scholarly journals Thyroid cytology during the COVID-19 pandemic: a single centre experience

2021 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Ozgur Kulahci ◽  
Zeynel Abidin Tas
Keyword(s):  
Malignant Tumour ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Follicular Neoplasm ◽  
Calendar Period ◽  
Thyroid Cytology ◽  
Number Of Patients ◽  
Before And After ◽  
Thyroid Fine Needle Aspiration ◽  
Undetermined Significance

Background: In our study, thyroid fine-needle aspiration biopsy (FNAB) data in the same calendar period of 1 year before and after the COVID-19 pandemic were compared.Methods: Thyroid FNAB data for the same calendar period of 1 year before and after the COVID-19 pandemic were included in the study. The patients were grouped according to age, gender and thyroid FNABs according to the Bethesda system for reporting thyroid cytopathology, and the data of both groups were compared considering the diagnoses of the patients who underwent thyroid surgery afterwards.Results: In the post-pandemic period, the number of thyroid FNABs and the number of patients over the age of 40 decreased (all p<0.001). In the post-pandemic period, the rates of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm or suspicious for a follicular neoplasm (FN/SFN), suspicious for malignancy, and malignant cytology increased despite the decrease in the number of patients (p=0.001). Furthermore, the malignant tumour rate was 1.4% before the pandemic in patients who underwent surgical thyroidectomy and/or lobectomy; this rate was 3.5% in the post-pandemic period (p=0.045).Conclusions: We found an increase in the percentage of AUS/FLUS, FN/SFN, suspicious for malignancy, and malignant cases during the period when there were restrictions, such as pandemics, and the sampling was reduced. This finding is valuable in terms of detecting an increased malignancy rate by performing less thyroid FNAB by carefully determining the indications for thyroid aspiration biopsy regarding the latest guidelines.

Thyroid Fine-Needle Aspiration Reporting Rates and Outcomes Before and After Bethesda Implementation Within a Combined Academic and Community Hospital System

2013 ◽  
Vol 137 (11) ◽  
pp. 1664-1668 ◽  
Author(s):  
Aaron M. Harvey ◽  
Dina R. Mody ◽  
Mojgan Amrikachi
Keyword(s):  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Hospital System ◽  
Fine Needle ◽  
Thyroid Cytology ◽  
Before And After ◽  
Thyroid Fine Needle Aspiration ◽  
Reporting Rates ◽  
Undetermined Significance

Context.—The current study compares data from our hospital system before and after the 2008 implementation of the Bethesda System for Reporting Thyroid Cytology (BSRTC). Objective.—To show the effects the BSRTC has had on the reporting rates and outcomes for thyroid lesions. Design.—A search for thyroid fine-needle aspiration biopsies (FNABs) was performed for 2002–2005 (before BSRTC) and 2009–2011 (after BSRTC). Diagnostic outcomes were reviewed for cases with available follow-up. Results.—For 2002–2005, cytology reports for 3302 thyroid FNABs were reviewed, and 309 (9.4%) were classified as suspicious. For 2009–2011, cytology reports for 3432 thyroid FNABs were reviewed; 72 (2.1%) were classified as “atypia of undetermined significance or follicular lesion of undetermined significance” (AUS/FLUS), and 142 (4.1%) were classified as suspicious. Follow-up material was available for 31 AUS/FLUS cases (43.0%), and 6 of these cases (19%) were malignant. Follow-up material was available for 60 cases (42.3%) classified as suspicious, and 23 of these cases (38%) were malignant. Conclusions.—The AUS/FLUS rate of 2.1% at our institution is at the lower range of the &lt;7% recommended by the BSRTC, and our rate of 19% for risk of malignancy for AUS/FLUS is slightly above the BSRTC recommendation of 5% to 15%. Implementation of the BSRTC did not significantly affect our institution's reporting rates, most likely because an essentially similar classification system was employed before implementation of the BSRTC.

