Cervical thyroid remnant consistent with papillary carcinoma as an incidental finding in a patient with benign total thyroidectomy ten years prior

2019 ◽  
Vol 91 (4) ◽  
pp. 1-3
Author(s):  
Adriana Ruano Campos ◽  
Daniel Rivera Alonso ◽  
Santiago Ochagavía Cámara
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Papillary Carcinoma ◽  
Cervical Lesion ◽  
Needle Puncture ◽  
Papillary Thyroid ◽  
Thyroid Remnant ◽  
Fine Needle ◽  
Fine Needle Puncture

Background: Differential diagnosis of a cervical lesion corresponding with papillary thyroid carcinoma (PTC) after benign total thyroidectomy can be a real challenge. Methods: A cervical thyroid remnant compatible with papillary carcinoma was incidentally found ten years after total thyroidectomy for a non-functional multinodular goitre. Histological analysis of fine needle puncture aspiration (FNPA) was highly suggestive for PTC. Surgical excision of the cervical lesion was performed. Specimen study demonstrated a classic variant of PTC contacting a peripheral margin, applying ablative treatment with radioactive iodine postoperatively. Results: The patient did not present signs of recurrence during follow-up. Small thyroid remnants after benign thyroidectomy are often left behind, although their risk of malignancy is exceptional. Conclusions: It is important to individualize therapeutic approach when facing this rare entity. We decided to treat the patient by removing the lesion followed by ablation therapy with successful results. PTC: Papillary thyroid carcinoma FNPA: Fine needle puncture aspiration

scholarly journals Cytohistological Concordance of Papillary Carcinoma of Thyroid and Its Variants

2021 ◽  
Vol 8 (04) ◽  
pp. 213-218
Author(s):  
Nameera Saleem ◽  
Naval Kishore Bajaj ◽  
Ezhil Arasi Nagamuthu
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Fine Needle Aspiration ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle ◽  
Nuclear Features

BACKGROUND Papillary thyroid carcinoma is the most common malignancy of the thyroid gland. Fine Needle Aspiration Cytology (FNAC) is a rapid, safe and economic procedure, and has a sensitivity approaching of 93.5 % and specificity close to 90 % for diagnosing papillary thyroid carcinomas. This study aims at correlating the cytological and histological diagnosis to arrive at the rate of concordance and discordance, identify variants of papillary thyroid carcinoma (PTC) on cytology and discuss the cytological mimics of PTC. METHODS Data from cases was collected over a period of three years (2015 - 2018). A descriptive study was done. Cases from Osmania General Hospital representing histologically proven cases of papillary carcinoma thyroid along with their corresponding cytological findings were analysed. Cytosmears were obtained from fine needle aspiration of thyroid lesions using a 26-gauge needle, stained with haematoxylin and eosin (H&E). Thyroidectomy specimens were fixed in 10 % buffered formalin, grossed and paraffin embedded. After processing, sections obtained by microtomy were stained with H & E for histopathologic evaluation. RESULTS The institute received a total of 258 thyroid specimens for histopathology and 686 cases for thyroid FNAC over a period of three years. This study includes 70 cases which had both cytology and histopathology correlation at our institution. 65 cases were diagnosed as PTC on histopathology and correct diagnosis was made on cytology with 73.8 % concordance (48 / 65 cases) and discordance was seen in 26.1 % (17 / 65 cases). 5 cases were misdiagnosed on cytology as PTC, and on histopathological examination were diagnosed as non-PTC. CONCLUSIONS Fine needle aspiration shows variable accuracy for PTC, ranging from 65 % to 90 %. The architectural arrangement of cells in papillary fragments and presence of nuclear features in majority of cells is diagnostic of the conventional variant of PTC. The other variants however, pose a diagnostic dilemma on account of their architectural variation, altered cytomorphology and the scant presence of nuclear features. An increase in the awareness of cytomorphology of variants and also of the mimics of PTC helps improve the diagnostic accuracy on FNAC. KEYWORDS Papillary Thyroid Carcinoma, Variants of PTC, Cytohistopathological Correlation

scholarly journals BRAF V600E mutation analysis increases diagnostic accuracy for papillary thyroid carcinoma in fine-needle aspiration biopsies

2009 ◽  
Vol 161 (3) ◽  
pp. 467-473 ◽  
Author(s):  
Maria Chiara Zatelli ◽  
Giorgio Trasforini ◽  
Stefania Leoni ◽  
Gemma Frigato ◽  
Mattia Buratto ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Diagnostic Accuracy ◽  
Total Thyroidectomy ◽  
Mutation Analysis ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle ◽  
Biomolecular Analysis

ObjectivePapillary thyroid carcinoma (PTC) represents the majority of differentiated thyroid cancers, presenting the V600E activating BRAF mutation in 29–83% of cases. The aim of our study is to analyze the influence of BRAF mutation analysis on the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) in patients with suspected PTC.Design and methodsThyroid cytoaspirates from 469 nodules (size: 1.1±0.8 cm) with ultrasonographic features suspicious of malignant lesion, performed in 374 patients, were submitted to cytological evaluation and to biomolecular analysis, carried out after somatic DNA isolation, specific PCR amplification, and subsequent automated direct sequencing. All PCR fragments were also processed by specific enzyme restriction analysis.ResultsBRAF V600E mutation was found in 48 samples, 41 of which were also cytologically diagnosed as PTC, with histologic confirmation after thyroidectomy. Total thyroidectomy was perfomed also in seven patients with negative cytology but positive BRAF mutation, with histological confirmation of PTC in all. Among the 429 BRAF-negative samples, 407 had negative cytology for PTC, while 22 were diagnosed as suspected PTC and underwent total thyroidectomy with histological diagnosis of PTC in 17 and benign lesion in five. The prevalence of BRAF V600E mutation among histologically diagnosed PTC patients was 64%. Biomolecular analysis significantly increased cytology sensitivity for PTC from 77.3 to 86.7% (P<0.01).ConclusionsThese data indicate that BRAF V600E mutation analysis can significantly improve FNAB diagnostic accuracy. However, biomolecular analysis is complementary to cytology, which should always be performed.

