Trends in Thyroid Fine-Needle Aspiration Cytology Practices: Results From a College of American Pathologists 2016 Practice Survey

Mais, Daniel D.; Crothers, Barbara A.; Davey, Diane D.; Natale, Kristen E.; Nayar, Ritu; Souers, Rhona J.; Blond, Barbara; Hackman, Sarah; Tworek, Joseph A.

doi:10.5858/arpa.2018-0429-cp

Cited by 14 publications

(5 citation statements)

References 31 publications

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“…This is higher than the typically accepted rates reported in the literature of 6‐18% and 10‐40%, respectively . The frequency of indeterminate cytology as well as the malignancy rate for these nodules is known to vary by institution, and similar malignancy rates for nodules interpreted as atypia of undetermined significance/follicular lesion of undetermined significance have been reported . However, the overall higher than expected malignancy rates in nodules with indeterminate cytology in our study may limit the generalizability of our results to institutions where the malignancy rate for these nodules is lower.…”

Section: Discussioncontrasting

confidence: 72%

Method of detection of thyroid nodules: correlation with frequency of fine‐needle aspiration and malignancy rate

et al. 2019

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Background: Thyroid nodules are commonly found by screening, and the clinical implications are unclear. Methods: We retrospectively studied 460 patients who were evaluated for thyroid nodules. Medical records were queried to determine how the nodules were detected. We compared the rates of fine needle aspiration (FNA) and malignancy between nodules detected clinically, incidentally on imaging, or by screening. Results: Nodules were detected clinically in 184 patients (40%), incidentally in 121 patients (26%), and by screening in 155 patients (34%). The rates of FNA and malignancy were lower for patients with nodules detected by screening (28% and 1%, respectively), compared to patients with clinically apparent nodules (75% and 15%) and patients with incidental nodules (69% and 8% [P < .001]). Conclusion: Thyroid nodules detected via screening has a lower rate of FNA and is less likely to be diagnosed as a malignancy compared to nodules detected clinically or incidentally on imaging. Thyroid ultrasound examinations should be reserved for nodules that are clinically apparent or to evaluate nodules found incidentally on imaging.

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Section: Discussioncontrasting

confidence: 72%

Method of detection of thyroid nodules: correlation with frequency of fine‐needle aspiration and malignancy rate

et al. 2019

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“…The literature on CBs in AUS/FLUS cases is limited. According to the College of American Pathologists 2016 Practice Survey, 69% of respondents used conventional CBs in thyroid cytology diagnostics [27]. In a large institutional study by VanderLaan, only 7.5% of material was adequate to proceed specimen into CB [28].…”

Section: Discussionmentioning

confidence: 99%

The Role of Cell Blocks and Immunohistochemistry in Thyroid Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Bethesda Category

Abram¹,

Huhtamella²,

Kalfeřt³

et al. 2021

Acta Cytologica

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Introduction: Thyroid cytology is a widely accepted tool in the clinical triaging of nodular lesions. Cell blocks (CBs) can help in the diagnosis of atypical lesions, namely, thyroid Bethesda category of Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS). Methods: In a series of 224 AUS/FLUS thyroid samples with CB, we studied CB cellularity and feasibility of 3 immunohistochemical markers (cytokeratin 19 [CK19], HBME-1, and galectin-3) apart and in combination. Results: The CBs were non-diagnostic in 34 cases. Twenty-four CBs contained <10 cells, 45 CBs 10–50 cells, and 121 CBs >50 cells. Notably, more cellularity was found in CBs performed by plasma-thrombin and in-house techniques (p < 0.001). The diagnostic accuracy to detect malignancy was 65.1% for CK19, 72.1% for HBME-1, and 70.3% for galectin-3. Conclusion: In conclusion, CB cellularity is essential for successful immunohistochemistry application and further diagnostic workup of AUS/FLUS cases.

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“…In some institutions, cell-block materials are performed routinely per the College of American Pathologists 2016 Practice Survey, which reported 73.7% laboratories (575 out of 735 respondents) processing cell-blocks as a common cytopreparation. [ 8 ] Nevertheless, limited literatures support their pivotal role in the diagnostic efficacy while others indicate their disadvantages such as labor intensive, skill dependent, and waste of resources. [ 9 , 10 ] This study focuses on the applicability of cell-block implementation in increasing diagnostic effectiveness of thyroid FNA.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic value of add-on thyroid cell block in the evaluation of thyroid lesions

Saharti¹

2023

Cytojournal

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Objectives: Fine-needle aspiration (FNA) cytology plays a pivotal role in diagnosing thyroid nodules. Imaging assessment, followed by thyroid lesion sampling, is a widely applied clinical practice. Tissue fragments remnants are retrieved in cell-block providing an adjunct diagnostic tool for histopathology visualization and use of ancillary testing. This study aimed to evaluate whether the auxiliary application of cell-block adds to the diagnostic accuracy of the thyroid FNA. Material and Methods: A total of 252 thyroid FNA cases between (2020 and 2021) were reviewed from patients aged 18–76. Of those, 150 cell-blocks were recovered and examined to assess their utility. Following categories were plotted during cell-blocks revision: (A) Inadequate material retrieved; (B) cell-block shows similar features along with their accompanying smears; and (C) value added to cytology diagnosis when using cell-block. Results: The distribution of cell-blocks according to the aforementioned classification are as follows: A — non-diagnostic 63%, B — similar observation seen in both preparations 35%, and C — value added to the rendered diagnosis 2%. Hence, the use of cell-block improved cytology diagnosis in only 2% of total cases. Mostly were of immunostains application for diagnosis confirmation. Conclusion: The non-diagnostic and atypical cytology cases have not been upgraded to a more meaningful category by the incorporation of cell-block performed with the routine non-enhancement random method. On the other hand, cell-blocks contributed generously toward immunostaining application in malignant scenarios.

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Trends in Thyroid Fine-Needle Aspiration Cytology Practices: Results From a College of American Pathologists 2016 Practice Survey

Cited by 14 publications

References 31 publications

Method of detection of thyroid nodules: correlation with frequency of fine‐needle aspiration and malignancy rate

Method of detection of thyroid nodules: correlation with frequency of fine‐needle aspiration and malignancy rate

The Role of Cell Blocks and Immunohistochemistry in Thyroid Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Bethesda Category

The diagnostic value of add-on thyroid cell block in the evaluation of thyroid lesions

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