scholarly journals Dilemma in diagnosing thyroid adenoma – A case report

2015 ◽  
Vol 17 (1) ◽  
pp. 91-96
Author(s):  
Faria Nasreen ◽  
Shamsun Nahar Bailey
Keyword(s):  
Nuclear Medicine ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Thyroid Adenoma ◽  
Thyroid Adenomas ◽  
Extent Of Surgery ◽  
Almost All ◽  
Work Up

A thyroid adenoma is a benign tumour of the thyroid gland. Almost all thyroid adenomas are follicular adenomas. In the clinical management of such patients, the extent of surgery depends on whether it is truly a follicular adenoma or a follicular carcinoma. In case of follicular adenomas where Fine Needle Aspiration (FNA) findings are inconclusive, nuclear medicine techniques play an important role in the pre operative work up. Here we present a case of follicular adenoma highlighting the role of nuclear medicine techniques in the pre operative workup along with the diagnostic dilemmas that can occur DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22497 Bangladesh J. Nuclear Med. 17(1): 91-96, January 2014

scholarly journals Better Understanding in the Differentiation of Thyroid Follicular Adenoma, Follicular Carcinoma, and Follicular Variant of Papillary Carcinoma: A Retrospective Study

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Jung Hyun Yoon ◽  
Eun-Kyung Kim ◽  
Ji Hyun Youk ◽  
Hee Jung Moon ◽  
Jin Young Kwak
Keyword(s):  
Differential Diagnosis ◽  
Frozen Section ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Fine Needle

Background.To evaluate the role of ultrasonography (US), US-guided fine-needle aspiration (USFNA) and intraoperative frozen section (FS) in follicular neoplasm.Methods. US features, USFNA cytology, and FS results were compared based on the pathology results of patients with follicular adenoma (FA), follicular carcinoma (FC), and follicular variant of papillary thyroid carcinoma (FVPTC).Results. FC and FVPTC showed significantly higher rates of suspicious US features (P<0.05) and positive findings on either US or cytology, 80.0% and 90.7%, compared to FA, 64.5% (P=0.001). Intraoperative FS showed higher malignant rates in FVPTC and FC (81.8% and 75.0%, resp.), compared to FA (3.8%,P<0.001).Conclusion. Suspicious US features were more significantly seen in FC and FVPTC compared to FA. Intraoperative FS is useful in the differential diagnosis of these lesions and supplements cytology results of USFNA.

The Thyroid Gland: Recurring Problems in Histologic and Cytologic Evaluation

2008 ◽  
Vol 132 (4) ◽  
pp. 622-632
Author(s):  
William C. Faquin
Keyword(s):  
Thyroid Gland ◽  
Follicular Adenoma ◽  
Endocrine System ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Poorly Differentiated Carcinoma ◽  
Different Types ◽  
Poorly Differentiated ◽  
Common Malignancy

Abstract Nodules of the thyroid gland are frequently encountered, occurring in up to 7% of the population, and although most of these nodules are benign, carcinomas of the thyroid gland are the most common malignancy of the endocrine system. Although the different types of thyroid carcinoma are few, a wide variety of recurring problems exists in both their histologic and cytologic evaluation. Here, I will review a selected group of problematic areas, including unusual histologic variants of follicular adenoma, criteria for diagnosing minimally invasive follicular carcinoma, the use of fine-needle aspiration as a screening test for follicular neoplasia, challenging variants of papillary carcinoma, and features of poorly differentiated carcinoma.

scholarly journals Polymerase Chain Reaction-Based Microsatellite Polymorphism Analysis of Follicular and Hürthle Cell Neoplasms of the Thyroid1

1998 ◽  
Vol 83 (6) ◽  
pp. 2036-2042
Author(s):  
Dorry L. Segev ◽  
Motoyasu Saji ◽  
Grace S. Phillips ◽  
William H. Westra ◽  
Yumi Takiyama ◽  
...  
Keyword(s):  
Surgical Management ◽  
Frozen Section ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
Microsatellite Polymorphism ◽  
Polymorphism Analysis ◽  
Exact Test ◽  
Allelic Alteration

