Intra-institutional second opinion diagnosis can reduce unnecessary surgery for indeterminate thyroid FNA: A preliminary report on 34 cases
| Autor: | Claudio Bellevicine, Giancarlo Troncone, Elena Vigliar, Ilaria Migliatico, Nicola Serra |
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| Přispěvatelé: | Bellevicine, Claudio, Migliatico, Ilaria, Vigliar, Elena, Serra, N, Troncone, Giancarlo |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male second opinion medicine.medical_specialty Histology Unnecessary Surgery Biopsy Fine-Needle Thyroid Gland 030209 endocrinology & metabolism Malignancy Pathology and Forensic Medicine 03 medical and health sciences Young Adult interobserver reproducibility 0302 clinical medicine Preliminary report medicine Humans Thyroid Nodule Medical diagnosis double slide view Referral and Consultation follicular neoplasm/suspicious for follicular neoplasm Aged Demography thyroid fine needle aspirates Thyroid.FNA Aged 80 and over business.industry Thyroid Second opinion indeterminate General Medicine Middle Aged medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Female Radiology Indeterminate business |
| Zdroj: | Cytopathology : official journal of the British Society for Clinical Cytology. 28(4) |
| ISSN: | 1365-2303 |
| Popis: | Introduction Indeterminate diagnoses are rendered on 15%-30% of thyroid fine-needle aspirates (FNA). Thus, a second diagnostic opinion given by an outside expert pathologist is a common practice that facilitates a more appropriate clinical management. Conversely, the role of an intra-institutional second opinion diagnosis (iSOD), which is usually informally performed in-house, has not been well established. Methods To assess the contribution of iSOD, a retrospective series of 34 thyroid FNA diagnosed as follicular neoplasm/suspicious follicular neoplasm (FN/SFN) with matched histological follow-up and a malignancy rate of 17.6% was selected and independently reviewed by two cytopathologists (CYT1 and 2). Cases with discrepant diagnoses were referred to a third in-house senior cytopathologist for the iSOD. The malignancy rates (MR) obtained after single independent reviews and iSOD were compared. Results MR obtained after CYT1 and CYT2 re-screening was similar (14.28% and 19.04%, respectively) and did not improve the original MR (17.64%). Conversely, after the iSOD of discrepant diagnoses, the overall malignancy rate increased up to the 27.27%, potentially sparing unnecessary surgical procedures. Conclusions Intra-institutional second opinion practice for “indeterminate” thyroid FNA avoids unnecessary surgeries and maximises the detection of malignant cases diagnosed as FN/SFN. |
| Databáze: | OpenAIRE |
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