scholarly journals Noninvasive follicular thyroid neoplasm with papillary-like nuclear features and the risk of malignancy in thyroid cytology: Data from Singapore

2021 ◽  
Vol 50 (12) ◽  
pp. 903-910
Author(s):  
Bryan Wei Wen Lee ◽  
Manish Mahadeorao Bundele ◽  
Rong Tan ◽  
Ernest Wei Zhong Fu ◽  
Agnes Siqi Chew ◽  
...  
Keyword(s):  
Distant Recurrence ◽  
Needle Aspiration ◽  
Thyroid Neoplasm ◽  
Thyroid Cytology ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Impact ◽  
Nuclear Features

Introduction: The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on the risk of malignancy (ROM) in fine-needle aspiration cytology (FNAC) per The Bethesda System for Reporting Thyroid Cytopathology has not been well reported in Singapore. Methods: We retrospectively identified 821 thyroid nodules with preoperative FNAC from 788 patients out of 1,279 consecutive thyroidectomies performed between January 2010 and August 2016 in a tertiary general hospital in Singapore. Possible cases of NIFTP were reviewed for reclassification and the impact of NIFTP on ROM was analysed. Results: The incidence of NIFTP was 1.2% (10 out of 821). If NIFTP is considered benign, ROM in Bethesda I through VI were 8.6%, 3.5%, 26.3%, 20.0%, 87.7%, 97.0% versus 8.6%, 4.2%, 28.1%, 26.7%, 89.2% and 100% if NIFTP is considered malignant. Eight patients with NIFTP had follow-up of 15 to 110 months. One had possible rib metastasis as evidenced by I131 uptake but remained free of structural or biochemical disease during a follow-up period of 110 months. None had lymph node metastasis at presentation, nor locoregional or distant recurrence. Conclusion: Classifying NIFTP as benign decreased ROM in Bethesda II through VI, but the benignity of NIFTP requires more prospective studies to ascertain. The impact of NIFTP on ROM in our institution also appears to be lower than that reported in the Western studies Keywords: Bethesda, cytology, NIFTP, risk of malignancy, TBSRTC, thyroid nodule

Evaluation of Indeterminate Thyroid Cytology by Second-Opinion Diagnosis or Repeat Fine-Needle Aspiration: Which Is the Best Approach?

2015 ◽  
Vol 59 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Rene Gerhard ◽  
Scott L. Boerner
Keyword(s):  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Definitive Diagnosis ◽  
Second Opinion ◽  
Fine Needle ◽  
Thyroid Cytology ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology

Objective: This study investigated a published series evaluating the role of second-opinion diagnosis (SOD) or repeat fine-needle aspiration cytology (RFNA) for indeterminate thyroid aspirates. Study Design: Twenty-three studies were selected and the following parameters were analyzed: disagreement between SOD or RFNA and the original diagnosis (OD), reclassification of OD according to the Bethesda system for reporting thyroid cytopathology, the rate of definitive diagnosis and the diagnostic performance of SOD and RFNA. Results: 7,154 thyroid FNAs were retrieved from 9 studies that investigated the role of SOD, including 1,048 (14.6%) cases originally reported as indeterminate. The 14 studies that analyzed the role of thyroid RFNA comprised 67,581 FNAs and included 7,246 (10.7%) indeterminate cases. A definitive diagnosis was achieved by SOD in 450 cases (42.9%) and RFNA in 1,645 cases (57.2%, p = 0.0001). Based on cases with histological follow-up, SOD demonstrated significantly higher rates of positive predictive value and accuracy than RFNA (55.8 vs. 37.7%, p = 0.0001; 67.4 vs. 56.0%, p = 0.0034, respectively). Conclusions: Both SOD and RFNA demonstrated an improvement in the diagnosis of initially indeterminate thyroid FNAs. RFNA achieved a definitive diagnosis for the majority of indeterminate cases. Regarding histological follow-up, SOD was shown to be more accurate than RFNA.

scholarly journals Diagnostic Accuracy of the Bethesda System of Reporting Thyroid Cytopathology in the Evaluation of Thyroid Nodule in a Tertiary Care Hospital of Kolkata

