Multiple squamous cells in thyroid fine needle aspiration: Friends or foes?

Gage, Heather; Hubbard, Elizabeth W.; Nodit, Laurentia

doi:10.1002/dc.23512

Cited by 15 publications

(19 citation statements)

References 12 publications

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“…Four of their cases had benign surgical follow‐up, including 2 branchial cleft/epidermoid cysts, 1 thyroglossal duct cyst, and 1 benign cyst with denuded lining. The other 5 cases had stable follow‐up of unspecified duration . Their data, together with the findings of the current study, support the conclusion that thyroid FNA specimens comprised almost exclusively of mature squamous cells represent benign lesions.…”

Section: Discussionsupporting

confidence: 86%

“…In their series of 15 thyroid FNA specimens with squamous cells, Gage et al included 9 cases that would have met the inclusion criteria used in the current study. Four of their cases had benign surgical follow‐up, including 2 branchial cleft/epidermoid cysts, 1 thyroglossal duct cyst, and 1 benign cyst with denuded lining.…”

Section: Discussionmentioning

confidence: 99%

“…A thyroid nodule comprised almost exclusively of mature, benign‐appearing squamous cells is an uncommon finding in fine‐needle aspiration (FNA) biopsies of thyroid nodules . To the best of our knowledge, the question of how to report such specimens was not addressed by the first edition of The Bethesda System for Reporting Thyroid Cytopathology .…”

Section: Introductionmentioning

confidence: 99%

“…A thyroid nodule comprised almost exclusively of mature, benign-appearing squamous cells is an uncommon finding in fine-needle aspiration (FNA) biopsies of thyroid nodules. 1 To the best of our knowledge, the question of how to report such specimens was not addressed by the first edition of The Bethesda System for Reporting Thyroid Cytopathology. 2 Although technically these FNA specimens might be classified as nondiagnostic/unsatisfactory due to insufficient follicular cellularity, we also have noted them reported variously as benign, atypia of undetermined significance, and even suspicious for malignancy with a note stating that a well-differentiated squamous cell carcinoma, either metastatic or primary, cannot be excluded.…”

Section: Introductionmentioning

confidence: 99%

“…The other 5 cases had stable follow-up of unspecified duration. 1 Their data, together with the findings of the current study, support the conclusion that thyroid FNA specimens comprised almost exclusively of mature squamous cells represent benign lesions. As such, they can be reported as benign and should be managed as per standard guidelines for benign nodules.…”

mentioning

confidence: 99%

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Thyroid FNA biopsies comprised of abundant, mature squamous cells can be reported as benign: A cytologic study of 18 patients with clinical correlation

Chen

Renshaw

Faquin

et al. 2018

Cancer Cytopathology

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Thyroid FNA biopsies comprised of abundant, mature squamous cells can be reported as benign: A cytologic study of 18 patients with clinical correlation

Chen

Renshaw

Faquin

et al. 2018

Cancer Cytopathology

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Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

Nauschuetz¹,

Ogden²,

Starling³

et al. 2017

Diagnostic Cytopathology

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Pharyngoesophageal diverticula (PED) of the Zenker's and Killian-Jamieson types arise in close proximity to the thyroid gland, and may rarely be confused with a thyroid nodule on ultrasonography. In this brief report, we detail the cytologic, clinical, and radiologic findings of three PED that were thought to be thyroid nodules, and were subjected to fine-needle aspiration (FNA). The patients were females with an age range of 51-64 years. All three patients had multiple thyroid nodules, and two patients reported symptoms attributable to the diverticulum. Nodule sizes ranged from 1.0 to 2.7 cm, and either the right or left thyroid lobe could be involved. Microcalcifications were present by ultrasonography in all three cases. FNA of these thyroid nodule mimics showed squamous cells with granular or amorphous debris, bacterial and/or fungal colonies, inflammation, and food particles. These cytologic features, particularly the presence of vegetable or meat fragments, are characteristic, and have also been reported in the few previous reports of PED. The presence of a diverticulum was confirmed with imaging studies in all our patients. Although a rare occurrence, the inadvertent FNA of a PED masquerading as a thyroid nodule is important to recognize, as a recommendation for appropriate radiologic studies could potentially avoid inappropriate therapy for thyroid disease.

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Squamous Cells in Thyroid Cytology and Their Clinical Significance: A Multi‐Institutional Study

Pedro,

Harjunpää,

Young

et al. 2024

Diagnostic Cytopathology

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BackgroundSquamous cells are uncommon in thyroid fine needle aspirations (FNAs) presenting diagnostic challenges. We report our multi‐institutional experience.Materials and MethodThe electronic data were searched for thyroid FNAs containing squamous cells at the Johns Hopkins Medicine, New York University Langone Hospital, United States, and Fimlab Laboratories, Finland (2001–2023). The patients' demographics, clinical history, and pathologic diagnosis were recorded.ResultsOne hundred and seven cases (103 patients) were identified 35 males and 68 females (median age 58 years). Forty‐eight cases (44.9%) were malignant, primary carcinomas with squamous features, such as anaplastic thyroid carcinoma (ATC), and metastatic or directly invasive squamous cell carcinomas (SqCC) including oral, oropharyngeal (HPV‐related), esophageal, and laryngeal SqCC. Twenty‐seven cases (25.2%) contained benign squamous cells with cystic background, suggestive of developmental cysts. Nineteen cases (17.8%) contained metaplastic benign squamous cells within an adenomatoid nodule. Seven cases (6.5%) contained atypical squamous cells. Four cases (3.7%) showed squamous cells with bacterial or fungal organisms, suggestive of esophageal fistula/diverticulum, and two cases (1.9%) contained benign squamous cells with unknown source. Thirty‐six cases had surgical follow‐up, 33 (91.7%) were concordant (23 metastatic or directly invasive SqCC, 8 undifferentiated/ATC, and 10 papillary thyroid carcinoma). Ancillary studies were used confirming HPV‐related SqCC, or therapeutic targets (BRAF V600E), with highly variable staining in ATC.ConclusionSquamous cells in thyroid FNAs carry a broad differential diagnosis with variable prognoses. It is crucial to interpret squamous cells in the context of clinical and radiographic findings for optimal patient care.

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Multiple squamous cells in thyroid fine needle aspiration: Friends or foes?

Cited by 15 publications

References 12 publications

Thyroid FNA biopsies comprised of abundant, mature squamous cells can be reported as benign: A cytologic study of 18 patients with clinical correlation

Thyroid FNA biopsies comprised of abundant, mature squamous cells can be reported as benign: A cytologic study of 18 patients with clinical correlation

Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

Squamous Cells in Thyroid Cytology and Their Clinical Significance: A Multi‐Institutional Study

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