Follicular and Hürthle cell carcinomas of the thyroid cannot be differentiated from adenomas by either preoperative fine needle aspiration or intraoperative frozen section examination, and yet there exist potentially significant differences in the recommended surgical management. We examined, by PCR-based microsatellite polymorphism analysis, DNA obtained from 83 thyroid neoplasms [22 follicular adenomas, 29 follicular carcinomas, 20 Hürthle cell adenomas (HA), and 12 Hürthle cell carcinomas (HC)] to determine whether a pattern of allelic alteration exists that could help distinguish benign from malignant lesions. Alterations were found in only 7.5% of informative PCR reactions from follicular neoplasms, whereas they were found in 23.3% of reactions from Hürthle cell neoplasms. Although there were no significant differences between follicular adenoma and follicular carcinoma, HC demonstrated a significantly greater percentage of allelic alteration than HA on chromosomal arms 1q (P &lt; 0.001) and 2p (P &lt; 0.05) by Fisher’s exact test. The documentation of an alteration on either 1q or 2p was 100% sensitive and 65% specific in the detection of HC (P &lt; 0.0005, by McNemar’s test). In conclusion, PCR-based microsatellite polymorphism analysis may be a useful technique in distinguishing HC from HA. Potentially, the application of this technique to aspirated material may allow this distinction preoperatively and thus facilitate more optimal surgical management. Consistent regions of allelic alteration may also indicate the locations of critical genes, such as tumor suppressor genes or oncogenes, that are important in the progression from adenoma to carcinoma. Finally, this study demonstrates that Hürthle cell neoplasms, now considered variants of follicular neoplasms, differ significantly from follicular neoplasms on a molecular level.

scholarly journals Prevalence of thyroid carcinoma in nodules with thy 3 cytology: the role of preoperative ultrasonography and strain elastography

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Giorgos Pikis ◽  
Eleni Kandaraki ◽  
Demetris Lamnisos ◽  
Sereen Abbara ◽  
Katerina Kyriakou ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Real Time ◽  
Multivariable Analysis ◽  
Needle Aspiration ◽  
Histologic Diagnosis ◽  
Strain Elastography ◽  
Elasticity Score ◽  
Risk Of Malignancy ◽  
Almost All

Abstract Background Fine needle aspiration (FNA) cytology, the gold standard in assessing thyroid nodules, is limited by its inability to determine the true risk of malignancy in Thy 3 nodules. Most patients with Thy3 cytology undergo surgery to establish a histologic diagnosis. The aims of this study were to evaluate the prevalence of malignancy in Thy3 nodules, to examine the ultrasound (US) characteristics that are associated with a high cancer risk and to assess the role of real-time strain elastography. Methods Retrospective cohort study of 99 nodules with Thy3 cytology in 99 patients who underwent thyroidectomy over a three-year period. Grayscale US, Doppler and real-time strain elastography data were evaluated. Results Eighty-one nodules (81.82%) were benign, 18 (18.18%) were malignant, and almost all were papillary thyroid carcinoma (PTC). Univariable analysis revealed irregular margins (p = 0.02), ill-defined borders (p ≤ 0.001), a taller than wide shape (p ≤ 0.001) and the elasticity score (p = 0.02) as significant predictors of malignancy. Multivariable analysis showed that ill-defined borders and the elasticity score were significant and independent factors associated with malignancy. All soft nodules (elasticity scores 1–2) were benign (sensitivity 100%, specificity 33%, NPV 100%, and PPV 23%). There was a higher rate of malignancy in Thy3a nodules than in Thy3f nodules (42.86% versus 11.54%) (p ≤ 0.001). Conclusions Irregular margins, ill-defined borders, a taller than wide shape and low elasticity were associated with malignancy. Elastography should be performed when evaluating Thy3 nodules.

scholarly journals Adenoma thyroid with supraclavicular tuberculous lymphadenitis Masquerading as malignancy thyroid with Metastasis - Diagnostic dilemma

2020 ◽  
Vol 8 (2) ◽  
pp. 106-108
Author(s):  
Nagendra Mahendra ◽  
Abhijeet Ingle ◽  
Dharmendra kumar borad ◽  
Majed Abdul Basit Momin
Keyword(s):  
Lymph Node ◽  
Clinical Examination ◽  
Follicular Adenoma ◽  
Clinical Importance ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Supraclavicular Lymph Node ◽  
Diagnostic Dilemma ◽  
Thyroid Swelling

