High frequency of cancer in cold thyroid nodules occurring at young age

1989 ◽  
Vol 121 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Antonino Belfiore ◽  
Dario Giuffrida ◽  
Giacomo L. La Rosa ◽  
Orazio Ippolito ◽  
Giovanna Russo ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Young Patients ◽  
Needle Aspiration ◽  
Young Age ◽  
Annual Incidence ◽  
Adult Patients ◽  
Consecutive Series ◽  
Cytologic Examination ◽  
Risk Of Malignancy ◽  
Cold Thyroid Nodules

Abstract. In order to evaluate the risk of malignancy of cold thyroid nodules occurring in young as compared with adult patients, we studied a consecutive series of 2327 patients with a solitary cold thyroid nodule over a 6-year period. None of these patients had been previously irradiated in the neck or head. Fine needle aspiration of the nodule and cytologic examination were carried out in all patients and, on the basis of this evaluation and clinical examination 391 patients were selected for surgery; 109 patients were 4–20 years old and 2218 patients were older than 20 years. Malignancy was found in 11 (10.1%) and in 112 (5.0%) of cold thyroid nodules occurring in young and adult patients, respectively. The annual incidence of cold thyroid nodules in the population of the area studied was 5.2 vs 55.9 (per 105 inhabitants) in the young and in the adult group, respectively, and the annual incidence of thyroid cancer was 0.53 vs 2.82 (per 105 inhabitants) in the young and in the adult patients, respectively. The present study indicates, therefore, that in the absence of head or neck irradiation, cold thyroid nodules are much less frequent in young age, but that the malignancy rate of cold nodules occurring in young patients is 2-fold higher than in adults patients

Risk of malignancy and neoplasia predicted by three molecular testing platforms in indeterminate thyroid nodules on fine-needle aspiration

2019 ◽  
Vol 47 (9) ◽  
pp. 853-862 ◽  
Author(s):  
Kristen L. Partyka ◽  
Karen Trevino ◽  
Melissa L. Randolph ◽  
Harvey Cramer ◽  
Howard H. Wu
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Molecular Testing ◽  
Fine Needle ◽  
Risk Of Malignancy

Contemporary Management of Thyroid Nodules

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Kristen Kobaly ◽  
Caroline S. Kim ◽  
Susan J. Mandel
Keyword(s):  
Thyroid Nodules ◽  
Cervical Lymphadenopathy ◽  
Standard Technique ◽  
Clinical History ◽  
Needle Aspiration ◽  
Annual Review ◽  
Publication Date ◽  
Molecular Testing ◽  
Risk Of Malignancy ◽  
Indeterminate Cytology

Thyroid nodules are common in the general population, with higher prevalence in women and with advancing age. Approximately 5% of thyroid nodules are malignant; the majority of this subset represents papillary thyroid cancer. Ultrasonography is the standard technique to assess the underlying thyroid parenchyma, characterize the features of thyroid nodules, and evaluate for abnormal cervical lymphadenopathy. Various risk stratification systems exist to categorize the risk of malignancy based on the ultrasound appearance of a thyroid nodule. Nodules are selected for fine-needle aspiration biopsy on the basis of ultrasound features, size, and high-risk clinical history. Cytology results are classified by the Bethesda system into six categories ranging from benign to malignant. When cytology is indeterminate, molecular testing can further risk-stratify patients for observation or surgery. Surveillance is indicated for nodules with benign cytology, indeterminate cytology with reassuring molecular testing, or non-biopsied nodules without a benign sonographic appearance. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Fine-needle aspiration biopsy of cold thyroid nodules

Cancer ◽  
1988 ◽  
Vol 62 (7) ◽  
pp. 1337-1342 ◽  
Author(s):  
Annette R. Nathan ◽  
Kristen B. Raines ◽  
Yeu-Tsu Margaret Lee ◽  
E. Lawrence Sakas ◽  
Judy M. Ribbing
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Needle Aspiration Biopsy ◽  
Cold Thyroid Nodules

scholarly journals ACR TI-RADS and ATA US scores are helpful for the management of thyroid nodules with indeterminate cytology

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Thayse Lozovoy Madsen Barbosa ◽  
Cleo Otaviano Mesa Junior ◽  
Hans Graf ◽  
Teresa Cavalvanti ◽  
Marcus Adriano Trippia ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Needle Aspiration ◽  
Molecular Testing ◽  
American Thyroid Association ◽  
Institutional Review ◽  
The Us ◽  
Risk Of Malignancy ◽  
Indeterminate Cytology

