The fine-needle aspiration biopsy efficacy of small thyroid nodules in the area of recently normalized iodine supply

Słowińska-Klencka, Dorota; Popowicz, Bożena; Lewiński, Andrzej; Sporny, Stanisław; Klencki, Mariusz

doi:10.1530/eje-08-0524

Cited by 11 publications

(19 citation statements)

References 41 publications

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“…This aspect, observed also by others [35,36], enlarges the opportunity for cytological examinations for small thyroid nodules.…”

Section: Prace Oryginalnesupporting

confidence: 63%

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

Zosin¹,

Balaş²

2013

Endokrynologia Polska

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Intriduction: The reported prevalence of chronic autoimmune thyroiditis associated with differentiated thyroid cancer (DTC) is heterogeneous. The aim of this study was to evaluate some epidemiological, clinical, sonographical and histological features of operated thyroid nodules with background diffuse autoimmune thyroiditis. Material and methods:The study included 411 cases with Hashimoto's thyroiditis (HT), of which 118 presented thyroid nodular disease (TND). Thyroidectomy was performed in 76 cases. Of these patients, 24 presented histologically confirmed DTC and 52 benign lesions. DTC types were as follows: papillary thyroid cancer (PTC) (n = 6), follicular variant of PTC (FVPTC) (n = 6), papillary microcarcinomas (n = 8), follicular thyroid carcinoma (n = 1) and the mixed form (classic PTC and FVPTC) (n = 3). The benign nodules were dominated by: follicular adenoma (48%), and colloid goitre (40.3%). Results:The sonographic features with predictive risk for malignancy in cases with HT associated with TND were represented by: solid composition, hypoechogenicity and microcalcifications. The characters of margins, the nodular shape and the type of vascularity do not seem to be as useful for identification of malignant nodules in HT. Fine needle-aspiration biopsy (FNAB) showed in DTC cases different cytological smears: malignant (ten), indeterminate (eight), benign (two), and non-diagnostic (four). In the group of benign nodules, the indeterminate smears represented also a significant percentage (n = 12). Conclusions: The incidence of TND associated with HT was 28.7%. Among 76 operated cases, 31.5% presented DTC. The accuracy of FNAB in the preoperative diagnosis showed higher sensitivity (90.0%) and specificity (61.5%) compared to sonographic criteria. StreszczenieWstęp: Podawane w literaturze dane na temat rozpowszechnienia przewlekłego autoimmunologicznego zapalenia tarczycy związanego ze zróżnicowanym rakiem tarczycy (DTC, differentiated thyroid cancer) cechuje duża rozpiętość. Celem badania była ocena wybranych cech epidemiologicznych, klinicznych, ultrasonograficznych i histopatologicznych operowanych guzków tarczycy u pacjentów z rozlanym autoimmunologicznym zapaleniem tarczycy. Materiał i metody: Do badania włączono 411 przypadków choroby Hashimoto (HT, Hashimoto thyroiditis), z czego 118 pacjentów zgłosiło się do lekarza z powodu choroby guzkowej tarczycy (TND, thyroid nodular disease). Tyroidektomię wykonano u 76 pacjentów, przy czym u 24 pacjentów badanie histopatologiczne wykazało DTC, a u pozostałych 52 -zmiany łagodne. Postacie DTC były następujące: rak brodawkowaty tarczycy (PTC, papillary thyroid cancer) (n = 6), wariant pęcherzykowy PTC (FVPTC, follicular variant of papillary thyroid cancer) (n = 6), mikroraki brodawkowate (n = 8), rak pęcherzykowy tarczycy (n = 1) i postać mieszana (klasyczny PTC i FVPTC) (n = 3). Większość guzków łagodnych stanowiły gruczolaki pęcherzykowe (48%) i wole koloidalne (40,3%). Wyniki: Cechy ultrasonograficzne związane z ryzykiem rozpoznania nowotworu złośl...

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“…This aspect, observed also by others [35,36], enlarges the opportunity for cytological examinations for small thyroid nodules.…”

Section: Prace Oryginalnesupporting

confidence: 63%

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

Zosin¹,

Balaş²

2013

Endokrynologia Polska

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“…Similarly, in other studies [14,17,28,30] males constituted 40%-50% and even more than 70% [15] of patients with metastasis to the thyroid gland. It should also be stressed that the percentage of males among patients with secondary thyroid tumours was much higher than the percentage of males among patients with primary thyroid cancers, which in our data was 11% [31].…”

Section: Prace Oryginalnecontrasting

confidence: 69%

Nowotwory wtórne ujawniane podczas BAC tarczycy — analiza częstości występowania i charakterystyka obrazu ultrasonograficznego