scholarly journals Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhichao Xing ◽  
Yuxuan Qiu ◽  
Zhe Li ◽  
Lingyun Zhang ◽  
Yuan Fei ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Independent Predictor ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin

Abstract Background To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC). Methods This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines. Results Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649–267.384; P = 0.019). Conclusion Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively.

scholarly journals Tall Cell Variant versus Conventional Papillary Thyroid Carcinoma: A Retrospective Analysis in 351 Consecutive Patients

2020 ◽  
Vol 10 (1) ◽  
pp. 70
Author(s):  
Alessandro Longheu ◽  
Gian Luigi Canu ◽  
Federico Cappellacci ◽  
Enrico Erdas ◽  
Fabio Medas ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Papillary Thyroid ◽  
Tall Cell Variant ◽  
Group A ◽  
Tall Cell ◽  
Cell Variant ◽  
Group B

Background: The aim of this retrospective study was to investigate clinical and pathological characteristics of the tall cell variant of papillary thyroid carcinoma compared to conventional variants. Methods: The clinical records of patients who underwent surgical treatment between 2009 and 2015 were analyzed. The patients were divided into two groups: those with a histopathological diagnosis of tall cell papillary carcinoma were included in Group A, and those with a diagnosis of conventional variants in Group B. Results: A total of 35 patients were included in Group A and 316 in Group B. All patients underwent total thyroidectomy. Central compartment and lateral cervical lymph node dissection were performed more frequently in Group A (42.8% vs. 18%, p = 0.001, and 17.1% vs. 6.9%, p = 0.04). Angiolymphatic invasion, parenchymal invasion, extrathyroidal extension, and lymph node metastases were more frequent in Group A, and the data reached statistical significance. Local recurrence was more frequent in Group A (17.1% vs. 6.3%, p = 0.02), with two patients (5.7%) in Group A showing visceral metastases, whereas no patient in Group B developed metastatic cancer (p = 0.009). Conclusions: Tall cell papillary carcinoma is the most frequent aggressive variant of papillary thyroid cancer. Tall cell histology represents an independent poor prognostic factor compared to conventional variants.

P-204 Case report of cutaneous papillary thyroid carcinoma 16 years post total thyroidectomy for benign goiter

Oral Oncology ◽  
2021 ◽  
Vol 118 ◽  
pp. 4-5
Author(s):  
Kefalogianni Thiresia ◽  
Klonaris Dionysios ◽  
Oikonomou Dimitris ◽  
Psomadaki Lydia ◽  
Mastorakis Georgios ◽  
...  
Keyword(s):  
Case Report ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Papillary Thyroid ◽  
Benign Goiter

scholarly journals Improvement in the Detection of Cystic Metastatic Papillary Thyroid Carcinoma by Measurement of Thyroglobulin in Aspirated Fluid

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Yong Wang ◽  
Huan Zhao ◽  
Yi-Xiang J. Wang ◽  
Min-Jie Wang ◽  
Zhi-Hui Zhang ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Characteristic Curve ◽  
Needle Aspiration ◽  
Normal Serum ◽  
Papillary Thyroid ◽  
Diagnostic Challenge ◽  
Cutoff Value ◽  
Fine Needle ◽  
Minimum Detection Level

Cystic change in metastatic lymph nodes of papillary thyroid carcinoma (PTC) is a diagnostic challenge for fine needle aspiration (FNA) because of the scant cellularity. The aim of this study was to evaluate the measurement of thyroglobulin in fine needle aspirate (Tg-FNA) for detecting metastatic PTC in patients with cystic neck lesions and to validate the optimal cutoff value of Tg-FNA. A total of 75 FNA specimens of cystic lesions were identified, including 40 of metastatic PTC. Predetermined threshold levels of 0.04 (minimum detection level), 0.9, 10.0, and 77.0 ng/mL (maximum normal serum-Tg level) were used to evaluate the diagnostic accuracy of Tg-FNA for metastatic PTC detection. The areas under the receiver operating characteristic curve for diagnosing metastatic PTC of Tg-FNA values of 0.04, 0.9, 10.0, and 77.0 ng/mL were 0.5 (95% confidence interval [CI], 0.382–0.618), 0.645 (95% CI, 0.526–0.752), 0.945 (95% CI, 0.866–0.984), and 0.973 (95% CI, 0.907–0.996), respectively. With a cutoff value of 77.0 ng/mL, the combination of Tg-FNA and FNA cytology showed superior diagnostic power (97.5% sensitivity and 100% specificity) compared to FNA cytology alone (80% sensitivity and 100% specificity). We recommend a Tg-FNA cutoff of 77.0 ng/mL, the maximum normal serum-Tg level, for cystic neck lesions.

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