scholarly journals The value of routine measurement of serum calcitonin on insufficient, indeterminate, and suspicious thyroid nodule cytology

2021 ◽  
Author(s):  
Murat Çalapkulu ◽  
Muhammed Erkam Sencar ◽  
Sema Hepsen ◽  
Hayri Bostan ◽  
Davut Sakiz ◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Thyroid Nodules ◽  
Medullary Thyroid Cancer ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Serum Calcitonin ◽  
Routine Measurement ◽  
Number Of Patients ◽  
Undetermined Significance

Routine calcitonin measurement in patients with nodular thyroid disease is rather controversial. The aim of this study was to evaluate the contribution of serum calcitonin measurement in the diagnostic evaluation of thyroid nodules with insufficient, indeterminate, or suspicious cytology. Out of 1668 patients who underwent thyroidectomy with the diagnosis of nodular thyroid disease and were screened, 873 patients with insufficient, indeterminate, or suspicious fine needle aspiration biopsy results were included in the study. From the total number of patients in this study, 10 (1.1%) were diagnosed as medullary thyroid cancer (MTC) using histopathology. The calcitonin level was detected to be above the assay-specific cut-off in 23 (2.6%) patients ranging between 6.5 - 4450 pg/mL. While hypercalcitoninemia was detected in all 10 MTC patients, a false positive elevation of serum calcitonin was detected in 13 patients (1.5%). Of the MTC group, 7 patients had cytology results that were suspicious for malignancy (Bethesda V), one patient’s cytology showed atypia of undetermined significance (Bethesda III) and two patient’s cytology results were suspicious for follicular neoplasm (Bethesda IV). Among the cases with non-diagnostic cytology (Bethesda I), none of the patients were diagnosed with MTC. In conclusion, routine serum calcitonin measurement can be performed in selected cases rather than in all nodular thyroid patients. While it is reasonable to perform routine calcitonin measurement in patients with Bethesda IV and Bethesda V, this measurement was not useful in Bethesda I patients. In Bethesda III patients, patient-based decisions can be made according to their calcitonin measurement. Read more in PDF.

scholarly journals Malignancy Risk and Related Factors of Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance in Thyroid Fine Needle Aspiration

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
So-hyeon Hong ◽  
Hyejin Lee ◽  
Min-Sun Cho ◽  
Jee Eun Lee ◽  
Yeon-Ah Sung ◽  
...  
Keyword(s):  
Clinical Features ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Related Factors ◽  
Fine Needle ◽  
Malignancy Risk ◽  
Thyroid Fine Needle Aspiration ◽  
Risk Of Malignancy ◽  
Undetermined Significance

Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) in thyroid fine needle aspiration (FNA) is a challenging category. The malignancy risk is different by multiple factors and subsequent management strategy is inconclusive. Therefore, we analyzed the malignancy risk of AUS/FLUS according to radiological and clinical features. A total of 687 nodules that had been initially diagnosed as AUS/FLUS were retrospectively reviewed from 6365 thyroid FNAs between 2011 and 2014. The ultrasonographic (US) features were categorized using the Korean Thyroid Imaging Reporting and Data System. Radiological and clinical features were compared according to the second FNA results or histologically confirmed results from surgery. Repeat FNA was performed on 248 (36%) nodules, and 49 (7%) nodules underwent immediate surgery. Among the 248 nodules subjected to repeated FNA, 49 (20%) nodules were diagnosed again as AUS/FLUS, 123 (50%) were found to be benign, and 47 (19%) were diagnosed as follicular neoplasm, suspicious for malignancy or malignant. Among histologically confirmed nodules, the US features were more unfavorable in malignant nodules, and hypo- or anechogenicity was associated with a higher risk of malignancy after adjusting for age, size, and other US features (P<0.01). In conclusion, we observed that malignant nodules tended to show unfavorable US features, especially hypo- or anechogenicity. Age, sex, and thyroid function were not significantly associated with malignancy risk. We also found out that malignancy risk was not different between the group which underwent immediate operation following the AUS/FLUS diagnosis and the group which underwent repeated FNA after the initial diagnosis.

scholarly journals Are MicroRNA 190 and MicroRNA95-3P in the Circulation Can Be Used As Predictive Bioindicators in Differentiated Thyroid Cancer in Patients with Atypia of Undetermined Significance Based on Thyroid Fine Needle Aspiration Biopsy Results?

