scholarly journals Subacute granulomatous (De Quervain's) thyroiditis: Fine-needle aspiration cytology and ultrasonographic characteristics of 21 cases

CytoJournal ◽  
2015 ◽  
Vol 12 ◽  
pp. 9 ◽  
Author(s):  
Çigdem Vural ◽  
Nadir Paksoy ◽  
Nazlı D Gök ◽  
Kadri Yazal

Background: Subacute granulomatous thyroiditis (SGT) is an inflammatory disease that presents with different clinical and cytological characteristics. Although the diagnosis is generally made clinically, imaging methods and fine-needle aspiration (FNA) may provide assistance, particularly in atypical cases. The objective of this study is to reveal the ultrasonographic (USG) and cytological characteristics of SGT. Materials and Methods: The clinical, USG and cytological findings of 21 cases diagnosed with SGT were reviewed. Results: Ultrasonographic data was available in 20 cases. A hypoechoic thyroid nodule with irregular margins was detected in 12 of the 20 total cases. Of these, 9 cases complained about pain in the thyroid lodge and generally had unilateral lesions, heterogeneous and hypoechoic areas with indistinct margins, rather than nodular lesions, which were seen in 7 cases. Cytologically, the multinuclear giant cells (MNGCs) found in all cases were accompanied by a dirty background containing varying numbers of granulomatous structures, including isolated epithelioid histiocytes, proliferated/regenerated follicle epithelium cells and inflammatory cells and colloid. Conclusion: Though hypoechoic and heterogeneous areas with irregular margins are strongly associated with thyroiditis, SGT may also appear as painful or painless hypoechoic, solid nodules and generate challenges in differential diagnosis. Although the most remarkable characteristic observed in FNA cytology was the presence of multiple MNGCs with cytoplasm, a dirty background accompanied by mild-moderate cellularity, degenerated-proliferated follicular epithelium cells, rare epithelioid granulomas and mixed type inflammatory cells are characteristic for SGT. The assessment of these radiological and cytological findings in conjunction with clinical findings will assist in the achievement of an accurate diagnosis.

2001 ◽  
Vol 125 (12) ◽  
pp. 1575-1578 ◽  
Author(s):  
Kamal K. Khurana ◽  
Zubair W. Baloch ◽  
Virginia A. LiVolsi

Abstract Context.—Solitary papillary hyperplastic thyroid nodules (SPHTNs) are frequently encountered in children and teenagers. Although the histologic features are well described, to the best of our knowledge, cytologic findings have not been reported. Objectives.—To review the cytologic features of histologically proven SPHTNs and to identify the potential diagnostic pitfalls in cytologic diagnosis. Materials and Methods.—Fine-needle aspiration cytology of 3 histologically proven SPHTNs was reviewed. Results.—Two girls and 1 boy (ages 11, 12, and 15 years) were affected. The cytologic diagnosis in all 3 cases was suspicious for papillary thyroid carcinoma (PTC). The spectrum of cytologic findings included broad flat sheets and 3-dimensional clusters with fire flares. There was mild to moderate nuclear pleomorphism and nuclear atypia. Short nonbranching papillae with transgressing vessels shown to represent hyperplastic papillae on histologic sections were identified in all cases. The background contained giant cells, histiocytes, and watery and inspissated colloid. Although nuclear grooves were identified in occasional cells, intranuclear inclusions were absent. A cell block section (1 case) and histologic sections of SPHTNs (2 cases) were immunohistochemically negative for cytokeratin 19. Conclusions.—Fine-needle aspiration of SPHTNs may be difficult to interpret accurately and can result in false-positive diagnosis of PTC. Although it shares several cytologic features with PTC, the presence of fire flares and short nonbranching papillae, as well as lack of intranuclear inclusions and watery and inspissated colloid in SPHTN appear to be useful features that are helpful in distinguishing SPHTN from PTC. Negative immunohistochemical staining for cytokeratin 19 is useful in excluding a diagnosis of PTC.


2021 ◽  
pp. 1-5
Author(s):  
Kenneth Y.Y. Kok ◽  
Pemasiri Upali Telisinghe ◽  
Sonal Tripathi

<b><i>Introduction:</i></b> Paraffin injections for breast augmentation once a popular form of mammoplasty are now considered obsolete. It had been abandoned by clinicians because of its associated serious complications. The practice is however still available and is being practiced by nonmedically qualified people. Paraffin injection results in the formation of multiple foreign-body granulomas known as breast paraffinoma. The clinical features of breast paraffinoma can mimic and be mistaken for breast carcinoma or inflammatory breast carcinoma. The use of fine-needle aspiration cytology (FNAC) in the evaluation of patients with breast paraffinoma has not been fully evaluated. <b><i>Methods:</i></b> Retrospective review was performed on 30 patients who presented with breast paraffinoma between June 1, 2010, and June 30, 2020, who also had FNAC as part of their breast lump evaluation. <b><i>Results:</i></b> FNAC of 73.3% patients showed multinucleated giant cells and macrophages or histiocytes containing engulfed clear, empty intracytoplasmic vacuoles of varying sizes. In 13.3% of the patients, macrophages or histiocytes with engulfed clear intracytoplasmic vacuoles of varying sizes were seen. In 6.7% of patients, multinucleated giant cells containing engulfed vacuoles of varying sizes were seen, and in 6.7% of patients, hypocellular smears with large amount of clear spaces were seen. Oily droplets were seen in the background of all the smears, and there were no malignant cells seen. These features were compatible with breast paraffinoma. <b><i>Conclusion:</i></b> Most patients with breast paraffinoma can be managed conservatively and they do not require further treatment; FNAC with its characteristic features can provide the reliable diagnosis of breast paraffinoma and therefore sparing these patients from more invasive diagnostic procedures.


