A case of trichogerminoma: a rare cutaneous follicular neoplasm

Poorly differentiated thyroid carcinoma (PDTC) is rare and is usually widely invasive at presentation. Here we present an unusual case with a component meeting diagnostic criteria for PDTC by Turin consensus proposal arising within a follicular adenoma. A 44-year-old female was found to have an incidental right thyroid nodule that was suggestive of follicular neoplasm on FNA. Histological examination of hemithyroidectomy revealed an 11 mm focus with insular growth pattern, alteration in cell morphology, and high mitotic count meeting criteria for PDTC. In addition there were several regions showing trabecular architecture with increased mitotic activity but not meeting criteria for PDTC. The literature for such cases is sparse but suggests much better prognosis than conventional invasive PDTC, although a biological potential for aggressive behaviour may be possible.

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Highly accurate diagnosis of cancer in thyroid nodules with follicular neoplasm/suspicious for a follicular neoplasm cytology by ThyroSeq v2 next-generation sequencing assay

Cancer ◽

10.1002/cncr.29038 ◽

2014 ◽

Vol 120 (23) ◽

pp. 3627-3634 ◽

Cited By ~ 329

Author(s):

Yuri E. Nikiforov ◽

Sally E. Carty ◽

Simon I. Chiosea ◽

Christopher Coyne ◽

Umamaheswar Duvvuri ◽

...

Keyword(s):

Next Generation Sequencing ◽

Thyroid Nodules ◽

Accurate Diagnosis ◽

Follicular Neoplasm ◽

Next Generation ◽

Diagnosis Of Cancer ◽

Generation Sequencing

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Intraoperative Frozen Section May Reduce the Need for Reoperative Thyroid Surgery in Patients with Follicular Neoplasm

Journal of Current Surgery ◽

10.14740/jcs286w ◽

2016 ◽

Vol 6 (1) ◽

pp. 1-5

Author(s):

Dena Arumugam ◽

Carlos A. Macias ◽

Renee L. Arlow ◽

Sumana Narayanan ◽

Shou-En Lu ◽

...

Keyword(s):

Thyroid Surgery ◽

Frozen Section ◽

Follicular Neoplasm ◽

Intraoperative Frozen Section ◽

Reoperative Thyroid Surgery

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What Is a Solitary Keratoacanthoma? A Benign Follicular Neoplasm, Frequently Associated with Squamous Cell Carcinoma

Diagnostics ◽

10.3390/diagnostics11101848 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1848

Author(s):

Azusa Ogita ◽

Shin-ichi Ansai

Keyword(s):

Elderly Patient ◽

Follicular Neoplasm ◽

Histopathological Diagnosis ◽

Complete Excision ◽

Exposed Area ◽

Pale Pink ◽

Proliferative Stage ◽

Epithelial Neoplasms ◽

Residual Tissue ◽

Careful Investigation

We present histopathological criteria for diagnosing keratoacanthoma (KA). In KA, four histological stages are recognized, which are the early/proliferative stage, well-developed stage, regressing stage and regressed stage. In diagnosing KA, we emphasize that KA consists of the proliferation of enlarged pale pink cells with ground glass-like cytoplasm without nuclear atypia, other than crateriform architecture. KA sometimes exhibits malignant transformation within the lesions. We describe the characteristics of benign and malignant epithelial crateriform tumors that should be differentiated from KA. We also present the data of histopathological diagnosis of lesions clinically diagnosed as KA, its natural course and related lesions after partial biopsy, and incidence of crateriform epithelial neoplasms. Based on these data, we recommend complete excision of the lesion when KA is clinically suspected, especially when the lesion is located on a sun-exposed area of an elderly patient. If complete excision is impossible, partial excision of a sufficient specimen with intact architecture is required. In such a case, however, careful investigation after biopsy will be needed, even if the histopathological diagnosis is KA, because there is some possibility that a conventional SCC lesion remains in the residual tissue.

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Clinicopathological study of thyroid swelling and its management

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201290 ◽

2020 ◽

Vol 6 (4) ◽

pp. 727

Author(s):

Seema Patel ◽

Varsha J. Gattani ◽

Ashok Z. Nitnaware

Keyword(s):

Papillary Carcinoma ◽

Surgical Management ◽

False Negative ◽

Malignant Lesion ◽

Nodular Goiter ◽

Follicular Neoplasm ◽

Histopathological Diagnosis ◽

Predictive Values ◽

Neoplastic Lesion ◽

Thyroid Swelling

Background: There is high prevalence of thyroid lesions in India. In this study, an attempt is made to find out the clinical spectrum of thyroid swellings in central India, diagnostic accuracy of fine needle aspiration cytology (FNAC), appropriate surgical management and to compare it with postoperative histopathological diagnosis so as to determine its role in surgical management.Methods: In this prospective study, 100 subjects presenting to ENT OPD of GMC, Nagpur during the period from September 2017 to August 2019 with thyroid swelling who were fit to undergo surgery and willing to participate in the study were selected. After detailed evaluation and routine investigations, thyroid function test (TFT), FNAC, ultrasonography (USG) neck, all the subjects underwent required thyroidectomy. The postoperative histopathological examination (HPE) report was correlated with cytological report. Results: In 100 subjects, majority of subjects were from 4th decade (32%) with female: male ratio=6.14:1. FNAC findings were colloid goiter (61%), nodular goiter (19%), follicular neoplasm (10%), and papillary carcinoma (9%). On HPE, colloid goitre (57%) was most common non-neoplastic lesion and papillary carcinoma (65.21 %) was most common malignant lesion. Hemithyroidectomy (70%) was most common procedure done. Transient hypocalcemia (5%), recurrent laryngeal nerve (RLN) paresis (2%) were the postoperative complications encountered. Sensitivity, specificity, accuracy, positive and negative predictive values of FNAC to diagnose malignancy were 55.6%, 100%, 91%, 100% and 90% respectively.Conclusions: FNAC is an easy, rapid, reliable, cost-effective, minimally invasive and readily repeatable technique for diagnosis of thyroid swellings. The common false negative diagnosis is seen in follicular pattern cases, cystic papillary thyroid carcinoma (PTC) and papillary microcarcinoma.

