Implementation of a joint protocol for the management of thyroid nodules with a cytological diagnosis of follicular lesion of undetermined significance: experience in one hospital

Chaves, Sacha Braun; Fernández-Aceñero, María Jesús; Cazorla, Alicia; Cedeño, Mabel; Fortes, José; Gavin, Eduardo; Mullor, R

doi:10.1111/j.1365-2303.2011.00931.x

Cited by 3 publications

(3 citation statements)

References 11 publications

(22 reference statements)

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“…Several research articles suggest that in cases in which the initial TFNAB report diagnosis is "follicular lesion of undetermined significance", it is more effective to perform a core biopsy instead of a second TFNAB(12); Furthermore, the study of Chaves et al suggests that a joined protocol, which combines TFNAB results with clinic-derived radiological data, would be most effective (13). In order to overcome these discrepancies in terms of choice of methodology, there are additional studies that suggest that analysis at a molecular level provides almost the same results as with a second TFNAB (2,14).…”

Section: Discussionmentioning

confidence: 99%

Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’

Ay¹

2013

CMR

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Abstract:Aim: Thyroid fine-needle aspiration biopsy (TFNAB) is the gold standard methodology for the evaluation of thyroid nodule. Nevertheless, diagnosis of TFNAB specimens is sometimes interpreted as "follicular lesion of undetermined significance": This indeterminate diagnosis is given upon TFNAB despite the presence of sufficient cellular material available for cytopathological analysis. Furthermore, this indeterminate diagnosis constitutes a grey zone between benign lesion and malignancy. As a result, it becomes difficult to determine the type of surgical intervention that needs to be performed on the patient and the technique that will be used. In this study, we aim to correlate the diagnosis of "follicular lesion of undetermined significance" with clinical and postoperative evaluations. Methods: A total of 147 patients, who were diagnosed as "follicular lesion of undetermined significance" following initial TFNAB, were included in this retrospective study. These patients were evaluated according to whether they underwent a second TFNAB or thyroidectomy pathology following initial diagnosis of "follicular lesion of undetermined significance". Results: Results were generated by evaluating the reports of the second TFNAB and 15 of 147 patients were followed. Histopathological examination of specimens derived from 132 patients following surgery revealed the following diagnosis: (i) hyperplasia in 67 patients, (ii) nodular lesion belonging to Hashimoto's thyroiditis in 34 patients, (iii) papillary carcinoma in 28 patients, (iv) follicular carcinoma in two patients, and (v) anaplastic carcinoma in one patient. Conclusion: Based on this retrospective study and on examination of the available literature concerning the treatment options and follow-up of patients initially diagnosed as "follicular lesion of undetermined significance" (FLUS or Atypia of undetermined significance) upon TFNAB, we conclude that it is important to keep in mind the elevated rates of malignancy that potentially develop from these undetermined lesions. is electronic document is a "live" template. The various components of your paper [title, text, heads, etc.] are already defined on the style sheet, as illustrated by the portions given in this document.

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Section: Discussionmentioning

confidence: 99%

Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’

Ay¹

2013

CMR

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“…For the follicular tumor or suspected follicular tumor, it is difficult to make definite diagnosis of benignity or malignancy according the results of ultrasonography and FNA. Surgical treatment is generally recommended instead of repeated FNA [47] or gene detection combined with FNA.…”

Section: Follicular Tumor or Suspected Follicular Tumormentioning

confidence: 99%

Ultrasound-guided Fine Needle Aspiration Cytological Examination of Thyroid Nodules: A Practical Guideline (2019 edition)

2021

Advanced Ultrasound in Diagnosis and Therapy

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“…The percentage of thyroid nodules classified as Bethesda category III on FNA varies, depending on the institutional experience, between 2.7 and 18% [7][8][9][10] . However, category III cases should not represent more than 7% of all thyroid FNA cases according to internationally accepted recommendations [5,6] .…”

Section: Introductionmentioning

confidence: 99%

Thyroid Atypia/Follicular Lesion of Undetermined Significance: Attitudes towards the Diagnosis of Bethesda System III Nodules

Muñoz

Arco²,

Ortega³

et al. 2016

Acta Cytologica

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Objectives: To review our institutional experience and to analyze the clinical decisions made after a cytological diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS). Study Design: This is a retrospective review of all thyroid fine-needle aspiration (FNA) cytologies performed in the Hospital Clínico San Carlos (Madrid) between 2010 and 2014. Results: One hundred thirty thyroid FNA were categorized as AUS/FLUS (5%). One hundred six (81.5%) patients were women, and the mean age was 59 years. In 61 patients a repeated FNA was performed (46%). Fifty-five nodules were treated surgically (42.3%), with a histopathological diagnosis of nodular hyperplasia in 36 cases (65%), adenoma in 11 (20%), and carcinoma in 8 (14.5%). In the group of nonsurgical patients (n = 75), a repeated FNA was performed in 43 (57.3%) cases. We found no statistically significant association between sex or age and clinical management (p = 0.13 and p = 0.31, respectively). Conclusions: Clinical management after an AUS/FLUS FNA diagnosis is erratic and does not match standardized management protocols. The AUS/FLUS classification has not led to new diagnostic tests in a relevant percentage of patients. The implementation of consensual institutional strategies could lead to better management of these cases.

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Implementation of a joint protocol for the management of thyroid nodules with a cytological diagnosis of follicular lesion of undetermined significance: experience in one hospital

Cited by 3 publications

References 11 publications

Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’

Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’

Ultrasound-guided Fine Needle Aspiration Cytological Examination of Thyroid Nodules: A Practical Guideline (2019 edition)

Thyroid Atypia/Follicular Lesion of Undetermined Significance: Attitudes towards the Diagnosis of Bethesda System III Nodules

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