Identification of parathyroid tissue in thyroid fine‐needle aspiration: A combined approach using cytology, immunohistochemical, and molecular methods

Domingo, Robert P.; Ogden, Lorna; Been, Laura; Kennedy, Giulia C.; Traweek, S. Thomas

doi:10.1002/dc.23711

Cited by 19 publications

(31 citation statements)

References 22 publications

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“…Thirteen samples that were indeterminate thyroid nodules subsequently were detected by the GEC to have a parathyroid gene expression signature. 9 The cases in 26 In the current study, ThyroSeq v.2 detected the PTH gene in 9 cases. Based on cytology alone, 8 cases (24%) initially were diagnosed incorrectly as thyroid tissue and amended to a diagnosis of parathyroid lesion, including 5 cases based on ThyroSeq v.2 results alone.…”

Section: Discussionmentioning

confidence: 55%

“…One study used the Afirma GEC to confirm indeterminate lesions as being of parathyroid origin. Thirteen samples that were indeterminate thyroid nodules subsequently were detected by the GEC to have a parathyroid gene expression signature . The cases in the current study underwent molecular testing using the ThyroSeq v.2 next‐generation sequencing assay because it is the preferred molecular test of the study institution.…”

Section: Discussionmentioning

confidence: 99%

“…Common major cytomorphologic features of parathyroid tissue that have been reported in the literature include a papillary-like pattern with fibrovascular cores or prominent vascular network/proliferation, stippled chromatin, follicular pattern, and bare nuclei (Table 5). 2,[4][5][6][7][8][9][18][19][20][21][22] The majority of these studies also concluded that a combination of cytomorphologic features supported by either ancillary studies or correlation with clinical, radiologic, and laboratory findings are important in establishing a correct diagnosis of parathyroid tissue. The main diagnostic features in the current study also included bare nuclei.…”

Section: Discussionmentioning

confidence: 99%

“…A high PTH concentration in FNA specimens also has been used to support a parathyroid origin . Furthermore, to the best of our knowledge, only one other study to date has used molecular methods (ie, the Afirma gene expression classifier [GEC]) to confirm indeterminate lesions as being of parathyroid origin …”

Section: Introductionmentioning

confidence: 99%

“…8 Furthermore, to the best of our knowledge, only one other study to date has used molecular methods (ie, the Afirma gene expression classifier [GEC]) to confirm indeterminate lesions as being of parathyroid origin. 9 Cytomorphologic patterns in parathyroid lesions are diverse. The objective of the current study was to examine the cytomorphologic patterns noted in the patient database from the study institution and correlate these patterns with clinical and radiologic data as well as the novel molecular test ThyroSeq v.2 to further clarify this challenging area of cytopathology.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Distinguishing parathyroid and thyroid lesions on ultrasound‐guided fine‐needle aspiration: A correlation of clinical data, ancillary studies, and molecular analysis

Cho

Oweity

Brandler

et al. 2017

Cancer Cytopathology

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Lesions with follicular lesion of undetermined significance-like or oncocytic features are prone to misdiagnosis. The current study identified distinct cytologic patterns in parathyroid lesions suggestive of parathyroid origin, which, together with PTH immunostains or assay, molecular studies, or sestamibi scans, aid in distinguishing parathyroid from thyroid lesions. Cancer Cytopathol 2017;125:674-82. © 2017 American Cancer Society.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Distinguishing parathyroid and thyroid lesions on ultrasound‐guided fine‐needle aspiration: A correlation of clinical data, ancillary studies, and molecular analysis

Cho

Oweity

Brandler

et al. 2017

Cancer Cytopathology

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Probability of malignancy and molecular alterations as determined by ThyroSeq v3 genomic classifier in Bethesda Category IV

