Value of quantitative nucleolar features in the preoperative cytological diagnosis of follicular neoplasias of the thyroid.

Abstract

Nucleolar prevalence, size, and outline were-investigated on cytological material from cold thyroid nodules obtained by fine needle aspiration. The percentage of nucleolated nuclei in follicular adenoma (32 cases) was less than in follicular carcinoma (26 cases). In adenoma most nuclei contained one nucleolus, and nuclei with two or more nucleoi were less common than in carcinoma where most cases showed the highest nucleolar diameter values. There was some overlap between adenomas and carcinomas, however, when the mean of the 10 largest values of the major nucleolar diameter was considered. In follicular carcinoma the percentage of marginated nucleoli-that is, those touching the nuclear membrane-was, in general, greater than 20%; in adenoma the values were equal to or lower than 16%.The overlap index showed that the percentages of marginated nucleoli and nucleolated nuclei are the two best discriminatory features between adenoma and carcinoma.

Follicular Neoplasms of the Thyroid

“…Montironi and coworkers, in various studies, [14][15][16][17] had shown the ability of nucleolar counts to differentiate follicular adenomas from follicular carcinomas. In our study all the nucleolar parameters studied showed an overlap (including nuclear margination).…”

“…In spite of the profusion of work available, only marginal success has been achieved in separating them cytologically. Parameters used for this purpose include morphologic features, such as cellular patterns, [9][10][11]18 morphometric criteria like nuclear diameter, 1,2,12 and number and margination of nucleoli [14][15][16][17] and flow cytometry, 3,5,6 either singly or in combination. The sensi-tivity of these results has varied from 40% 19 to 75%.…”

Lactoferrin in Thyroid Lesions

“…7,33 The morphologic patterns of some types of thyroid lesions, such as hyperplastic areas of nodular goiter, follicular adenoma and well-differentiated follicular carcinoma, can be remarkably similar, 3,5 calling for a search for markers for this differential diagnosis with higher accuracy.…”

“…3,19 Several other diagnostic techniques for distinguishing these lesions are used for research in cytologic and tissue samples, including immunocytochemical techniques using antibodies to several markers 9,[11][12][13][14][15][16][17]20,23,24,26,28,29 and morphometric studies. 10,33 Lactoferrin is an iron-binding protein present in many biologic fluids and tissues. 42 It has been suggested that iron plays a crucial role in the initiation and maintenance of DNA synthesis and the mitotic process since addition of iron chelating agents to living cells causes selective inhibition of DNA synthesis.…”

Differential Diagnosis of Hürthle Cell Neoplasms on Fine Needle Aspirates

“…No previous study performed on Hürthle cell neoplasms attempted to quantify nucleolar features, but a few studies have investigated the usefulness of nucleolar morphometry in the differential diagnosis of follicular neoplasms and have reached conflicting results. Montironi et al [52][53][54][55][56] found follicular carcinomas to have significantly more nucleolated nuclei, more nucle- …”