as our blinded pathologists commented on the possibility of malignancy in 77% of adenomas that had undergone FNA.…”

Vanishing Thyroid Tumors: A Diagnostic Dilemma After Ultrasonography-Guided Fine-Needle Aspiration

“…However, FNA-induced reactive changes in thyroid nodules can be "worrisome" [6][7][8][9] and include atypical nuclei, hemorrhage, infarction, fibrinoid necrosis, fibrosis, cystic degeneration, pseudocapsular invasion, and squamous metaplasia. Rarely these changes completely or extensively replace a thyroid nodule,so as to render the final surgical pathology diagnosis on thyroidectomy difficult or impossible ('vanishing tumors').…”

Vanishing tumors of thyroid: histological variations after fine needle aspiration

“…The remaining ten nodules showed partial replacement of tumors by regressive changes (case 6,[8][9][10][11][12][13][14][15]17). These lesions had FNA diagnosis of indeterminate in five (FLUS in three, FN in one and suspicious for malignancy in one) and benign in five nodules.…”

“…These changes are expressed in the form of atypical nuclei, hemorrhagic cysts, fibrosis, cystic degeneration, necrosis, and squamous metaplasia on specimen histopathology after the patient undergoes surgical excision (12)(13)(14). Following FNA, these changes can partially or extensively replace thyroid tumor tissue, obscuring the final diagnosis of the previously biopsyproven tumor.…”