2020 ◽  
Author(s):  
Mustafa Gökhan Ünsal ◽  
Erdem Barış Cartı ◽  
Mustafa Ünübol ◽  
Elif Duygu Topan ◽  
Zehra Erdemir ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Atypical Cells ◽  
Thyroid Fine Needle Aspiration ◽  
Needle Aspiration Biopsy ◽  
Undetermined Significance

INTRODUCTION: It is not always possible to make a definitive diagnosis preoperatively with thyroid fine needle aspiration biopsy. Decision making is quite complicated in cases with atypical cells of undetermined significance. MicroRNAs have been shown to be associated with the development of neoplasia. For this purpose, we aimed to investigate the circulating microRNA 190 and microRNA 95-3P levels as a biomarker to distinguish benign and malign cases with preoperative atypical cells of undetermined significance diagnosis. METHODS: Patients with preoperative atypical cells of undetermined significance.diagnosis were included in the study. 29 malign and 29 benign patients were included. Venous blood samples isolated using a specific miRNA kit. RESULTS: According to the postoperative pathology results statistically significant between circulating miRNA 190 and miRNA 95-3p between cases with thyroid cancer. differences were detected. DISCUSSION AND CONCLUSION: It can be asserted that miRNA 95 and miRNA 190 assessment can help to differentiate thyroid cancer from benign thyroid nodules and may be useful in avoiding unnecessary surgery in patients with atypical cells of undetermined significance results.

scholarly journals A Comparative Study of the Bethesda System of Reporting of Fine Needle Aspiration Cytology Thyroid with Histopathology

2020 ◽  
Vol 7 (52) ◽  
pp. 3171-3175
Author(s):  
Kirthi Nath K.V ◽  
Geetha Sukumaran
Keyword(s):  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Thyroid Cytology ◽  
Thyroid Fine Needle Aspiration ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
The Bethesda System

BACKGROUND The Bethesda system of reporting thyroid cytopathology is an outstanding and systematic approach of reporting thyroid cytology samples, thereby reducing the communication gap between cytopathologist and clinician, leading to a better patient care approach. We aim to study the thyroid fine needle aspiration (FNA) using the Bethesda system and evaluate its accuracy taking histopathology as gold standard. METHODS This was a descriptive study including 200 consecutive cases which came to our cytology department between January 2014 and December 2014. All thyroid fine needle aspiration cytology (FNAC) were categorised as per the Bethesda system and followed up with corresponding histopathology. RESULTS Out of the 200 cases, adequacy criteria was met in 196 (98 %) cases. 176 (88 %) cases fell in the benign category, 4 (2 %) cases were inadequate samples, 8 (4 %) showed features of follicular neoplasm / suspicious of follicular neoplasm and 12 (6 %) were malignant lesions. Histopathology follow up was available for all cases. Statistical analysis showed a specificity of 100 % (high), sensitivity of 40 % (low). Positive predictive value was 100 %, negative predictive value was 90.4 %. Accuracy rate was 91 %. CONCLUSIONS Interpreting the thyroid FNAC results using Bethesda system allowed a superior interlaboratory agreement leading to improved clinical management. KEYWORDS Thyroid, Cytology, Bethesda

The Bethesda System for Reporting Thyroid Fine-Needle Aspiration Cytology: A Kuwaiti Experience - A Cytohistopathological Study of 374 Cases

