Infarction in a Thyroid Nodule After Fine Needle Aspiration

Das, Dilip K.; Janardan, Chandrashekar; Pathan, Shahed K.; George, Sara S.; Sheikh, Zafar A.

doi:10.1159/000325386

Cited by 17 publications

(3 citation statements)

References 15 publications

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“…Infarctions of thyroid Hurthle cell neoplasms and papillary carcinomas post FNA have also been reported [ 3 , 6 ]. Our patient had an oncocytic morphology.…”

Section: Discussionmentioning

confidence: 99%

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Papillary carcinoma? or Reactive papillary changes? in the infarcted thyroid nodule after FNA and accompanying synchronous brain stem astrocytoma: Case report and literature review

Göret

Özkan

et al. 2017

North Clin Istanbul

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A 22-year-old patient underwent fine needle aspiration of a nodule at the outer center of the right lobe of the thyroid, and it was reported to be Bethesda system category IV, Hurthle cell follicular neoplasia. The patient, who persented to Onsekiz Mart University Research and Application Hospital, underwent surgery. During right total thyroidectomy, an almost totally infarcted nodule and papillary structures around these infarcted areas were detected. Herein, we report on diagnostic challenges faced in confirming whether the infarcted nodule was a case of reactive papillary changes or an underdiagnosed papillary carcinoma and how the challenges were overcome using immunohistochemistry analysis and molecular genetic testing. In addition, we examined the case along with a literature review because an accompanying synchronous brain stem astrocytoma was detected in the patient after thyroidectomy.

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“…Infarctions of thyroid Hurthle cell neoplasms and papillary carcinomas post FNA have also been reported [ 3 , 6 ]. Our patient had an oncocytic morphology.…”

Section: Discussionmentioning

confidence: 99%

“…Batsakis et al classified post-FNA tissue effects into three categories: [ 1 ] micronecrosis and hemorrhage, where diagnostic properties can be recognized; [ 2 ] macronecrosis without diagnostic properties; and [ 3 ] reactive proliferative areas with macronecrosis and micronecrosis and stromal cells [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Papillary carcinoma? or Reactive papillary changes? in the infarcted thyroid nodule after FNA and accompanying synchronous brain stem astrocytoma: Case report and literature review

Göret

Özkan

et al. 2017

North Clin Istanbul

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“…As a result, there may have been a time lapse between the initial FNA and the patients' enrollment in the study. During this interval, the size of the nodules could have changed due to factors such as the accumulation of intranodular cystic fluid, inflammation following FNA, and/or micro-bleeding [23,[27][28][29]. Despite this potential limitation, it is noteworthy that the current study represents the largest cohort of exclusively enrolled patients with PTMC and investigates the discrepancy between preoperative and postoperative size measurements in relation to clinical outcomes.…”

Section: Article In Pressmentioning

confidence: 97%

Diagnostic Accuracy of Preoperative Radiologic Findings in Papillary Thyroid Microcarcinoma: Discrepancies with the Postoperative Pathologic Diagnosis and Implications for Clinical Outcomes

Li,

Kwon,

Choi

et al. 2024

Endocrinol Metab

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Background:The diagnostic accuracy of preoperative radiologic findings in predicting the tumor characteristics and clinical outcomes of papillary thyroid microcarcinoma (PTMC) was evaluated across all risk groups. Methods: In total, 939 PTMC patients, comprising both low-risk and non-low-risk groups, who underwent surgery were enrolled. The preoperative tumor size and lymph node metastasis (LNM) were evaluated by ultrasonography within 6 months before surgery and compared with the postoperative pathologic findings. Discrepancies between the preoperative and postoperative tumor sizes were analyzed, and clinical outcomes were assessed. Results: The agreement rate between radiological and pathological tumor size was approximately 60%. Significant discrepancies were noted, including an increase in tumor size in 24.3% of cases. Notably, in 10.8% of patients, the postoperative tumor size exceeded 1 cm, despite being initially classified as 0.5 to 1.0 cm based on preoperative imaging. A postoperative tumor size >1 cm was associated with aggressive pathologic factors such as multiplicity, microscopic extrathyroidal extension, and LNM, as well as a higher risk of distant metastasis. In 30.1% of patients, LNM was diagnosed after surgery despite not being suspected before the procedure. This group was characterized by smaller metastatic foci and lower risks of distant metastasis or recurrence than patients with LNM detected both before and after surgery. Conclusion: Among all risk groups of PTMCs, a subset showed an increase in tumor size, reaching 1 cm after surgery. These cases require special consideration due to their association with adverse clinical outcomes, including an elevated risk of distant metastasis.

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Infarction of Papillary Thyroid Carcinoma After Fine-Needle Aspiration

Liu

Ahmed

Bhuta

et al. 2014

JAMA Otolaryngol Head Neck Surg

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Although infarction of PTC after FNA occurs infrequently, it may lead to difficulties in histologic diagnosis. Awareness of this phenomenon and its histologic associations, along with careful reevaluation of the FNA and surgical specimens, is important for appropriate diagnosis and subsequent treatment. At this point, infarction in PTC should not alarm a head and neck surgeon to change management, but future prospective studies with a large population of patients with infarcted PTCs are needed to establish the impact of infarction on differences in treatment outcomes for therapies that may be used in PTCs.

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Infarction in a Thyroid Nodule After Fine Needle Aspiration

Cited by 17 publications

References 15 publications

Papillary carcinoma? or Reactive papillary changes? in the infarcted thyroid nodule after FNA and accompanying synchronous brain stem astrocytoma: Case report and literature review

Papillary carcinoma? or Reactive papillary changes? in the infarcted thyroid nodule after FNA and accompanying synchronous brain stem astrocytoma: Case report and literature review

Diagnostic Accuracy of Preoperative Radiologic Findings in Papillary Thyroid Microcarcinoma: Discrepancies with the Postoperative Pathologic Diagnosis and Implications for Clinical Outcomes

Infarction of Papillary Thyroid Carcinoma After Fine-Needle Aspiration

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