Sonographic criteria for fine-needle aspiration cytology in a korean female population undergoing thyroid ultrasound screening

2010 ◽  
Vol 51 (5) ◽  
pp. 475-481 ◽  
Author(s):  
Seung Ja Kim ◽  
Woo Kyung Moon ◽  
Nariya Cho
Keyword(s):  
Thyroid Cancer ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Ultrasound Screening ◽  
Thyroid Ultrasound ◽  
Fine Needle ◽  
Thyroid Abnormalities ◽  
Thyroid Lesions

Background: Thyroid sonography is commonly used as a screening procedure resulting in finding of innumerable benign nodules. It would be necessary to apply strict sonographic criteria for incidentally detected thyroid nodules to avoid unnecessary invasive procedures or further examinations. Purpose: To prospectively evaluate the incidence of diverse thyroid lesions including thyroid cancer detected during thyroid ultrasound (US), and to establish the diagnostic value of sonographic criteria for thyroid nodules. Material and Methods: During 2 years, 2250 patients visited the breast clinic for a breast US examination. In 2079 of these women (mean age 42.6 years, age range 15–77 years) without a history of previous thyroid surgery or thyroid abnormalities, thyroid screening with US was performed as well. The overall findings of all thyroid lesions detected during thyroid US were recorded. Fine-needle aspiration (FNA) was performed for all suspicious thyroid lesions and some with probably benign findings. The sonographic features of 113 aspirated nodules were analyzed and classified as either positive or negative findings. Sonographic classifications were correlated with the histological findings. The diagnostic index was calculated for individual sonographic criteria. Results: Of the 2079 patients, 1209 patients (58%) had normal findings. Abnormal findings (42%) included thyroid cancer ( n=53, 2.5%), solid nodules except for thyroid cancer ( n=300, 14.4%), mixed echoic nodules ( n=112, 5.4%), cysts ( n=294, 14%), thyroiditis features without thyroid nodules ( n=106, 5.1%), and parenchymal calcifications ( n=5, 0.2%). Of 113 aspirated nodules, 80 nodules were classified as positive and 33 nodules as negative according to the sonographic criteria in a retrospective analysis. Of 80 lesions classified as positive, 51 lesions were malignant. Of 33 lesions classified as negative, 2 lesions were malignant. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 96.2%, 51.7%, 63.8%, 93.9%, and 72.6%, respectively. Conclusion: Thyroid abnormalities were detected in 42% of all screened women. The use of the sonographic criteria showed excellent diagnostic performance for FNA and could be useful to provide practitioners with an objective tool to decide whether to perform a biopsy or not.

THE RISK OF THYROID CANCER IN PATIENTS WITH THYROID NODULE 3 CM OR LARGER

2020 ◽  
Vol 26 (11) ◽  
pp. 1286-1290
Author(s):  
Edy Kornelius ◽  
Shih-Chang Lo ◽  
Chien-Ning Huang ◽  
Yi-Sun Yang
Keyword(s):  
Thyroid Cancer ◽  
Positive Predictive Value ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Fine Needle

Objective: There are conflicting data on the risk of thyroid cancer in thyroid nodules 3 cm or larger, and few such studies on this issue have been conducted in Asia. This study aimed to examine the risk of thyroid cancer in patients with thyroid nodules 3 cm or larger. Methods: This was a 7-year retrospective study conducted in a tertiary referral hospital in Taiwan. All patients with a thyroid nodule measuring ≥3 cm who underwent thyroid operation with or without fine-needle aspiration biopsy (FNAB) were included. The prevalence rate of thyroid cancer, as well as the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false-negative rate of FNAB for thyroid nodule ≥3 cm were also examined. Results: A total of 132 patients were included in this study. Thyroid cancer was detected in 19 of 132 (14.4%) thyroid nodules measuring ≥3 cm. The performance of FNAB for detecting cancer in nodules 3 cm or larger without considering other ultrasonography parameters was relatively poor with a sensitivity of 50%, but the specificity (100%), PPV (100 %), and NPV (93.4 %) were excellent. Conclusion: The risk of thyroid cancer for thyroid nodules ≥3 cm in this study was low. The PPV and NPV of FNAB were high for the detection of cancer in large nodules. The decision to perform thyroidectomy should not be solely based on nodule size and should include other factors, such as ultrasound characteristics and surgical risk. Abbreviations: ATA = American Thyroid Association; FNAB = fine-needle aspiration biopsy; mPTC = micropapillary thyroid carcinoma; NPV = negative predictive value; PPV = positive predictive value; PTC = papillary thyroid carcinoma

scholarly journals Cytomorphological patterns of thyroid lesions among 1646 Sudanese patients: what we can learn from fine needle aspiration cytology retrospective analysis?