Wysocka

Małyska

Zadworny

et al. 2015

Endokrynologia Polska

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Introduction: Metastases to the thyroid are revealed at autopsy with a frequency of 2-24%; however, clinically they appear less frequently, at 0.1-3%. The aim of the study was analysis of the frequency of revealing metastases to the thyroid (TM) and to the regional lymph nodes (NM) (neoplasms other than primary thyroid tumours) in preoperative diagnostics of the thyroid in patients with positive (C+) and negative (C-) history of cancer; analysis of ultrasound (US) images of metastases. Material and Methods: Results of US/fine needle aspiration (FNA) of the thyroid in 1276 C+ patients and 18,947 C-patients. Results: TM and NM were diagnosed/suspected in 57 patients (0.3% of all examined; 40 TM, 22 NM, 5 both), and their frequency was higher in the C+ group (2.9% vs. 0.1% in C-, p < 0.0001). In the C+ group, diagnosis of metastasis accounted for 72.3% of FNA results from the category "malignant neoplasm"; in the C-group it was 9.5% (p < 0.0001). The highest relative frequency of TM was found for cancers infiltrating thyroid by direct extension (> 10%), lymphomas (7.7%), and kidney (5.3%) and lung (4.9%) cancers. The mean age of patients with metastasis (63.9 ± 11.7 years) was similar to that of the C+ group and higher than the C-group (53.9 ± 14.8 years, p < 0.0001). The proportion of males among the patients with metastasis was three-fold higher than in the patients without metastasis (p < 0.0001). TM lesions presented suspicious borders in US twice as often as primary cancers . Conclusions: Metastases to the thyroid are rare; however, for patients with a history of cancer, their presence is more likely than primary thyroid cancer. US/FNA imaging of metastases allows the selection of patients requiring further diagnostics and treatment.

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“…Nowadays, there is no endemic goitre in children and adolescents, but the prevalence of goitre and follicular lesions in the elder population is considerable. The occurrence of chronic thyroiditis features in cytological specimens is also observed (3,4,8).…”

Section: Introductionmentioning

confidence: 83%

“…Difficulties in diagnosis of follicular lesions are the main limitation of FNAB, especially in endemic regions. In such areas, patients with nodular goitre and follicular neoplasms (FNs) predominate and the percentage of FNABs with equivocal diagnoses is high, but in contrast to iodine-rich regions, the risk of cancer related to such outcomes is lower -'follicular lesions' correspond more frequently to non-neoplastic hyperplastic nodules or follicular adenoma than to thyroid cancers (3,4). The introduction of iodine prophylaxis is related to a gradual decline in the occurrence of non-neoplastic nodular goitre as well as of FNs, but this process lasts for many years (5,6).…”

Section: Introductionmentioning

confidence: 99%

Low malignancy risk of thyroid follicular lesion of undetermined significance in patients from post-endemic areas

Słowińska-Klencka¹,

Wozniak²,

Wojtaszek³

et al. 2013

European Journal of Endocrinology

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Objective: New classification of the thyroid fine-needle aspiration biopsy (FNAB) results tries to stratify the risk of malignancy of thyroid follicular lesions using 'follicular lesion of undetermined significance' (FLUS) subcategory. Clinical significance of this category in the endemic (or post-endemic) areas has not been clearly established. Design: The aim of the study was to determine the risk of malignancy for FLUS as well as to evaluate ultrasound (US) malignancy risk features (MRF) in such nodules in comparison with 'suspicious for neoplasm' (SFN) and 'benign lesions' (BL). Methods: The US images and cytological diagnoses of 589 thyroid follicular lesions were analysed from January 2010 to July 2012. Cytological follow-up was assessed in 110 cases and surgical one in 100 cases. Results: FLUS was diagnosed in 340 cases (3.8% of all cytological diagnoses and 57% of thyroid follicular lesions). Altogether, clinical and/or surgical follow-up revealed thyroid cancer in 3.2% patients with FLUS nodules. Repeat FNAB led to more specific diagnosis in 74.4% of FLUS (3.5%, papillary cancers or their suspicion; 2.3%, SFN; 68.6%, BL). The histopathological examination showed thyroid cancer in 6.4% cases of FLUS and 7.0% of SFN and follicular adenoma in 8.5% of FLUS and 11.6% of SFN (NS, FLUS vs SFN). FLUS showed MRF of intermediate values between BL and SFN; SFN more often than FLUS showed at least two MRF (53 vs 30%, P!0.0001). Conclusions: The risk of cancer in FLUS in areas with recently corrected iodine supply is low. In such areas, repeated biopsy leads to more precise cytological diagnosis in about 3/4 cases.

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The fine-needle aspiration biopsy efficacy of small thyroid nodules in the area of recently normalized iodine supply

Cited by 11 publications

References 41 publications

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

Nowotwory wtórne ujawniane podczas BAC tarczycy — analiza częstości występowania i charakterystyka obrazu ultrasonograficznego

Low malignancy risk of thyroid follicular lesion of undetermined significance in patients from post-endemic areas

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