Pitfalls in the cytological assessment of thyroid nodules

Canberk, Şule; Firat, Pınar; Schmitt, Fernando

doi:10.5146/tjpath.2015.01312

Cited by 21 publications

(60 citation statements)

References 48 publications

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“…According to their study, convoluted nuclei might be a new clue of PTC. In concordance with some studies, such as Stamaki et al [6], Canberk et al [14], Kefeli et al [18], our study revealed that nucleus of PTC appeared to be large, oval, hypochromic, with small eosinophilia nucleoli, nuclear groove and pseudo inclusion. Dark-staining, "sticky" colloid (chewing gum-like) also can be observed but this finding is non-specific [14].…”

Section: Discussionsupporting

confidence: 80%

“…In some of them, small nucleolus might be observed and there were no colloid ( Figure 9). In concordance with the study of Canberk et al [14], main findings were uniformly distributed cells, salt and pepper sign of chromatin, sporadically existence of amyloid on the ground, plasmocytoid, spindle, polygonal cells in TP smears from the medullary carcinoma. Presence of cellular structure in the aspirate is an important finding.…”

Section: Discussionsupporting

confidence: 74%

“…avoid misdiagnosis in the presence of nuclear groove, expanded and hyper-chromasia. In their study, Canberk et al [14] indicated reactive reparative changes in nucleus expanding, presence of fine chromatin, small nucleolus, suspicious grooves and pseudo inclusion-like nuclear hole and similar cytomorphologic characteristics are found hyperplastic lesions. LiVolsi's study [15] stated that abnormalities in benign lesions morphology were found in degenerative nodules, Graves' disease and nodular goitre although it is most often seen in Hashimoto's thyroiditis.…”

Section: Discussionmentioning

confidence: 99%

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Cytomorphologic Evaluation of the Thin Prep for Fine Needle Aspiration of the Fresh Thyroidectomy Specimens

BaAA¹,

Keser²,

Erenler³

2017

J Cytol Histol

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Objective: This study aimed to compare cytomorphology of ThinPrep Papanicolaou (TP PAP) method with the macroscopic-microscopic findings of the nodules on fresh thyroidectomy specimens.Study Design: A total of 75 thyroid surgical specimens were included in our study. Fine Needle Aspiration Biopsy (FNAB) of specimens was performed by a pathologist. Aspirate was taken into TP liquid and stained with PAP. We defined cytological findings, compatible with macroscopic-microscopic findings. Results:In cytologic evaluation 108 nodules were diagnosed benign, while 18 nodules were malignant and 2 cystic nodules were insufficient. Cytological diagnosis was compatible with histologically benign a total of 110 nodules, and 18 malignant nodules. Nuclear groove/irregular nuclear membrane, nuclear overlap/crowding, nuclear enlargement, nuclear pseudoinclusion, pale/fine chromatin are determined as statistically significant cytological parameters in malignant cases. Conclusion:FNAB and the histo-morphological and TP PAP cytological slides were evaluated by pathologists at every stage of biopsy process. It is clearly understood how important it is to obtain adequate cells from the benign or malignant thyroid nodules with this method. Although controversial opinions among the cytopathologists regarding the association using TP method are present, in this study we revealed that TP method is easy to use for FNAB.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cytomorphologic Evaluation of the Thin Prep for Fine Needle Aspiration of the Fresh Thyroidectomy Specimens

BaAA¹,

Keser²,

Erenler³

2017

J Cytol Histol

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“…Owing to this reason, clinicians must keep the pathologist informed and immunohistochemistry must be performed. 11 In the diagnosis of MTC, calcitonin, chromogranin A, or CEA immunostaining can be used. 8 Calcitonin is an important molecule because it has a very significant role in the diagnosis and clinical followup of patients with MTC.…”

Section: Discussionmentioning

confidence: 99%

“…One of these is a paraganglioma-like pattern. 9,11 Another type of NE cancer is an extra-adrenal parasympathetic paraganglioma that is usually found in the head and neck region. These type of paragangliomas are usually non-functional tumors (95%).…”

Section: Introductionmentioning

confidence: 99%

Serum Calcitonin Levels may be Used in the Differential Diagnosis of Vagal Glomus

