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Nguyen, Gia‐Khanh; Lee, Mark W.; Ginsberg, Jody; Wragg, Tina; Bilodeau, Darcy

doi:10.1186/1742-6413-2-12

Cited by 90 publications

(26 citation statements)

References 54 publications

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“…AH was diagnosed if the cytology revealed the presence of colloids and varying numbers of follicular cells, and lymphocytic thyroiditis was diagnosed if there were follicular cells with scattered background lymphocytes. 5 23 …”

Section: Methodsmentioning

confidence: 99%

Focal Lymphocytic Thyroiditis Nodules Share the Features of Papillary Thyroid Cancer on Ultrasound

et al. 2015

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PurposeIt is often difficult to discriminate focal lymphocytic thyroiditis (FLT) or adenomatous hyperplasia (AH) from thyroid cancer if they both have suspicious ultrasound (US) findings. We aimed to make a predictive model of FLT from papillary thyroid cancer (PTC) in suspicious nodules with benign cytologic results.Materials and MethodsWe evaluated 214 patients who had undergone fine-needle aspiration biopsy (FNAB) and had shown thyroid nodules with suspicious US features. PTC was confirmed by surgical pathology. FLT and AH were confirmed through more than two separate FNABs. Clinical and biochemical findings, as well as US features, were evaluated.ResultsOf 214 patients, 100 patients were diagnosed with PTC, 55 patients with FLT, and 59 patients with AH. The proportion of elevated thyrotropin (TSH) levels (p=0.014) and thyroglobulin antibody (Tg-Ab) or thyroid peroxidase antibody (TPO-Ab) positivity (p<0.001) in the FLT group was significantly higher than that in the PTC group. Regarding US features, absence of calcification (p=0.006) and "diffuse thyroid disease" (DTD) pattern on US (p<0.001) were frequently seen in the FLT group. On multivariate analysis, Tg-Ab positivity, presence of a DTD pattern on US, and absence of calcification in nodules were associated with FLT with the best specificity of 99% and positive predictive value of 96%. In contrast, a taller than wide shape of nodules was the only variable significant for differentiating AH from PTC.ConclusionSuspicious thyroid nodules with cytologic benign results could be followed up with US rather than repeat FNAB, if patients exhibit Tg-Ab positivity, no calcifications in nodules, and a DTD pattern on US.

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Section: Methodsmentioning

confidence: 99%

Focal Lymphocytic Thyroiditis Nodules Share the Features of Papillary Thyroid Cancer on Ultrasound

et al. 2015

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“…Sampling of this hemorrhagic fluid with sparse tumor cells may result in false interpretation as a benign cyst. [30] In the present case, suggestion for surgical excision had been given by the pathologist in order to rule out an underlying malignancy, which led to timely surgery and saved the patient of undue complications of PTC.…”

Section: Discussionmentioning

confidence: 90%

An analysis of trends of incidence and cytohistological correlation of papillary carcinoma of the thyroid gland with evaluation of discordant cases

Sharma

2016

J Cytol

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Background:The role of fine-needle aspiration cytology (FNAC) in thyroid nodules has been well-studied but there is a paucity of studies solely involving papillary thyroid carcinoma (PTC). The diagnostic criteria for PTC are established but still there is a worrisome possibility of false positive and false-negative results, which can have a serious impact on patient care. This article correlates the cytological and histological diagnosis of PTC with an eventual aim of analyzing the cause of false positive and false negative results in order to prevent misdiagnosis. An increase in the incidence of PTC in the younger population has been noted.Aims:To analyze the epidemiological trends and cytohistological correlation of PTC and evaluate the discordant cases and pitfalls of FNAC.Materials and Methods:Seventy-two cases who had undergone both FNAC and histopathological examination (HPE) of the thyroid gland were selected. Age and sex distribution as well as cytohistological correlation were done for all the cases.Results:Cytohistological correlation was 81.94%. False positives were 5.56% and the false negative rate was 13.2%. Sensitivity was 86.7% and the positive predictive value was 93.6%. The peak age was 31-40 years among females and 41-60 years among males. Seven of our patients were <20 years of age (10%).Conclusion:FNAC is an indispensible tool for the early diagnosis of PTC. However, certain conditions of the thyroid gland can cause diagnostic dilemma. Awareness of pathologists regarding these pitfalls can prevent misdiagnosis and provide better patient care. Increasing the incidence of PTC with a more striking increase in the younger population makes early diagnosis all the more important owing to better prognosis in this age group.

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“…Diagnostic limitations of PTC on FNA has been debated as follows: (1) overlap of cytological patterns between neoplastic and non-neoplastic lesions, (2) overlap of cytological features between various neoplasms, (3) coexistence of non-neoplastic and neoplastic processes and multiple malignancies in the same gland. [ 24 ] In this study, we encountered similar difficulties, with follicular variant PTC being the most misdiagnosed entity. The cytomorphological overlap with follicular neoplasm and the absence/indiscernible nuclear features contributed to the misdiagnosis.…”

Section: Discussionmentioning

confidence: 92%

Cytomorphologic diversity of papillary thyroid carcinoma

Monappa

Kudva

2017

J Cytol

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Introduction:Cytologic features of papillary thyroid carcinoma (PTC) have been extensively documented in literature. However, PTC variants can prove to be diagnostically challenging on fine needle aspiration cytology (FNAC).Aims:To study the FNAC features of PTC and its variants and explore the causes for misdiagnosis.Materials and Methods:This is a retrospective study. All cases of histopathologically (HP) confirmed cases of PTC during a 2-year period (January 2012 to December 2013) with presurgical FNAC were included. The cytologic findings and FNAC diagnosis of each case were documented and compared with the HP report. The misdiagnosed cases were reviewed to look for any cytological clues and reasons for misdiagnosis.Results:A total of 58 cases were included. The overall diagnostic accuracy was 55.6% which improved to 64.8% on including suspicious for PTC cases. Follicular variant was the most misdiagnosed variant; 41.2% of the cases were called follicular neoplasm. Oncocytic variant showed cells with abundant eosinophilic cytoplasm along with bizarre giant cells. Warthin tumor-like variant showed cells with moderate eosinophilic cytoplasm with close apposition of lymphocytes in a background of reactive lymphocytes and lymphoid tangles. Cystic variant was paucicellular. Columnar cell variant showed tall columnar cells with nuclear stratification. Cribriform–morular variant showed syncytial sheets of cells and hyaline globules.Conclusions:PTC variants have distinct cytomorphological features. In some variants (follicular, columnar cell), nuclear grooves and inclusions may not be apparent, contributing to the diagnostic confusion. Benign nodule adjacent to the tumor can dominate the FNAC smear and lead to misdiagnosis.

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Cited by 90 publications

References 54 publications

Focal Lymphocytic Thyroiditis Nodules Share the Features of Papillary Thyroid Cancer on Ultrasound

Focal Lymphocytic Thyroiditis Nodules Share the Features of Papillary Thyroid Cancer on Ultrasound

An analysis of trends of incidence and cytohistological correlation of papillary carcinoma of the thyroid gland with evaluation of discordant cases

Cytomorphologic diversity of papillary thyroid carcinoma

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