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RISK FACTORS OF MALIGNANCY IN PATIENTS WITH FINE NEEDLE ASPIRATION BIOPSY RESULTS INTERPRETED AS “SUSPICIOUS FOR FOLLICULAR NEOPLASM”

Wiadomości Lekarskie ◽

10.36740/wlek202007103 ◽

2020 ◽

Vol 73 (7) ◽

pp. 1323-1329

Author(s):

Jarosław Świrta ◽

Michał Romaniszyn ◽

Marcin Barczyński

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Biopsy ◽

Follicular Adenoma ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Follicular Neoplasm ◽

Fine Needle ◽

Risk Of Malignancy ◽

Needle Aspiration Biopsy ◽

Aggregate Amount

Introduction: Approximately 10% of fine needle aspiration biopsy (FNAB) of thyroid nodules may be verified as “suspicious for follicular neoplasm”; this category involves follicular adenoma, follicular carcinoma, follicular variants of papillary carcinoma and subclass “suspicious for Hurthle cell neoplasm”. At present, there is no diagnostic tool to discriminate between follicular adenoma and cancer. Most patients are required surgery to exclude malignant process. The aim: To define factors correlating with risk of malignancy in patients with FNAB of thyroid focal lesions and nodules verified as Bethesda tier IV. Materials and Methods: In this study 110 consecutive patients were included. All patients were operated because of FNAB result “suspicious for follicular neoplasm” of thyroid gland at a single institution from January 2016 until March 2020. From this set, six specific categories were defined and the clinical records for patients were collected: sex, age, presence of oxyphilic cells, diameter of the tumour, presence of Hashimoto disease, aggregate amount of clinical and ultrasonographic features of malignancy according to ATA. Results: In 18 patients (16,3%) thyroid cancer occurred. Most frequent subtype turned out to be papillary cancer (66,6%). In group of benign lesion (92 patients) predominance of follicular adenoma was disclosed – (49%). Age, gender, tumour diameter, aggregate amount of clinical and ultrasonografic factors, presence of Hashimoto disease and fine needle aspiration biopsy result suspicious for Hurthle cell neoplasm did not correspond to increased risk of malignancy. Conclusions: In patients with FNAB results classified as Bethesda tier IV there are no reliable clinical features associated with low risk of malignancy and surgery should be consider in every case as most appropriate manner to exclude thyroid cancer

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

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2021.5756 ◽

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.

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Correlation study of thyroid nodule cytopathology and histopathology at two institutions in Jordan

CytoJournal ◽

10.4103/cytojournal.cytojournal_53_17 ◽

2018 ◽

Vol 15 ◽

pp. 24 ◽

Cited By ~ 1

Author(s):

Niveen Abdullah ◽

Manar Hajeer ◽

Loay Abudalu ◽

Maher Sughayer

Keyword(s):

Test Performance ◽

Predictive Value ◽

Diagnostic Category ◽

Needle Aspiration ◽

Correlation Study ◽

Follicular Neoplasm ◽

Risk Of Malignancy ◽

Thyroid Fna ◽

Undetermined Significance

Background: Fine-needle aspiration (FNA) plays a fundamental role in determining the appropriate management for patients presenting with thyroid nodules. Aims: The aims of this study are to evaluate thyroid FNA test performance parameters through a cytohistological correlation. Materials and Methods: A retrospective analysis of all thyroid FNAs received over a period of 18 months was carried out. The findings were compared to their subsequent definite diagnoses on surgical specimens as well as to their follow-up repeat FNA results. A total of 499 thyroid FNAs were collected and reviewed against The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The percentage of each diagnostic category was calculated, and the implied risk of malignancy was determined by comparing the cytology results to their definite diagnoses obtained on the resection specimens. Analytical procedures were performed using Microsoft Excel. Results: Out of 499 thyroid FNAs, a benign interpretation was found in 273 patients (54.7%), atypia of undetermined significance in 81 (16.2%), follicular neoplasm in 20 (4%), suspicious for malignancy in 36 (7.2%), malignant in 32 (6.4%) and were nondiagnostic in 57 patients (11.4%). Only 101 patients (20.2%) underwent surgical resection and 47 (9.4%) underwent a follow-up FNA. After cytohistological correlation, FNA test performance, calculated by excluding the inadequate and undetermined categories revealed test sensitivity, specificity, and diagnostic accuracy of 95.6%, 54.8%, and 78.9%, respectively. The positive predictive value was 75.4%, and the negative predictive value was 89.5%. Conclusions: Our results are comparable to those previously published figures. The rate of atypia of undetermined significance/follicular lesion of undetermined significance is higher than what is currently recommended in TBSRTC.

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