Güneş¹,

Akarsu²,

Sar³

et al. 2017

Otolaryngol Open J

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Medullary thyroid carcinoma (MTC) is a neuroendocrine (NE) tumor and is very rarely observed. MTC originates from the parafolliculer C cell and can show various histopathological patterns. Head and neck paragangliomas are seen rarely. Paragangliomas in the head and neck region are usually non-functional. MTC should be considered in the differential diagnosis of paragangliomas in the head and neck region. A high degree of clinical investigation is needed to determine the rare potential etiology underlying this condition. Because patients with MTC can present different clinical manifestations, otolaryngologist must be aware of MTC and its rare medical presentations. This case presented here highlights the importance of serum calcitonin levels in the differential diagnosis of paragangliomas in the head and neck region.

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Preoperative diagnosis of thyroid nodules: An integrated multidisciplinary approach

Eloy¹,

Russ²,

Suciu³

et al. 2022

Cancer Cytopathology

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Because of the coronavirus disease 2019 pandemic, the joint session between the European Society of Pathology Working Groups of Endocrine Pathology and Cytopathology, initially scheduled in Glasgow (United Kingdom) for September 1, 2020, was converted into a virtual meeting that took place on December 8, 2020. Chaired by Catarina Eloy (Porto, Portugal) and Philippe Vielh (Paris, France), this session was entitled "Diagnosis of Thyroid Nodules: An Integrated Multidisciplinary Approach." The title reflects how a combined approach is critical to helping us better characterize thyroid nodules preoperatively. Gilles Russ (Paris, France), a radiologist specializing in thyroid ultrasonography, described the various systems for stratifying the risk of malignancy (ROM) in adults, and he was followed by Voichita Suciu (Villejuif, France), an interventional cytopathologist, who reported the extensive experience of the one-stop clinic set up at the Gustave Roussy Cancer Center. Three additional cytopathologists focused on specific thyroid cytopathology issues: Sarah J. Johnson (Newcastle Upon Tyne, United Kingdom) illustrated new entities and potential pitfalls, Esther Diana Rossi (Rome, Italy) talked about indeterminate cytology (especially atypia), and Liron Pantanowitz (Ann Arbor, Michigan) discussed the potential of using both molecular and artificial intelligence (AI) tools. This report summarizes the main ideas and data shared between speakers and attendees during this successful session. RadiologySince the late 2010s, thyroid ultrasound (US) has evolved in 2 directions. First, risk stratification of thyroid nodules with US emerged as a new concept. Second, during the same period, thermal ablation was applied for treating large thyroid nodules and cancer recurrences. In 2017, the European Thyroid Association issued guidelines for US malignancy risk stratification in adults: the European Thyroid Imaging and Reporting Data System (EU-TIRADS). 1 Those guidelines include a standardized illustrated lexicon and report to improve interobserver description agreement. The core of the system is the score that allows a quantitative approach to ROM. It ranges from 1 to 5 with an increasing ROM: 1 is for normal, 2 is for benign (ROM ≈ 0%), 3 is for low risk (ROM ≤ 4%), 4 is for intermediate risk (ROM = 6%-17%), and 5 is for high risk (ROM = 26%-87%). Determining the score is mainly based on looking for features of high suspicion (a taller than wide shape, irregular margins, microcalcifications, and marked hypoechogenicity) and, if none of these are present, on the echogenicity of the solid component of the lesion. A score of 2 corresponds to simple cysts and mainly spongiform nodules. Elsewhere, similar systems have been issued, including the British Thyroid Association System, 2 the American College of Radiology Thyroid Imaging and Reporting Data System (ACR-TIRADS), 3 the American Thyroid Association System, 4 and the Korean Thyroid Imaging and Reporting Data System (K-TIRADS). 5 Besides malignancy risk stratification, these syst...

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Pitfalls in the cytological assessment of thyroid nodules

Cited by 21 publications

References 48 publications

Cytomorphologic Evaluation of the Thin Prep for Fine Needle Aspiration of the Fresh Thyroidectomy Specimens

Cytomorphologic Evaluation of the Thin Prep for Fine Needle Aspiration of the Fresh Thyroidectomy Specimens

Serum Calcitonin Levels may be Used in the Differential Diagnosis of Vagal Glomus

Preoperative diagnosis of thyroid nodules: An integrated multidisciplinary approach

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