Tjendra

Kerr

Zuo

et al. 2023

Cancer Cytopathology

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BackgroundThyroSeq molecular testing assesses the probability of malignancy (POM) in thyroid fine‐needle aspiration cytology (FNAC) with indeterminate cytology. The aim was to investigate whether Bethesda category IV (BIV) subcategories are associated with specific molecular alterations, molecular‐derived risk of malignancy (MDROM), and risk of malignancy (ROM).MethodsFNAC slides, associated ThyroSeq, version 3, Genomic Classifier results, and surgical follow‐up were retrieved for BIV nodules. Nodules were subcategorized as follicular neoplasm (FN) with or without cytologic atypia or oncocytic follicular neoplasm (OFN). The MDROM, ROM, and frequency of molecular alterations in FN and OFN were analyzed. p < .05 was considered significant.ResultsA total of 92 FNAC were identified and subcategorized into 46 FN (15 with and 31 without cytologic atypia) and 46 OFN. The benign call rate and the positive call rate were 49% and 51%, respectively. The MDROM in BIV was 34.3%, trending lower in OFN than in FN. RAS mutations were significantly more frequent in FN when compared to OFN (p = .02). Chromosomal copy number alterations were more often present in OFN than in FN (p < .01). On histologic follow‐up, ROM in OFN was trending lower than in FN (p = .1). The most common diagnosis in OFN was oncocytic adenoma, whereas follicular variant papillary thyroid carcinoma was most common in FN.ConclusionsThe MDROM and ROM were trending lower in OFN compared with FN, and the molecular alterations differed between OFN and FN subcategories.

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Fine‐needle aspiration of parathyroid adenomas: Indications as a diagnostic approach

Suzuki

Hirokawa

Kanematsu

et al. 2020

Diagnostic Cytopathology

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Background We aimed to determine the indication of fine‐needle aspiration (FNA) for parathyroid adenoma (PA)‐suspected nodules and the cytological features of PA, and to discuss the ancillary techniques for diagnostic confirmation. Method Clinical, cytological, and histological examinations of 15 PA patients (4.0% of all PA resected patients) were conducted through FNA on 16 nodules. We also examined the cytological preparations of 10 follicular neoplasms (FNs) and 10 poorly differentiated thyroid carcinomas (PDTCs). Results FNA was performed to detect PA in nine (56.3%) nodules. The remaining seven (43.8%) nodules underwent FNA for lesions considered as thyroid nodules or lymph nodes. The levels of parathyroid hormone (PTH) in the aspiration needle washout fluid were observably high, except for that from one nodule with unsatisfactory FNA. Cytologically, the incidences of wedge pattern (86.7%) and salt and pepper chromatin (86.7%) in PAs were significantly higher than in FNs and PDTCs. In contrast, the appearance of colloid globules and nuclear grooves was less frequent than that of FNs and PDTCs. GATA‐3 expression was intense in all PAs that immunocytochemistry were performed. Histologically, capsular invasion and/or laceration, tumor seeding, granulation tissue, and fibrosis were observed. Conclusions When PA localization is unusual or inconclusive despite extensive imaging, FNA may be performed. We asserted that wedge pattern, salt and pepper chromatin, and the absence of colloid globules and nuclear grooves are diagnostic cytological indicators of PA rather than of FN or PDTC. We recommend PTH measurements using needle washout fluid for PA‐suspected nodules, and immunocytochemistry with the GATA‐3 antibody for cytologically PA‐suspected nodules.

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Identification of parathyroid tissue in thyroid fine‐needle aspiration: A combined approach using cytology, immunohistochemical, and molecular methods

Cited by 19 publications

References 22 publications

Distinguishing parathyroid and thyroid lesions on ultrasound‐guided fine‐needle aspiration: A correlation of clinical data, ancillary studies, and molecular analysis

Distinguishing parathyroid and thyroid lesions on ultrasound‐guided fine‐needle aspiration: A correlation of clinical data, ancillary studies, and molecular analysis

Probability of malignancy and molecular alterations as determined by ThyroSeq v3 genomic classifier in Bethesda Category IV

Fine‐needle aspiration of parathyroid adenomas: Indications as a diagnostic approach

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