Malignancy Rates of Thyroid Cytology: Cyst Fluid Benign or Non-Diagnostic?

Abstract

BackgroundWe sought to investigate subgroup distribution using Bethesda classification and risks for malignancy. We also compared the malignancy risk of cases that were denoted as non-diagnostic due to cystic contents, with cases that were denoted as non-diagnostic due to presence of other features.Material/MethodsThe study included pathology test results of 1,440 thyroid nodule samples diagnosed using Bethesda classification. Results of 305 thyroidectomy excision specimens from these patients were also compared with cytology results to determine the frequency of malignancy. The non-diagnostic group was divided into two categories: those with cystic contents, and others. Malignancy rates were separately calculated for the two groups, and compared with the other classification groups.ResultsDistribution of malignancy rates by Bethesda classification were as follows: non-diagnostic 12.5% (6/48), benign 1.5% (3/198), atypia of undetermined significance/follicular lesion of undetermined significance (AFLUS) 9% (1/11), suspicious for follicular neoplasm (SFN) 37.5% (3/8), suspicious malignancy 70% (8/26), malignancy 100% (14/14).ConclusionsDespite the limited number of cases, our study concluded that cystic content was closer to the benign category than the non-diagnostic category if the assessment was based on malignancy rates. In this group, similar to aspirations containing plenty of lymphocytes that indicates colloid or lymphocytic thyroiditis, it is still controversial whether criterion for adequacy of follicular epithelial cells should be sought, or if they should be regarded as benign in order to prevent unnecessarily performance of repeat aspirations.

Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis

“…We excluded a further 233 studies and finally selected 38 studies, which included 145,066 thyroid nodules, for meta‐analysis (Fig. ) . Among the included studies, 4 were prospective and 34 were retrospective.…”

Comparison of physical examination and simultaneous ultrasonography results in patient in whom thyroid gland nodule was diagnosed on scintigraphy previously and referred to general surgery clinics

“…The risk in mixed lesions is up to 15% [11] . A recent study also reported that cystic lesions regarded as non-diagnostic on FNA are more prone to be benign [12] . We found nodules with cystic degeneration only in one patient, but this could not be understood on PE.…”

Risk of malignancy and clinical outcomes of cyst fluid only nodules in the thyroid based on ultrasound and aspiration cytology

“…The ROM of CFO nodules have reportedly ranged from 0% to 14.3% 6,[16][17][18]. Güney and Şahiner reported that, in their study, malignancy was not detected in any of the specimens taken from 14 out of 48 patients who were diagnosed with CFO nodules and had undergone operations 8. According to a report by Jaragh et al, of the 76 CFO cases with subsequent thyroidectomy, 10 cases (13.2%) had an ipsilateral diagnosis of papillary carcinoma measuring ≥1.0 cm 7.…”

“…5 Thus, CFO nodules have two different clinical managements that can be determined based on ultrasound findings. To date, the availability of extensive research focusing on CFO nodules is limited, [6][7][8] and the ROM in CFO nodules has not been well established. The purpose of the current study was to review cytological and ultrasound findings of CFO nodules, define the ROM, and determine the recommended clinical management of CFO nodules.…”

“…To date, the availability of extensive research focusing on CFO nodules is limited,[6][7][8] and the ROM in CFO nodules has not been well established. To date, the availability of extensive research focusing on CFO nodules is limited,[6][7][8] and the ROM in CFO nodules has not been well established.…”