Overview of Diagnostic Terminology and Reporting

Baloch, Zubair W.; Cooper, David S.; Schlumberger, Martin; Alexander, Erik K.

doi:10.1007/978-3-031-28046-7_1

Cited by 4 publications

(5 citation statements)

References 74 publications

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“…However, this was higher than the diagnostic accuracy of conventional PTC (65–79%) reported in previous studies ( 10 , 11 , 12 ). The aspiration cytology of lesions with marked cystic changes can be difficult to diagnose because of low cellularity and degenerative changes ( 1 , 4 , 13 ). Therefore, TBSRTC advocates that specimens with only foam cells should be classified as non-diagnostic because the possibility of CPTC cannot be ruled out ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…The aspiration cytology of lesions with marked cystic changes can be difficult to diagnose because of low cellularity and degenerative changes ( 1 , 4 , 13 ). Therefore, TBSRTC advocates that specimens with only foam cells should be classified as non-diagnostic because the possibility of CPTC cannot be ruled out ( 4 ). However, no CPTC nodules were classified as non-diagnostic due to cyst fluid in this study.…”

Section: Discussionmentioning

confidence: 99%

“…The following findings were obtained from the electronic medical records: age, sex, ultrasound and cytology reports, and postoperative course. The cytology reports were classified according to the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) ( 4 ). Pathological staging was based on the pathological TNM classification of the American Joint Committee on Cancer 8th Edition ( 5 ).…”

Section: Methodsmentioning

confidence: 99%

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Utility of solid area diameter in management of cystic papillary thyroid carcinoma

Suzuki,

Hirokawa,

Otsuka

et al. 2024

Endocrine Connections

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Papillary thyroid carcinoma (PTC) with marked cystic formation (CPTC) is not a subtype of PTC, and its clinical characteristics have not been fully investigated. This study aimed to clarify the clinical and pathological characteristics of CPTC and propose important indicators for its clinical management. 33 CPTC nodules with cystic areas occupying >50% of their volume were examined. Two matched controls (AC) were prepared, one with tumor diameter matched for whole tumor diameter (WTD) of CPTCs (WTD-MC) and the other with tumor diameter matched for solid area diameter (SAD) of CPTCs. The mean age of patients with CPTC was 55.2 years and significantly older than that in SAD-MCs. Of the CPTCs, 69.7% were classified as highly suspicious by ultrasonography, and the prevalence was lower than that in WTD-MCs (88.9%) and SAD-MCs (91.2%). Total thyroidectomy was performed in 69.7% of CPTC cases, which was significantly less frequent than that in WDT-MCs (91.7%), and similar to that in SAD-MCs (76.1%). Histologically, CPTCs exhibited two characteristic findings: invasion from the solid area into the surrounding normal thyroid tissue and granulation tissue around the cystic wall. The frequencies of the cases with pathological lateral node metastasis, extrathyroidal extension, and Ki-67 labeling index ≥5% in CPTCs were significantly lower than those in WTD-MCs and relatively similar with that in SAD-MCs. In the surgical strategy and prognosis of CPTC, the evaluation of tumor size is based on SAD rather than on WTD. We advocate measuring not only WTD but also SAD in CPTC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Utility of solid area diameter in management of cystic papillary thyroid carcinoma

Suzuki,

Hirokawa,

Otsuka

et al. 2024

Endocrine Connections

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“…In another example, some entities have different prevalence in children than adults, and this may subsequently affect malignancy rates 29 . Even though TBSRTC has reported the risks in the pediatric population, 8,9 this is still pending for the other systems. Notably, not only is heterogeneity associated with meta‐analytical values, but also the systematic reviews conducted in the context of ROM have identified an unclear or high risk of bias for many of the included primary studies.…”

Section: Problems Of Rom Terminology and Estimates In Nongynecologica...mentioning

confidence: 99%

Challenging the concept of “risk of malignancy” in cytology

Nikas,

Souza da Silva,

Sousa‐Pinto

et al. 2023

Cancer Cytopathology

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Several standardized systems for nongynecological cytopathology have been published following the successful implementation of The Bethesda System for Reporting Cervical Cytology. Each of these systems comprises a set of reporting categories accompanied by a risk of malignancy. However, in most cases, these risk of malignancy estimates have not been based on high‐quality evidence and often may not be consider proper “risks” (because they have been estimated based on cross‐sectional studies). This commentary discusses the problems related to the data used to generate these risks. To make nongynecological cytopathology reporting more evidence‐based, large‐scale prospective cohort studies and randomized trials, in addition to high‐quality systematic reviews and meta‐analyses, should be performed.

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“…Fine needle aspiration (FNA) is important in the work‐up of thyroid nodules 1,2 . There are six categories in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC): (I) Nondiagnostic, (II) Benign, (III) Atypia of Undetermined Significance, (IV) Follicular Neoplasm, (V) Suspicious for Malignancy, and (VI) Malignant 3,4 . Each category has an estimated risk of malignancy (ROM), which determines management 4 .…”

Section: Introductionmentioning

confidence: 99%

The histologic outcomes of indeterminate thyroid nodules with rat sarcoma mutations: A case series

Jones

Abendano

Turner

et al. 2023

Diagnostic Cytopathology

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Molecular testing is an adjunct test for thyroid fine needle aspirations with indeterminate diagnoses, with certain mutations showing a greater risk of malignancy (ROM). Rat sarcoma (RAS) point mutations are the most common alterations in indeterminate thyroid nodules. While they can have a high ROM, they are also found in benign disease. This study describes the histologic outcomes of indeterminate nodules with RAS mutations. Bethesda III and IV thyroid nodules with ThyroSeq results showing RAS mutations (NRAS, KRAS, and HRAS) were identified between November 1, 2018 and February 28, 2023. Baseline patient characteristics, ThyroSeq results, and surgical diagnoses were collected. We identified 18 nodules with RAS mutations from 17 patients. Fourteen were NRAS (isolated NRAS in 6; NRAS with other abnormalities [NRAS+] in 8); one was isolated KRAS; and three were HRAS with other abnormalities (HRAS+). NRAS Q16R was the most common amino acid change. Twelve cases had follow‐up. Two were malignant, a minimally invasive follicular carcinoma (NRAS+) and a papillary thyroid carcinoma, follicular variant (HRAS+). Three were noninvasive follicular thyroid neoplasms with papillary‐like nuclear features (NIFTP), 2 HRAS+ and 1 NRAS+. Four were follicular adenomas, one being atypical (3 NRAS+ and one isolated NRAS). One was an oncocytic adenoma (isolated NRAS). Two were nodular hyperplasias (isolated NRAS and NRAS+, respectively). Twenty‐eight percent of our RAS‐mutated nodules were malignant or NIFTP. All three HRAS‐mutated nodules were malignant or NIFTP. The three isolated RAS mutations with follow up were benign (adenomas or nodular hyperplasia). These findings were in line with the literature.

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Overview of Diagnostic Terminology and Reporting

Cited by 4 publications

References 74 publications

Utility of solid area diameter in management of cystic papillary thyroid carcinoma

Utility of solid area diameter in management of cystic papillary thyroid carcinoma

Challenging the concept of “risk of malignancy” in cytology

The histologic outcomes of indeterminate thyroid nodules with rat sarcoma mutations: A case series

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