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Ali I. E. Osman ◽  
Ahmed O. Almobarak ◽  
Asma Kamalaldin Mohammed ◽  
Nouh S. Mohamed ◽  
Mohamed S. Muneer ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Benign Thyroid ◽  
Thyroid Lesions

Introduction: Fine-needle aspiration (FNA) cytology biopsy of the thyroid gland is an accurate and useful diagnostic tool in the initial evaluation of nodular thyroid lesions. We aimed in this study to determine the cytomorphological patterns of thyroid lesions diagnosed by FNA among Sudanese patients. Methods: A descriptive retrospective, clinic-based study was performed. Cytopathological records of patients that attended the Total Lab Care Clinic in Khartoum-Sudan between January 2016 and December 2017 were reviewed. Results: A total of 1646 patients records were reviewed; 1385 (84.1%) were females and 261 (15.9%) males. A total of 1563 (94.9%) were negative for malignancy, 39 (2.4%) were positive for malignancy, 42 (2.6%) were indeterminate for malignancy and 2 (0.1%) were non-diagnostic. Colloid goiter was seen in 1147 patients (73.4%), benign hemorrhagic cysts were seen in 257, Hashimoto thyroiditis was seen in 77, benign thyroid nodules were seen in 76, keratocysts were seen in 2, thyroglossal duct cysts were seen in 2, thyroid follicular adenoma was seen in 1 and myxedema was seen in 1. For malignant patients; 11 had anaplastic thyroid cancer, 8 had papillary thyroid cancer, 7 had follicular thyroid cancer, 5 had metastatic thyroid cancer, 4 had medullary thyroid cancer, 3 had non-Hodgkin lymphoma and 1 had thyroid follicular adenoma. For those indeterminate for malignancy, 24 had follicular neoplasm and 18 had Hurthle cell neoplasm. Conclusions: Fine needle aspiration cytology for thyroid nodules provides a rapid and non-invasive technique for the evaluation and differentiation between benign and malignant lesions. This study also addresses the increased predominance of benign thyroid lesions among young patients and thyroid malignancy among the 4th decade of life.

scholarly journals Combined molecular and mathematical analysis of long noncoding RNAs expression in fine needle aspiration biopsies as novel tool for early diagnosis of thyroid cancer

Endocrine ◽  
2020 ◽  
Author(s):  
C. Possieri ◽  
P. Locantore ◽  
C. Salis ◽  
L. Bacci ◽  
A. Aiello ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Noncoding Rnas ◽  
Digital Pcr ◽  
Needle Aspiration ◽  
Long Noncoding Rnas ◽  
Molecular Profile ◽  
Fine Needle

Abstract Purpose In presence of indeterminate lesions by fine needle aspiration (FNA), thyroid cancer cannot always be easily diagnosed by conventional cytology. As a consequence, unnecessary removal of thyroid gland is performed in patients without cancer based on the lack of optimized diagnostic criteria. Aim of this study is identifying a molecular profile based on long noncoding RNAs (lncRNAs) expression capable to discriminate between benign and malignant nodules. Methods Patients were subjected to surgery (n = 19) for cytologic suspicious thyroid nodules or to FNA biopsy (n = 135) for thyroid nodules suspicious at ultrasound. Three thyroid-specific genes (TG, TPO, and NIS), six cancer-associated lncRNAs (MALAT1, NEAT1, HOTAIR, H19, PVT1, MEG3), and two housekeeping genes (GAPDH and P0) were analyzed using Droplet Digital PCR (ddPCR). Results Based on higher co-expression in malignant (n = 11) but not in benign (n = 8) nodules after surgery, MALAT1, PVT1 and HOTAIR were selected as putative cancer biomarkers to analyze 135 FNA samples. Cytological and histopathological data from a subset of FNA patients (n = 34) were used to define a predictive algorithm based on a Naïve Bayes classifier using co-expression of MALAT1, PVT1, HOTAIR, and cytological class. This classifier exhibited a significant separation capability between malignant and benign nodules (P < 0.0001) as well as both rule in and rule out test potential with an accuracy of 94.12% and a negative predictive value (NPV) of 100% and a positive predictive value (PPV) of 91.67%. Conclusions ddPCR analysis of selected lncRNAs in FNA biopsies appears a suitable molecular tool with the potential of improving diagnostic accuracy.

