Histologic Analysis and Comparison of Techniques in Fine Needle Aspiration–Induced Alterations in Thyroid

Sharma, Charu; Krishnanand, Geeta

doi:10.1159/000325435

Cited by 24 publications

(35 citation statements)

References 6 publications

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“…Several subsequent studies confirmed their observations [16][17][18][19] . Thyroid FNAB-related histopathological changes often include haemorrhage, fibrosis, granulation tissue, and necrosis [15][16][17][18][19][20][21] .…”

supporting

confidence: 58%

“…This observation is in agreement with our results, as FNAB history was negative/unavailable in 15 cases in our series. Sharma and Krishnanand [19] investigated the role of the FNAB technique in the aetiology of vascular proliferation, finding a 21-G needle to be less traumatic than other options. The numerous and multiple needle passes increase vascular proliferation development and capsular pseudoinvasion [15,20] that interferes with follicular adenoma versus carcinoma diagnostics.…”

Section: Discussionmentioning

confidence: 99%

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Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Hovi

Kholová²

2017

Acta Cytologica

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Objective: Fine needle aspiration biopsy (FNAB) can cause reactive histopathological changes, commonly including haemorrhage and granulation tissue. The literature describing vascular proliferation after FNAB is sparse. We aimed to describe neovascularisation in thyroid gland specimens as a consequence of FNAB. Study Design: We analysed all thyroid histopathological specimens from the Fimlab Laboratories collected between 2010 and 2013 for neovascularisation and distortions in the accompanying tissue. We evaluated HE-stained slides and CD31-, podoplanin-, and Ki-67-immunostained slides. Results: We observed vascular proliferation in 64 out of 787 specimens (8.1%). In these patients, the mean age was 62 years, 43 were female and 21 were male. Previous FNAB data were available in 49 cases (76.6%). In 51 cases (79.7%), the neovascularisation occupied less than 5% of the thyroid gland area. The vessel dilatation was moderate in 28 cases (43.8%) and low in 20 cases (31.3%). In tumours, neovessels were detected within the tumour and in the surrounding tissue. Conclusions: Post-FNAB tissue samples include dilated newly formed vessels, which pathologists should differentiate from rare thyroid vascular tumours. The proposed mechanism is a traumatically induced haemorrhage followed by haematoma and thrombosis that resolves by recanalisation. A knowledge of tissue alteration is needed to avoid misdiagnoses.

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confidence: 58%

Section: Discussionmentioning

confidence: 99%

Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Hovi

Kholová²

2017

Acta Cytologica

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“…Therefore, efforts must be made to minimize the occurrence of histological alterations following FNA. It may be of importance to utilize the French (capillary) technique in thyroid FNA rather than the more traumatic negative pressure aspiration technique (31,32).…”

Section: Discussionmentioning

confidence: 99%

Vanishing tumors of thyroid: histological variations after fine needle aspiration

et al. 2016

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“…However, Fine needle Aspiration has some limitations like specimen inadequacy, sampling techniques and WHAFFT changes. [15] The diagnosis of follicular patterned lesions can be challenging because of overlapping features between benign and malignant lesions and is considered as a 'gray zone'. [5,14,16] The use of diagnostic categories is central to the practice of cytopathology, but in the case of follicular lesions of the thyroid, such categories are poorly standardized.…”

Section: Discussionmentioning

confidence: 99%

Analyzing the ‘Gray Zone’ in Follicular Lesions of Thyroid

Sharma¹

2015

jemds

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BACKGROUND: Fine needle aspiration (FNA) is used as a gold standard for diagnosis of thyroid nodules. But, diagnostic efficacy of FNA declines sharply when follicular patterned lesions of thyroid are considered. Hence these lesions form a "gray zone" where a definite diagnosis on FNA is difficult. This article discusses the umbrella diagnosis of 'follicular lesions' on cytology, which largely comprises of four entities i.e., adenomatous goiter, follicular adenoma, follicular carcinoma, and the follicular variant of papillary thyroid carcinoma. AIMS: To assess the accuracy of FNAC in differentiating benign and malignant follicular patterned lesions so as to contribute to better patient care. MATERIALS AND METHODS: A retrospective analysis was conducted between 2009 and 2014 at our institution. Sixty two cases with diagnosis of 'follicular lesion' and 'follicular lesion with atypical cells' on FNA were included in the study. The cytological features were correlated with histopathology and the results tabulated. RESULTS: Sixty two cases with a FNA diagnosis of 'follicular lesion' or 'follicular lesion with atypical cells' was analyzed in the present study. The diagnosis of 'Follicular lesion' was noted in 46 cases and 'follicular lesion with atypical cells' in 16 cases. The histopathology diagnosis was adenomatous goiter in 35 cases, follicular adenoma in 16 cases, follicular carcinoma in four cases, and follicular variant of papillary carcinoma of thyroid (PTC) in seven cases. The malignancy rate in follicular pattern lesions (N=62) was 17.7% and neoplasia rate was 43.5%. In atypical or suspicious cases (N=16) the malignancy rate was 43.7% and the neoplasia rate was 68.7%. CONCLUSION: Follicular-patterned thyroid lesions remain a 'gray zone' and a challenge for cytopathologist. High malignancy rate in these patients supports the concept of giving an umbrella diagnosis of "follicular lesion" and advising excision of the nodule for histopathology to confirm the diagnosis or maintain close follow up.

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Histologic Analysis and Comparison of Techniques in Fine Needle Aspiration–Induced Alterations in Thyroid

Cited by 24 publications

References 6 publications

Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Vanishing tumors of thyroid: histological variations after fine needle aspiration

Analyzing the ‘Gray Zone’ in Follicular Lesions of Thyroid

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