p53 Immunolocalization in Cell Block Preparations of Squamous Lesions of the Neck: An Adjunct to Fine-Needle Aspiration Diagnosis of Malignancy

1999 ◽  
Vol 123 (5) ◽  
pp. 421-425
Author(s):  
Kamal K. Khurana ◽  
Ibrahim Ramzy ◽  
Luan D. Truong
Keyword(s):  
Fine Needle Aspiration ◽  
P53 Protein ◽  
Needle Aspiration ◽  
Protein Accumulation ◽  
Branchial Cleft Cyst ◽  
Cytologic Diagnosis ◽  
Fine Needle ◽  
Squamous Cells ◽  
Branchial Cleft

Abstract Objective.—Mutations of the p53 tumor suppressor gene, with consequent nuclear p53 protein accumulation, are among the most common genetic abnormalities in human cancers. The purpose of this study was to determine the utility of p53 immunostaining as an adjunct to the diagnosis of malignancy in fine-needle aspirations of squamous lesions of the neck. Materials and Methods.—Using a monoclonal antibody to the p53 protein and a standard avidin-biotin complex technique, immunostaining was performed on paraffin-embedded cell blocks of 20 cases with the following cytologic diagnoses: (1) metastatic squamous cell carcinoma (SCC) (7 cases); (2) atypical squamous cells, SCC cannot be excluded (7 cases); and (3) cytologic findings consistent with branchial cleft cyst (6 cases). Tissue or clinical follow-up was available in all cases. Results.—Five (71%) of 7 cases with an unequivocal cytologic diagnosis of metastatic SCC were positive for p53 protein. Tissue follow-up confirmed metastatic SCC in all of these 7 cases. Of the 7 cases with cytologic diagnosis of atypical squamous cells, 2 were negative and 5 (71%) were positive for p53 protein. Subsequent excisional biopsies in these cases revealed metastatic SCC (6 cases) and branchial cleft cyst (1 case). The squamous cells in all 5 cases with cytologic findings consistent with branchial cleft cyst were negative for p53 protein; tissue follow-up confirmed the diagnoses of branchial cleft cyst in 4 cases. In the remaining 2 cases excision was not performed, as the cystic lesion was completely decompressed and, clinically, no recurrences were identified at 14 and 8 months of follow-up. Conclusions.—Our findings suggest that p53 immunostaining is helpful in differentiating benign and malignant squamous lesions. While negative staining for p53 does not exclude malignancy, positive immunostaining may aid in accurate fine-needle aspiration diagnosis of malignancy in cytomorphologically equivocal squamous lesions of the neck.

Glial Fibrillary Acidic Protein and CD57 Immunolocalization in Cell Block Preparations Is a Useful Adjunct in the Diagnosis of Pleomorphic Adenoma

2007 ◽  
Vol 131 (9) ◽  
pp. 1373-1377 ◽  
Author(s):  
Sejal S. Shah ◽  
Vishal S. Chandan ◽  
David C. Wilbur ◽  
Kamal K. Khurana
Keyword(s):  
Salivary Gland ◽  
Glial Fibrillary Acidic Protein ◽  
Pleomorphic Adenoma ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Acidic Protein ◽  
Cell Block ◽  
Cytologic Diagnosis ◽  
Fine Needle

Abstract Context.—The cytologic distinction between pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) can be diagnostically challenging in aspirate smears. Hence a cytologic diagnosis of “atypical cytology” with a differential diagnosis including PA and ACC is occasionally rendered in a subset of salivary gland fine-needle aspirations. Objective.—To evaluate the role of glial fibrillary acidic protein (GFAP) and CD57 expression in cell block material obtained during fine-needle aspiration procedure in differentiating PA from ACC. Design.—We performed GFAP and CD57 immunostains on formalin-fixed, paraffin-embedded cell block sections of 26 salivary gland fine-needle aspiration cases with the following cytologic diagnoses: (1) PA (10 cases); (2) atypical cytology, cannot exclude ACC (8 cases); and (3) ACC (8 cases). Results.—All 10 (100%) cases with cytologic diagnoses of PA were positive for GFAP, and 8 (80%) of 10 cases were positive for CD57; tissue follow-up confirmed the diagnosis of PA in all cases. All 8 (100%) cases with cytologic diagnosis of ACC were negative for both GFAP and CD57; tissue follow-up confirmed the diagnoses of ACC in all cases. Of the 8 cases with diagnoses of atypical cytology, 4 (50%) were negative and 4 (50%) were positive for both GFAP and CD57. Subsequent tissue follow-up in these cases revealed 4 cases of ACC (all negative for GFAP and CD57) and 4 cases of PA (all positive for GFAP and CD57). Conclusions.—Our results show that positive staining for GFAP and CD57 serves as a useful adjunct for the diagnosis of PA and helps to reduce the uncertainty in challenging cases.