Thyroid swelling or goitre is one of the commonest presentations among female patients more than males attending ENT out patients. The clinical importance of thyroid swelling is related to evaluating their functional status and assess,whether it is benign,malignant ,hypo or hyper active.Even if benign should look for pressure symptoms which justifies surgery.Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis.Coexistence of thyroid swelling with supraclavicular lymph node mimicking malignancy with metastatic deposit is unusual and always to be evaluated. We report a case of a 45-year female,who on outside initial evaluation was diagnosed as follicular carcinoma of thyroid. However clinical examination revealed a palpable supraclavicular lymph node. Thus subjected to a repeat FNA (fine needle aspiration) from thyroid which revealed benign thyroid follicular adenoma and FNA from supraclavicular lymph node revealed tuberculous lymphadenitis, which was further confirmed by histological sections post operatively. This case emphasizes the need for thorough clinical examination and utility of image guided FNA to rule out the biological nature of these lesions.

scholarly journals Pathobiology of MicroRNAs and Their Emerging Role in Thyroid Fine-Needle Aspiration

2015 ◽  
Vol 59 (6) ◽  
pp. 435-444 ◽  
Author(s):  
Marie Ludvíková ◽  
David Kalfeřt ◽  
Ivana Kholová
Keyword(s):  
Posttranscriptional Regulation ◽  
Regulation Of Gene Expression ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Disease Status ◽  
Needle Aspiration ◽  
Thyroid Tumors ◽  
Fine Needle ◽  
Rna Molecules ◽  
Distinct Disease

Objective: MicroRNAs (miRs) are noncoding, single-stranded regulatory RNA molecules involved in the posttranscriptional regulation of gene expression. They control the development and maintenance of the diverse cellular processes including proliferation, differentiation, motility and apoptosis. Expression of miRs is tissue-specific and each alteration of the tissue miR profile is associated with a distinct disease status. Study Design: We reviewed the literature on the expression of miRs in thyroid tumors, focusing on methodology and diagnostic and prognostic output. Separately, we analyzed 11 studies on miR profiles in thyroid cytological material. Results: Numerous studies have evaluated the miR profiles of thyroid tumors in an attempt to find a possible diagnostic and prognostic role. Both downregulation and upregulation of numerous miRs was found, but differences between the surgical pathology specimens and corresponding fine-needle aspirates in the expression of the same miRs were also reported. Conclusions: The results from surgically resected material cannot be extrapolated into preoperative use without validation. For diagnostic use, the strong overlap between follicular adenoma and follicular carcinoma miR profiles is challenging. In summary, miR-221 and miR-222 are consistently upregulated in different types of thyroid carcinomas and might be used as markers of malignancy.

scholarly journals Correlation between fine needle aspiration cytology and histopathological examination in thyroid swellings-a pilot study

2020 ◽  
Vol 7 (11) ◽  
pp. 4381
Author(s):  
Sanjay V. Gupta ◽  
Manish Munjal ◽  
Devyani Gupta ◽  
Siddharth Gupta ◽  
Shubham Munjal ◽  
...  
Keyword(s):  
Papillary Carcinoma ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Background: Thyroid swellings are an enigma that necessitates either, a partial thyroidectomy and a tissue diagnosis to be followed by completion surgery or straightaway a radical intervention. A preoperative presumptive diagnosis of a thyroid swelling, solitary or otherwise is correlated with the post-surgical histopathological finding in the present study.Methods: 30 patients of thyroid nodules were selected from the head-neck tumour clinic of Dayanand medical college hospital, Ludhiana. Pre-operative fine needle aspiration cytology (FNAC) was performed and subjects taken for thyroidectomy, partial or total as the case maybe.Results: There were 20 (66.6%) females in the age group 25-65 years and 10 males (33.3%) 19-50 years with thyroid nodules. 86.6%, 26 patients were of follicular adenoma, 10% 3 patients of papillary carcinoma and 3.33% 1 patient of follicular carcinoma. No case in this study was reported as medullary carcinoma. In the cytological diagnosis of follicular neoplasm in 5 cases, 3 were diagnosed as thyroid adenoma, 2 were finally found to be papillary carcinoma. Overall sensitivity of fine needle aspiration was 40%. There was 84.6% agreement in follicular adenoma; 33% in papillary carcinoma and 100% in follicular carcinoma, and overall accuracy was 85.7%.Conclusion: FNAC is an ideal preoperative investigative modality in thyroid swellings with overall accuracy of 85 % and can differentiate preoperatively a benign from a   malignant thyromegaly; and thereby plan extent of surgery, with or without a neck dissection, Maximum cases of follicular adenoma could be easily diagnosed with this aspiration modality.                                               

scholarly journals Role of p27 in differentiating follicular adenoma and follicular carcinoma of the thyroid