2021 ◽  
Vol 8 (05) ◽  
pp. 241-245
Author(s):  
Sweta Verma ◽  
Mita Saha Dutta Chowdhury ◽  
Souradeep Ray ◽  
Ruma Guha
Keyword(s):  
Diagnostic Accuracy ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Hospital ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Bethesda System

BACKGROUND Thyroid cancer has the most rapidly increasing incidence of all major cancers in India. The overall prevalence of thyroid malignancy is approximately 1 - 5 % of all cancers in women and less than 2 % in men. Thyroid nodules are a common clinical finding and have a reported prevalence of 4 – 7 % in the general population. The vast majority of these nodules are non-neoplastic or benign and the risk of malignancy varies from 5 to 10 %. Fine needle aspiration cytology (FNAC) is an efficient and reliable means for the evaluation of thyroid nodules. A key challenge for clinicians is to choose which thyroid nodule is to be investigated further and treated. Early detection and treatment of malignant thyroid nodules is associated with excellent outcomes. The aim of our study is to compare and correlate between fine needle aspiration cytology and histopathology of resected specimen and to determine the diagnostic accuracy of TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology) in thyroid nodule. METHODS This is a cross sectional validation study conducted in a tertiary care hospital (R.G. Kar Medical College) of Kolkata to find the sensitivity, specificity and diagnostic accuracy of TBSRTC in evaluation of thyroid nodule. RESULTS We have observed that TBSRTC is highly sensitive and specific in stratifying the malignancy risk of thyroid nodule. CONCLUSIONS It aids the clinician to choose the thyroid nodules which require further evaluation and intervention. It also guides the clinician to decide the operability of thyroid nodule. TBSRTC is highly accurate and is highly specific in stratifying the risk of malignancy of thyroid nodule. KEYWORDS TBSRTC, FNAC, Thyroid Nodules, Thyroid Cancer

scholarly journals Malignancy Rate in Thyroid Nodules with Atypia or Follicular Lesion of Undetermined Significance

2020 ◽  
Vol 24 (02) ◽  
pp. e221-e226
Author(s):  
Hamdan Ahmed Pasha ◽  
Rahim Dhanani ◽  
Ainulakbar Mughal ◽  
Kaleem S. Ahmed ◽  
Anwar Suhail
Keyword(s):  
Thyroid Nodules ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Diagnostic Categories ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Undetermined Significance

Abstract Introduction Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) is one of the six diagnostic categories of the Bethesda System for Reporting Thyroid Cytopathology. The prevalence of malignancy among Bethesda category III cytology is variable, ranging from 5% to 37% in the literature. Objective To determine the rate of malignancy in thyroid nodules reported as Bethesda category III. Methods A total of 495 patients underwent surgical intervention for thyroid nodules from January 2015 to December 2017. The present study included 81 cases reported as Bethesda category III, and their medical records were reviewed. Results Out of 495 fine-needle aspiration cytology samples, 81 (16.4%) samples were labeled as AUS/FLUS. Among these 81 patients, the mean age was 43.0 years (± 13.9), with only 11 (14%) patients older than 55 years of age. Most of our patients were female (n = 69; 85.2%), and the rest were male. The rate of malignancy based on the final histology was of 33.3% (n = 27). The majority were 17 cases (21%) of papillary carcinoma, followed by follicular carcinoma (n = 6) (7.4%). Conclusion The risk of malignancy can be higher than it is commonly believed, and guidelines should be based on the data from the institutions themselves for a better assessment of the outcomes.

Cytomorphologic, Imaging, Molecular Findings, and Outcome in Thyroid Follicular Lesion of Undetermined Significance/Atypical Cell of Undetermined Significance (AUS/FLUS): A Mini-Review

2018 ◽  
Vol 63 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Bita Geramizadeh ◽  
Somayeh Bos-hagh ◽  
Zahra Maleki
Keyword(s):  
Needle Aspiration ◽  
American Thyroid Association ◽  
Atypical Cell ◽  
Thyroid Cytology ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
The Bethesda System ◽  
Ancillary Studies ◽  
Undetermined Significance