2015 ◽  
Vol 59 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Kusum Kapila ◽  
Laila Qadan ◽  
Rola H. Ali ◽  
Mohammed Jaragh ◽  
Sara S. George ◽  
...  
Keyword(s):  
Predictive Value ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Thyroid Fine Needle Aspiration ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity ◽  
The Bethesda System ◽  
Undetermined Significance

Introduction: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) identifies 6 diagnostic categories in which the risk of malignancy increases respectively. The aim of our study was to assess TBSRTC reporting in our hospital and to evaluate its specificity based on cytohistological correlation. Methods: A histological diagnosis was available in 374 (110 males and 264 females) out of 7,809 thyroid aspirates examined at Mubarak Al-Kabeer Hospital, Kuwait, from 2004 to 2012. The aspirates were classified in accordance with TBSRTC. Results: Thyroid aspirates were classified as nondiagnostic (n = 18; 4.8%), benign (n = 114; 30.5%); atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS; n = 59; 15.8%), follicular neoplasm/suspicious for follicular neoplasm (FN/SFN; n = 17; 4.5%), suspicious for malignancy (SM; n = 80; 21.4%), or malignant (n = 86; 23.0%). In 75 of 86 malignant cases, a papillary carcinoma was detected. There were 3 (1.6%) false-positive aspirates and the sensitivity, specificity, negative predictive value, and positive predictive value were 91.0, 61.9, 84.2, and 75.3%, respectively. Conclusions: Our results are fairly comparable to those of various previous studies in the SM, AUS/FLUS, and SFN categories. The higher rates observed in the nondiagnostic and benign categories were possibly due to limited guided aspirations and a lack of on-site evaluation for all cases.

scholarly journals Diagnosis of atypia/follicular lesion of undetermined significance: An institutional experience

CytoJournal ◽  
2014 ◽  
Vol 11 ◽  
pp. 23 ◽  
Author(s):  
Lawrence Q. Wong ◽  
Virginia A. LiVolsi ◽  
Zubair W. Baloch
Keyword(s):  
Surgical Excision ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Malignancy Rate ◽  
Thyroid Fine Needle Aspiration ◽  
Clinicopathologic Factors ◽  
Institutional Experience ◽  
Thyroid Fna ◽  
Undetermined Significance

Background: The overall malignancy rate for the thyroid fine-needle aspiration (FNA) diagnosed as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) ranges from 5% to 30%. In this study, we present our institutional experience with thyroid nodules diagnosed as AUS/FLUS and further stratified into subcategories. In addition, we also assessed the significance of various clinicopathologic factors that may influence AUS/FLUS diagnoses and their outcomes. Design: A search of our laboratory information system was performed to identify all in-house thyroid FNA cases diagnosed as AUS/FLUS from 2008 to 2012. The data were collected and characterized by patient demographic information, cytopathology diagnosis with sub-classifiers and follow-up. Results: The case cohort included 457 cases diagnosed as AUS/FLUS. These were further sub-classified into one of six subcategories depending on the cytomorphologic findings and suspicion for or against a neoplastic process. Of the 457 cases, repeat FNA and/or surgical follow-up was available in 363 cases. There were 182 (39.8%) cases with cytologic follow-up only; 18 (9.9%) remained as AUS/FLUS, while 158 (86.8%) were re-classified with the majority being benign (142 cases). Histologic follow-up was available in 181 (39.6%) cases. There were 60 malignant cases confirmed by surgical excision, with an overall malignancy rate of 33.1%. The malignancy rate was 38.8% for cases with a repeat FNA versus 25.6% for cases that went directly to surgery without a repeat FNA. Papillary thyroid carcinoma accounted for 93.3% (56 cases) of the malignant cases. Conclusion: Based on our study, even though the malignancy rate of AUS/FLUS cases is similar to those reported for cases diagnosed as follicular neoplasm/suspicious for follicular neoplasm, we are of the belief that these comparable malignancy rates are a product of better clinical management and selection of patients diagnosed as AUS/FLUS for surgery after a repeat FNA.

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