Molecular Diagnostics of Thyroid Tumors

2011 ◽  
Vol 135 (5) ◽  
pp. 569-577 ◽  
Author(s):  
Yuri E. Nikiforov
Keyword(s):  
Thyroid Cancer ◽  
Molecular Markers ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Genetic Alterations ◽  
Braf V600e ◽  
Fine Needle ◽  
Molecular Alterations ◽  
Diagnostic Use

Abstract Context.—Thyroid cancer is the most common type of endocrine malignancy and its incidence is steadily increasing. Papillary carcinoma and follicular carcinoma are the most common types of thyroid cancer and represent those tumor types for which use of molecular markers for diagnosis and prognostication is of high clinical significance. Objective.—To review the most common molecular alterations in thyroid cancer and their diagnostic and prognostic utility. Data Sources.—PubMed (US National Library of Medicine)–available review articles, peer-reviewed original articles, and experience of the author. Conclusions.—The most common molecular alterations in thyroid cancer include BRAF and RAS point mutations and RET/PTC and PAX8/PPARγ rearrangements. These nonoverlapping genetic alterations are found in more than 70% of papillary and follicular thyroid carcinomas. These molecular alterations can be detected in surgically resected samples and fine-needle aspiration samples from thyroid nodules and can be of significant diagnostic use. The diagnostic role of BRAF mutations has been studied most extensively, and recent studies also demonstrated a significant diagnostic utility of RAS, RET/PTC, and PAX8/PPARγ mutations, particularly in thyroid fine-needle aspiration samples with indeterminate cytology. In addition to the diagnostic use, BRAF V600E mutation can also be used for tumor prognostication, as this mutation is associated with higher rate of tumor recurrence and tumor-related mortality. The use of these and other emerging molecular markers is expected to improve significantly the accuracy of cancer diagnosis in thyroid nodules and allow more individualized surgical and postsurgical management of patients with thyroid cancer.

NO BENEFIT OF DEDICATED THYROID NODULE SCREENING IN PATIENTS WITH ACROMEGALY

2020 ◽  
Vol 26 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Ngan Betty Lai ◽  
Dave Garg ◽  
Anthony P. Heaney ◽  
Marvin Bergsneider ◽  
Angela M. Leung
Keyword(s):  
United States ◽  
Growth Hormone ◽  
Thyroid Cancer ◽  
Growth Factor ◽  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle

Objective: Acromegaly results from the excessive production of growth hormone and insulin-like growth factor-1. While there is up to a 2-fold increased prevalence of thyroid nodules in patients with acromegaly, the incidence of thyroid cancer in this population varies from 1.6 to 10.6% in several European studies. The goal of our study was to determine the prevalence of thyroid nodules and thyroid cancer among patients with acromegaly at a large urban academic medical center in the United States (U.S.). Methods: A retrospective chart review was performed of all patients with acromegaly between 2006–2015 within the University of California, Los Angeles health system. Data were collected regarding patient demographics, thyroid ultrasounds, thyroid nodule fine needle aspiration (FNA) biopsy cytology, and thyroid surgical pathology. Results: In this cohort (n = 221, 49.3% women, mean age 53.8 ± 15.2 [SD] years, 55.2% Caucasian), 102 patients (46.2%) underwent a thyroid ultrasound, from which 71 patients (52.1% women, mean age 52.9 ± 15.2 [SD] years, 56.3% Caucasian) were found to have a thyroid nodule. Seventeen patients underwent a thyroid nodule FNA biopsy and the results revealed 12 benign biopsies, 1 follicular neoplasm, 3 suspicious for malignancy, and 1 papillary thyroid cancer (PTC), from which 6 underwent thyroidectomy; PTC was confirmed by surgical pathology for all cases (8.5% of all nodules observed). Conclusion: In this sample, the prevalence of thyroid cancer in patients with acromegaly and coexisting thyroid nodules is similar to that reported in the general U.S. population with thyroid nodules (7 to 15%). These findings suggest that there is no benefit of dedicated thyroid nodule screening in patients newly diagnosed with acromegaly. Abbreviations: AACE = American Association of Clinical Endocrinologists; ATA = American Thyroid Association; DTC = differentiated thyroid cancer; FNA = fine needle aspiration; GH = growth hormone; IGF-1 = insulin-like growth factor-1; PTC = papillary thyroid cancer; U.S. = United States

Preoperative evaluation and predictive value of fine-needle aspiration and frozen section of thyroid nodules

1998 ◽  
Vol 187 (5) ◽  
pp. 494-502 ◽  
Author(s):  
Loretta A Boyd ◽  
Richard C Earnhardt ◽  
John T Dunn ◽  
Henry F Frierson ◽  
John B Hanks
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Preoperative Evaluation ◽  
Needle Aspiration ◽  
Fine Needle

Correlation of Fine Needle Aspiration Cytology of Thyroid Gland with Histopathological Results

2018 ◽  
Vol 90 (5) ◽  
pp. 1-5 ◽  
Author(s):  
Ewa Machała ◽  
Jan Sopiński ◽  
Iulia Iavorska ◽  
Krzysztof Kołomecki
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Cost Effective ◽  
Needle Aspiration ◽  
The Other ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Thyroid Lesions

ABSTRACT Fine needle aspiration cytology (FNAC) is considered as the gold standard diagnostic test for the diagnosis of thyroid nodules. It is a cost-effective procedure that provides specific diagnosis rapidly with minimal complications. It plays an important role in the determination of treatment- patients with suspected malignancy diagnosis can be subjected to surgery. On the other hand it can decrease the rate of unnecessary surgeries. Aims: The aim of this study was to evaluate and compare the correlation, accuracy of fine needle aspirational cytology (FNAC) in the diagnosis of thyroid lesions with the final histopathologic diagnosis in the surgical specimens. Materials and Methods: In our study we have performed a retrospective analysis of a case series of patients who were admitted to the Department of Endocrine, General and Oncological Surgery of Hospital of M. Kopernik in Łodź (Poland) between May 2016 and December 2017 and underwent FNAC with subsequent surgery. Cytological diagnosis was classified into six Bethesda categories. Results: On cytological examination 1070/1262 were reported as benign, 49 malignant and 143 suspicious. On histopathological examination, 956/1070 cases were confirmed as benign but there were 114 discordant cases. Among the other cases histopathology diagnosis of malignancy matched in 45/49 and 128/143 cases.The sensitivity and specificity were 60,28% and 98,05% respectively. False positive rate was 1.95% and false negative rate was 39.72%. The positive predictive value was 90.1% and negative predictive value was 89.35%. Accuracy of FNA in differentiating benign from malignant thyroid lesions was 89,46%. Conclusions: Fine needle aspiration cytology is a simple, cost-effective and popular procedure for the diagnosis of thyroid cancer. It is recommended as the first line investigation for the diagnosis of thyroid lessions.

scholarly journals Comparison of Elastographic Strain Index and Thyroid Fine-Needle Aspiration Cytology in 631 Thyroid Nodules

2013 ◽  
Vol 98 (12) ◽  
pp. 4790-4797 ◽  
Author(s):  
Flavia Magri ◽  
Spyridon Chytiris ◽  
Valentina Capelli ◽  
Margherita Gaiti ◽  
Francesca Zerbini ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Strain Index ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNAC results), and then tested in a replication set (252 FNAC results). In all cases, a SI value of ≥2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.

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