2018 ◽  
Vol 27 (2) ◽  
pp. 216-220 ◽  
Author(s):  
Norio Motoda ◽  
Munehiko Onda ◽  
Munenaga Nakamizo ◽  
Ryuji Ohashi ◽  
Kimihiro Okubo ◽  
...  

Crystalloid granuloma (CG) of salivary gland is an extremely rare inflammatory disease, and only 6 cases have been reported in the English literature. CG is histologically characterized by a granulomatous reaction to amylase crystalloid deposition. A 73-year-old woman presented with a painful left neck mass. Computed tomography depicted a mass located in the lower pole of the left parotid gland, suspicious for a tumoral lesion. Preoperative fine needle aspiration cytology found amylase crystalloid deposition with a few inflammatory cells. Surgical sections of the mass revealed formation of a granuloma containing abundant eosinophilic but glassy and transparent amorphous crystalloids, suggestive of α-amylase crystalloid. No neoplastic elements were detected. The case was eventually diagnosed with CG in the parotid gland. Our findings suggest that when we identify amylase crystalloids in fine needle aspiration cytology smears from the salivary gland, CG should be considered even if neoplasm is clinically or radiographically suspected.


CytoJournal ◽  
2013 ◽  
Vol 10 ◽  
pp. 12 ◽  
Author(s):  
Rajni Yadav ◽  
Deepali Jain ◽  
Sandeep R. Mathur ◽  
Atul Sharma ◽  
Venkateswaran K. Iyer

Background: Carcinoma of the gallbladder (CaGB) is common in India and its prognosis depends primarily on the extent of the disease and histological type. We aim to study the role of guided fine needle aspiration cytology (FNAC) for diagnosis of CaGB and to evaluate the feasibility of applying world health organization (WHO) classification on fine needle aspiration (FNA) material to predict the outcome of the tumor. Materials and Methods: Retrospective cytomorphologic analysis was performed in all cases of CaGB diagnosed by ultrasound (US) guided FNAC over a period of 2 years. A specific subtype was assigned according to WHO classification based on characteristic cytologic features. These included papillary or acinar arrangement, intra and extracellular mucin, keratin, rosettes and columnar, signet ring, atypical squamous, small, clear, spindle and giant cells. Correlation with histopathology was performed when available. Results: A total of 541 aspirations with clinical or radiological suspicion of primary CaGB were studied. Of these, 54 aspirates were unsatisfactory. Fifty cases were negative for malignancy. Remaining 437 aspirates were positive for carcinoma. Histopathologic diagnosis was available in 32 cases. Adenocarcinoma was the most frequent diagnosis in 86.7% of cases. Mucinous, signet ring, adenosquamous, squamous, small cell, mixed adenoneuroendocrine and undifferentiated carcinoma including spindle and giant cell subtypes were diagnosed identifying specific features on FNAC. Correlation with histopathology was present in all, but one case giving rise to sensitivity of 96.8%. No post-FNA complications were recorded. Conclusions: US guided FNAC is a safe and effective method to diagnose CaGB. Although, rare, clinically and prognostically significant variants described in WHO classification can be detected on cytology.


2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Mukhtar Hussain ◽  
Akram Shad Chishti ◽  
Rubina Mukhtar ◽  
Hanif Khan ◽  
Hussain Siddiqui ◽  
...  

Objective: To compare the results of Fine Needle Aspiration Cytology (FNAC) with open biopsy in cases of Peripheral Lymphadenopathy. Design: A comparative study. Place and duration of study: Department of Paediatric Surgery & Department of Pathology, Nishtar Medical College & Hospital, Multan from January 2004 to September 2004. Subjects and methods: Patients presenting with Peripheral Lymphadenopathy in Paediatric Surgery out patient department were included in study. Relevant history and clinical findings were entered in performa and patients were submitted to investigations like FNAC and open lymphnode biopsy, after getting consent, on OPD basis. Results: Results of both FNAC and histopathology in 54 patients were available for comparison at the end of study. FNAC showed tuberculosis in 36 (66.67%), lymphoproliferative process in 16 (29.63%) and poor yield in 2 (3.71%) cases. Whereas open lymphnode biopsy on histopathology confirmed tuberculosis in 42 (77.78%), Hodgkin`s lymphoma in 4.(7.42%), Non Hodgkin`s in 6 (11.13%) and reactive hyperplasia in 2 (3.71%) cases. Sensitivity of FNAC in tuberculosis was 85.7% with a specificity of 100% in cases of tuberculosis while it was 71.5% in cases of lymphomatous process with an overall sensitivity of 78.5% in peripheral lymphadenopathy. Conclusion: In our setup lymphnode biopsy should be performed in all suspected cases to avoid long term morbidity and mortality especially in clinically malignant illnesses.


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