Abstract Background Cytologically indeterminate thyroid nodules currently present a challenge for clinical decision-making. The main aim of our study was to determine whether the classifications, American College of Radiology (ACR) TI-RADS and 2015 American Thyroid Association (ATA) guidelines, in association with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), could be used to stratify the malignancy risk of indeterminate thyroid nodules and guide their clinical management. Methods The institutional review board approved this retrospective study of a cohort of 140 thyroid nodules in 139 patients who were referred to ultrasound-guided fine-needle aspiration cytology (FNAC) from January 2012 to June 2016 with indeterminate cytological results (44 Bethesda III, 52 Bethesda IV and 44 Bethesda V) and in whom pre-FNAC thyroid US images and histological results after surgery were available. Each included nodule was classified by one radiologist blinded to the cytological and histological diagnoses according to the ACR TIRADS scores and the US patterns as recommended in the 2015 ATA guidelines. The risk of malignancy was estimated for Bethesda, TI-RADS scores, ATA US patterns and their combination. Results Of the 140 indeterminate thyroid nodules examined, 74 (52.9%) were histologically benign. A different rate of malignancy (p < 0.001) among Bethesda III, IV and V was observed. The rate of malignancy increased according to the US suspicion categories (p < 0.001) in both US classifications (TI-RADS and ATA). Thyroid nodules classified as Bethesda III and the lowest risk US categories (very low, low and intermediate suspicion by ATA and 2, 3 and 4a by TI-RADS) displayed a sensitivity of 95.3% for both classifications and a negative predictive value of 94.3 and 94.1%, respectively. The highest risk US categories (high suspicion by ATA and 4b,4c and 5 by TI-RADS) were significantly associated with cancer (odds ratios [ORs] 14.7 and 9.8, respectively). Conclusions Ultrasound classifications, ACR TI-RADS and ATA guidelines, may help guide the management of indeterminate thyroid nodules, suggesting a conservative approach to nodules with low-risk US suspicion and Bethesda III, while molecular testing and surgery should be considered for nodules with high-risk US suspicion and Bethesda IV or V.

scholarly journals Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy

2017 ◽  
Vol 9 (3) ◽  
pp. 100-103
Author(s):  
Saad Alqahtani ◽  
Saif Alsobhi ◽  
Riyadh I Alsalloum ◽  
Saleh N Najjar ◽  
Hindi N Al-Hindi
Keyword(s):  
Fine Needle Aspiration ◽  
Surgical Outcome ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Biopsy ◽  
Undetermined Significance

ABSTRACT Aim To correlate selected clinical and ultrasonographic (US) characteristics with the final histopathological diagnosis in patients with atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS), and whether this information can be used in planning the surgical approach. Materials and methods It is a retrospective study including the operated cases of AUS/FLUS from 2011 to 2014 treated at one center. Results This cohort included 87 women and 28 men. To test for independence between categorical variables, the chi-square test was used. There was no significant correlation between age or US variables and final pathological diagnosis. However, final diagnosis of malignancy was higher in men compared with women (64.3 and 41.4% respectively; p = 0.035). Furthermore, a significant association between the diagnosis of repeated fine needle aspiration biopsy (FNAB) and the final pathological diagnosis was noted (benign vs malignant, p = 0.005). Conclusion The FNAB has a significant role in the assessment of thyroid nodules. Our results showed no correlation between age, US variables, and the risk of malignancy. Male gender is associated with higher risk of malignancy. Clinical significance Determining the risk of malignancy and prediction of surgical outcome may help triaging cases for repeat FNA or proceeding to surgery. How to cite this article Alqahtani S, Alsobhi S, Alsalloum RI, Najjar SN, Al-Hindi HN. Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy. World J Endoc Surg 2017;9(3):100-103.

scholarly journals 1629 The Risk of Malignancy in Cytologically Indeterminate Thyroid Nodules

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
O Jones ◽  
V Blackabey ◽  
N Bhat
Keyword(s):  
Thyroid Nodules ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Needle Aspiration ◽  
Diagnostic Assessment ◽  
Patient Counselling ◽  
Conversion Rates ◽  
Significant Difference ◽  
Risk Of Malignancy ◽  
Malignant Conversion

Abstract Introduction Fine needle aspiration (FNA) is the gold standard for the diagnostic assessment of thyroid nodules, with cytology stratified using the Thy classification (Thy 1-5). The management of cases where cytology is indeterminate (Thy-3) is challenging and subject to controversy. The current British Thyroid Association guidelines subclassify Thy-3 lesions into Thy-3a (atypia) and Thy-3f (follicular). Repeat FNA is generally recommended for Thy-3a specimens, whilst Thy-3f lesions should proceed to diagnostic hemithyroidectomy. The aim of this study was to determine the risk of malignancy in Thy-3a and Thy-3f lesions. Method This was a retrospective study of all patients who underwent FNA of a thyroid nodule from 01/01/2018 – 31/12/19. Those with Thy-3 cytology were identified and results correlated with final surgical histology. Results In total, there were 179 patients with Thy-3 cytology: 37 Thy-3a and 142 Thy-3f. The rate of malignancy was 21.6% (n = 8) for Thy-3a lesions and 20.4% (n = 29) for Thy-3f. When excluding microcarcinoma, the rates fell to 20.4% (n = 7) and 12.7% (n = 18) respectively. There was no statistically significant difference in malignant conversion between the two groups (p = 0.20). Conclusions This study does not demonstrate any statistically significant difference in the risk of malignancy between the Thy-3a and Thy-3f groups, suggesting that this subclassification does not add any additional utility to clinical decision making. Consideration should be given to the use of local malignant conversion rates to guide further management and pre-operative patient counselling in the Thy3 group.

Sign in / Sign up

Export Citation Format

Share Document