2021 ◽  
Vol 9 (3) ◽  
pp. 812
Author(s):  
Bimanjyoti Deuri ◽  
Musfika Tabassum ◽  
Nandinee Lahkar
Keyword(s):  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Immunohistochemical Analysis ◽  
Thyroid Neoplasms ◽  
Thyroid Function Tests ◽  
Cell Cycle Protein ◽  
Over Expression ◽  
Malignant Lesions ◽  
Malignant Thyroid Neoplasms

Background: Thyroid neoplasms represent a broad spectrum of tumors with different biologic behaviour. Although investigations like thyroid function tests, scintigraphy and ultrasonography were routinely used for the diagnosis of thyroid nodules, they could not discriminate between benign and malignant lesions. The present study is undertaken to assess the expression of cell cycle protein such as p27kip1 (p27) in thyroid neoplasms which might be useful in predicting behaviour of various thyroid neoplasms and aid in their diagnosis. Aim of the study was to assess the expression of p27 and its role in differentiating follicular adenoma and follicular carcinoma of the thyroid.Methods: The present study was undertaken to evaluate the expression of p27 in thyroid neoplasms with the help of immunohistochemical analysis over a period of 1 year. The study was conducted on archival blocks retrieved from the Department of Pathology, SMCH. 19 thyroid neoplasms were diagnosed (7 benign, 12 malignant) and IHC expression of p27 was studied.Results: There was over-expression of p27 staining in case of follicular adenoma whereas malignant lesions showed underexpression on p27 staining. P27 expression was significantly different in follicular adenoma and follicular carcinoma of the thyroid.Conclusions: The role of p27 in differentiating benign and malignant thyroid neoplasms may prove it to be a candidate marker if combined with other additional investigations like radionuclide scan or using a broad panel of IHC markers. This may provide more insight into the behaviour of tumors in a detailed manner.

scholarly journals Argyrophilic nucleolar organizer regions of thyroid lesions on fi ne needle aspiration smears

2013 ◽  
Vol 3 (5) ◽  
pp. 361-366
Author(s):  
S Chalise ◽  
S Thapa ◽  
G Sayami ◽  
A Shrestha
Keyword(s):  
Organizer Region ◽  
Nucleolar Organizer Region ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Nucleolar Organizer ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Nucleolar Organizer Regions ◽  
Cross Sectional ◽  
Argyrophilic Nucleolar Organizer Region

Background: Argyrophilic nucleolar organizer region is higher in malignant nuclei as compared to reactive and benign nuclei. The main objective of this study was to evaluate the role of Argyrophilic nucleolar organizer region and its extent in differentiating benign and malignant lesions, particularly with respect to follicular neoplasms of the thyroid. Materials and Methods: This was a prospective, cross sectional study which included 110 patients presenting with thyroid swelling. The fi ne needle aspiration smears were studied by conventional methods and silver staining for Argyrophilic nucleolar organizer region. In 50 cases, diagnosis was confi rmed by histopathology. The Argyrophilic nucleolar organizer region count was done and the mean Argyrophilic nucleolar organizer region count per nucleus was calculated along with pattern of distribution. Results: Mean Argyrophilic nucleolar organizer region count was higher in neoplastic as compared to non-neoplastic and infl ammatory lesions. Papillary carcinoma had the highest mean Argyrophilic nucleolar organizer region count (5.40 ± 0.86) and the lowest count was seen in Hashimoto’s thyroiditis (2.10 ± 0.36). Higher mean Argyrophilic nucleolar organizer region count was recorded in follicular carcinoma (4.84 ± 1.42) as compared to follicular adenoma (3.5 ± 0.27) which was found to be statistically signifi cant (P<0.05). Argyrophilic nucleolar organizer region dots were arranged in clusters in colloid goiter whereas scattered discrete black dots were seen in neoplastic lesions. Conclusion: Argyrophilic nucleolar organizer region study of thyroid can be used as an additional diagnostic adjunct with cytomorphological features to differentiate benign and malignant follicular neoplasms. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 361-366 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7859

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