Objectives: Since the introduction of the entity of “Atypical cell of undetermined significance /follicular lesion of undetermined significance” (AUS/FLUS) by The Bethesda System for Reporting Thyroid Cytology (TBSRTC) in 2007, there have been many published studies about the cytomorphologic criteria, subclassification, outcome, and management of patients with the diagnosis of AUS/FLUS. There have been many studies in different aspects of this indeterminate category, i.e., cytologic and molecular findings, ultrasonographic findings, and in some instances even core-needle biopsy to address a better and safer way of the management of patients with this fine-needle aspiration cytology diagnosis. The second edition of TBSRTC and the 2015 American Thyroid Association guidelines provide an update on the follow-up and management of AUS/FLUS. A multidisciplinary team consisting of pathologists, endocrinologists, surgeons, and radiologists should be involved in the diagnosis and management of AUS/FLUS, and all of them should be aware of the heterogeneity of this lesion for the prediction of the treatment and outcome. Study Design: In this review, we consider different research platforms (2008–2017) to find the best and key reports for the above-mentioned challenging aspects of AUS/FLUS. Conclusion: AUS/FLUS is now a well-defined group of thyroid lesions, which can be most accurately diagnosed and managed with cytomorphology, molecular, and ancillary studies.

scholarly journals The Bethesda system for reporting of thyroid cytopathology and its category wise management

2019 ◽  
Vol 8 (10) ◽  
pp. 2228
Author(s):  
Varun Gupta ◽  
Pooja Singh
Keyword(s):  
Thyroid Nodules ◽  
Reporting System ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Thyroid Cytology ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Background: Fine-needle aspiration cytology (FNAC) of thyroid is a rapid diagnostic test for thyroid nodules. The Bethesda system classifies thyroid FNAC into six categories. Each category is linked to a malignancy risk and has recommended clinical management. The aim of this study was to analyze the thyroid cytology smears by Bethesda system and to assess the frequency of various categories and to correlate it previous published studies. Category wise management is also discussed in detail.Methods: A total of 388 thyroid FNAC samples were examined from January 2017 to June 2018 in the Department of Pathology, in Medanta- The Medicity Gurugram.Results: A total of 388 cases were reported according to Bethesda system of reporting. Categories were as follows: I (14.69%), II (61.85%), III (11.34%), IV (2.57%), V (2.660%), VI (4.91%) nodules.Conclusions: The Bethesda System for reporting thyroid cytopathology proved to be an excellent reporting system and it puts clinician and the cytopathologist on the same page and easier to communicate regarding diagnosis.

scholarly journals Impact of non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) on risk of malignancy in patients undergoing lobectomy/thyroidectomy for suspected malignancy or malignant fine-needle aspiration cytology findings: a systematic review and meta-analysis

2019 ◽  
Vol 181 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Massimo Bongiovanni ◽  
William C Faquin ◽  
Luca Giovanella ◽  
Cosimo Durante ◽  
Peter Kopp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Diagnostic Categories ◽  
Non Invasive ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology ◽  
Nuclear Features

Objective The second version of The Bethesda System for Reporting Thyroid Cytopathology endorsed the introduction of non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) as a distinct entity with low malignant potential into clinical practice. Consequently, the risk of malignancy (ROM) of cytological diagnoses has changed, but the magnitude of the change remains uncertain. The present systematic review was undertaken to obtain more robust information about the true impact of NIFTP on the ROM among patients undergoing surgery following a fine-needle aspiration cytology (FNAC) diagnosis of suspicious for malignancy (Bethesda V) or malignant (Bethesda VI). As they are managed surgically, these two diagnostic categories are the primary entities that are clinically impacted by the advent of NIFTP. Design Systematic review and meta-analysis. Methods A comprehensive literature search of online databases was performed in November 2018. The search was conducted looking for data of histologically proven NIFTP with preoperative FNAC. Results One-hundred fifty-seven articles were identified and nine were included in the study. Overall, there were 13,752 thyroidectomies with a cancer prevalence of 45.7%. When NIFTP was considered non-malignant, the pooled risk difference for ROM was 5.5%. Applying meta-analysis, the pooled prevalence of NIFTP among nodules with FNAC of Bethesda V or Bethesda VI was 14 and 3%, respectively. Conclusion This meta-analysis shows that the inclusion of NIFTP leads to a reduction in the ROM for the Bethesda V and Bethesda VI FNAC diagnostic categories by 14 and 3%, respectively. Clinicians should be aware of these data to avoid overtreatment.

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