Worrisome Histologic Alterations Following Fine Needle Aspiration of the Thyroid

Pandit, Ajita Avinash; Phulpagar, Mayura Dinkar

doi:10.1159/000327273

Cited by 39 publications

(36 citation statements)

References 3 publications

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“…Several subsequent studies confirmed their observations [16][17][18][19] . Thyroid FNAB-related histopathological changes often include haemorrhage, fibrosis, granulation tissue, and necrosis [15][16][17][18][19][20][21] . Necrosis and infarction of the thyroid gland had already been described before the WHAFFT concept, mainly as case reports and case series [22,23] .…”

supporting

confidence: 57%

“…In contrast, Bolat et al [18] reported vascular changes in only 2.7% of studied thyroids. In another series, 10 out of 102 thyroids showed vascular changes, led by thrombosis and recanalisation in 5 cases [17] . It is noteworthy that, in contrast to our data, all the cases of vascular changes were associated with necrosis.…”

Section: Discussionmentioning

confidence: 91%

“…They include haemangioma-like vascular proliferation, angiosarcomalike proliferation, papillary endothelial hyperplasia, and thrombosis with recanalisation [16,17,20] . Notably, thyroid vascular tumours such as haemangioma and angiosarcoma are remarkably rare [26] .…”

mentioning

confidence: 99%

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Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Hovi

Kholová²

2017

Acta Cytologica

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Objective: Fine needle aspiration biopsy (FNAB) can cause reactive histopathological changes, commonly including haemorrhage and granulation tissue. The literature describing vascular proliferation after FNAB is sparse. We aimed to describe neovascularisation in thyroid gland specimens as a consequence of FNAB. Study Design: We analysed all thyroid histopathological specimens from the Fimlab Laboratories collected between 2010 and 2013 for neovascularisation and distortions in the accompanying tissue. We evaluated HE-stained slides and CD31-, podoplanin-, and Ki-67-immunostained slides. Results: We observed vascular proliferation in 64 out of 787 specimens (8.1%). In these patients, the mean age was 62 years, 43 were female and 21 were male. Previous FNAB data were available in 49 cases (76.6%). In 51 cases (79.7%), the neovascularisation occupied less than 5% of the thyroid gland area. The vessel dilatation was moderate in 28 cases (43.8%) and low in 20 cases (31.3%). In tumours, neovessels were detected within the tumour and in the surrounding tissue. Conclusions: Post-FNAB tissue samples include dilated newly formed vessels, which pathologists should differentiate from rare thyroid vascular tumours. The proposed mechanism is a traumatically induced haemorrhage followed by haematoma and thrombosis that resolves by recanalisation. A knowledge of tissue alteration is needed to avoid misdiagnoses.

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supporting

confidence: 57%

Section: Discussionmentioning

confidence: 91%

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Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Hovi

Kholová²

2017

Acta Cytologica

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“…These histologic alterations may also lead to positive cytology findings and a negative histological diagnosis of PTC in the thyroid. Histologic alterations caused by FNA are reported in approximately 38% of cases who underwent FNA [18,19]. Hemorrhage was the most common finding (80%), followed by fibrosis, infarction, nuclear atypia, capsular and/or vascular pseudoinvasion, and metaplasia [8].…”

Section: Discussionmentioning

confidence: 99%

Positive Cytology Findings and a Negative Histological Diagnosis of Papillary Thyroid Carcinoma in the Thyroid: Is It a False-Positive Cytology or a Disappearing Tumor

et al. 2013

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Background: It infrequently occurs that cytologic diagnosis of papillary thyroid carcinoma (PTC) cannot be confirmed by histology after surgery. This phenomenon may be a false-positive cytology or a true disappearing tumor. Objectives: We evaluated patients who had consistent findings of PTC at fine needle aspiration cytology (FNAC) and no evidence of PTC in surgical specimens. Methods: Positive cytology findings and a negative histological diagnosis of PTC in the thyroid was defined as thyroid nodules with FNAC findings of PTC prior to surgery and no evidence of malignancy on histological examination of surgically removed thyroids. We retrospectively reviewed patients who underwent fine needle aspiration (FNA) and thyroidectomy in Asan Medical Center from 2004 to 2012. Results: Six patients were found who fit the definition of positive cytology findings and a negative histological diagnosis of PTC in the thyroid. The FNAC diagnosis of 6 patients was ‘malignancy' suggesting PTC according to the Bethesda system. All patients underwent thyroidectomy with central neck dissection. Three patients had reactive changes after FNA due to needle passage. Among these 3 patients, 2 had pathologically confirmed metastatic PTC in dissected lymph nodes. These 2 patients could be defined as true disappearing PTC in the thyroid after FNA. The remaining 3 patients had neither histologic alterations nor evidence of PTC in the thyroid and lymph nodes specimens. Conclusions: Both disappearing PTC and a false-positive result of FNAC should be considered in patients with positive cytology findings and a negative histological diagnosis of PTC in the thyroid.

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“…2 Many studies regarding these changes have been published in the literature, but there is still a lack of studies detailing statistical analysis of WHAFFT changes and technical factors influencing these changes. [1][2][3][4][5][6][7][8][9][10][11][12] This study was undertaken to assess histologic alterations following FNA of thyroid; to differentiate these from ominous lesions, such as papillary carcinoma of the thyroid, and compare the degree of tissue trauma with respect to different techniques, that is, needle only or needle with syringe, as well as size of the needle and number of FNAs.…”

mentioning

confidence: 99%

Histologic Analysis and Comparison of Techniques in Fine Needle Aspiration–Induced Alterations in Thyroid

Sharma

Krishnanand²

2008

Acta Cytologica

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Worrisome Histologic Alterations Following Fine Needle Aspiration of the Thyroid

Cited by 39 publications

References 3 publications

Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Vascular Proliferation of the Thyroid: Potential Histopathological Pitfalls as a Consequence of Fine Needle Aspiration

Positive Cytology Findings and a Negative Histological Diagnosis of Papillary Thyroid Carcinoma in the Thyroid: Is It a False-Positive Cytology or a Disappearing Tumor

Histologic Analysis and Comparison of Techniques in Fine Needle Aspiration–Induced Alterations in Thyroid

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