The importance of risk of neoplasm as an outcome in cytologic‐histologic correlation studies on thyroid fine needle aspiration
| Autor: | Kristen L. Partyka, Harvey M. Cramer, Rae Dougherty, Yu-Hsin Chen, Howard H. Wu |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Risk medicine.medical_specialty Histology Adenoma Biopsy Fine-Needle Thyroid Gland 030209 endocrinology & metabolism medicine.disease_cause Gastroenterology Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Atypia Humans Neoplasm Thyroid Neoplasms Correlation of Data Thyroid neoplasm Retrospective Studies Suspicious for Malignancy medicine.diagnostic_test business.industry Thyroid General Medicine medicine.disease Bethesda system for reporting thyroid cytopathology Carcinoma Papillary medicine.anatomical_structure Fine-needle aspiration Thyroid Cancer Papillary 030220 oncology & carcinogenesis Female business |
| Zdroj: | Diagnostic Cytopathology. 48:1237-1243 |
| ISSN: | 1097-0339 8755-1039 |
| DOI: | 10.1002/dc.24557 |
| Popis: | Background The introduction of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) altered the practice of thyroid pathology and reduced the risk of malignancy (ROM) associated with the indeterminate categories in the Bethesda system for reporting thyroid cytopathology (TBSRTC). It has been proposed that the evaluation of the risk of neoplasm (RON) is important in cytologic-histologic correlation studies. Methods A total of 5224 thyroid aspirates were performed at our institution during an 8-year period. Of the 1475 cases (28%) with surgical follow-up, the histologic diagnoses comprised benign non-neoplastic (BNN, n = 669), follicular adenoma (FA, n = 188), NIFTP (n = 42), papillary microcarcinoma (PMC) (n = 223), and malignant neoplasm excluding PMC (n = 353). The RON was calculated to include neoplasia with low risk biologic behavior (FA, NIFTP, PMC) and malignant neoplasms. In contrast, the ROM was reserved for malignant neoplasms excluding PMC. Results The RON for each TBSRTC category was: nondiagnostic (ND) 38.3%, benign 20.9%, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) 63.2%, follicular neoplasm or suspicious for follicular neoplasm (FN/SFN) 83.9%, suspicious for malignancy (SFM) 94%, and malignant 100%. The ROM excluding PMC was: ND 14%, benign 1.6%, AUS/FLUS 17.8%, FN/SFN 28.4%, SFM 84.4%, and malignant 99.5%. Conclusions The RON and ROM support the recommended management guidelines from TBSRTC for all categories, except for FN/SFN. Histopathologic follow-up of FN/SFN aspirates in our study contain a very high rate of neoplasm (83.9%), which might support the management preference of conservative surgery. |
| Databáze: | OpenAIRE |
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