scholarly journals Papillary Thyroid Microcarcinoma with a Large Cystic Dilated Lymph Node Metastasis to the Neck Mimicking a Branchial Cleft Cyst: A Potential Pitfall

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Osman Ilkay Ozdamar ◽  
Gul Ozbilen Acar ◽  
Cigdem Kafkasli ◽  
M. Tayyar Kalcioglu ◽  
Tulay Zenginkinet ◽  
...  
Keyword(s):  
Young Adult ◽  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Cystic Mass ◽  
Papillary Thyroid ◽  
Branchial Cleft Cyst ◽  
Fine Needle ◽  
Branchial Cleft

Lateral cervical cystic mass in a young adult very rarely could be a first sign of an occult thyroid papillary microcarcinoma metastasis. In this paper, we presented a 37-year-old male patient whose preoperative 6 cm left lateral cervical cystic mass was initially diagnosed as branchial cleft cyst, but then the postoperative histopathological examination of the mass was revealed as papillary thyroid carcinoma metastasis. Preoperative fine needle aspiration biopsy was relevant with a branchial cleft cyst. In the left thyroid lobe there were 3 solid nodules with 4, 6, and 12 mm dimensions, respectively. One of the nodules had malignant well-differentiated cells diagnosed after fine needle aspiration biopsy. After total thyroidectomy, histopathologic evaluation of biopsy material’s showed papillary thyroid microcarcinomas. This case indicates that especially in a young adult lateral cervical cystic mass should be carefully considered preoperatively for the possibility of metastatic occult thyroid carcinoma, especially for papillary carcinoma in differential diagnosis, and evaluation of the thyroid gland should be taken into account.

scholarly journals Follow-up of Benign Thyroid Nodules—Can We Do Less?

2019 ◽  
Vol 70 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Manijeh Mohammadi ◽  
Carrie Betel ◽  
Kirsteen Rennie Burton ◽  
Kevin McLughlin Higgins ◽  
Zeina Ghorab ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Descriptive Study ◽  
Needle Aspiration ◽  
Thyroid Malignancy ◽  
Fine Needle ◽  
Nodule Size ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Objective To determine the incidence of malignancy, follow-up ultrasound (US), and repeat fine needle aspiration (FNA) in thyroid nodules that have been previously biopsied as benign. Methods This is a retrospective, descriptive study of benign thyroid nodules evaluated by US between 2010-2011. We determined the frequency of follow-up ultrasounds and FNAs, mean years of follow-up, interval between follow-up US, change in nodule size, reasons for repeat FNA (rFNA), frequency of thyroidectomy, and thyroid malignancy during 5 years of follow-up. Results A total of 733 benign thyroid nodules were reviewed in 615 patients. Mean years of US follow-up was 3.47 ± 1.65 years; 275 (37.5%) had no follow-up US; 109 (14.9%) had 1 follow-up US; 93 (12.7%) had 2 follow-up US; and 256 (34.9%) had 3 or more follow-up US. Assessment of thyroid nodule size showed that 215 (28.8%) nodules decreased in size, 145 (19.4%) increased in size by less than 50%, and 91 (12.1%) increased in size by more than 50%. Of the 733 nodules, 17 nodules (2.3%) underwent thyroidectomy for which the pathology result of 9 (1.2%) showed malignancy, and 65 (8.9%) thyroid nodules underwent rFNA. When applying the 2015 recommendations for repeat FNA, 35% were done unnecessarily. Conclusion In our sample of initially benign thyroid nodules, only 9 patients (1.2%) had pathology-proven malignancy after a mean follow-up of 3.5 years. Over 30% of patients had more than 3 rUSs. Decreased interval and frequency of rUS should be considered in future guidelines for thyroid management.

scholarly journals Predictive Factors of Malignancy in Cytology of Indeterminate Follicular and Hürthle Cell Neoplasms of the Thyroid Gland

2019 ◽  
Vol 103 (1-2) ◽  
pp. 9-14
Author(s):  
Bahadır Öz ◽  
Serap Doğan ◽  
Ertan Emek ◽  
Muhammed Akyüz ◽  
Alper Akcan ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Family History ◽  
Radiation Exposure ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Cytologic Diagnosis ◽  
Fine Needle ◽  
Solitary Nodule ◽  
History Of

The objective of the current study was to determine the risk of malignancy in patients with thyroid nodules with cytology of indeterminate follicular and indeterminate Hürthle cell neoplasm (HN). The cytologic diagnosis of follicular neoplasm (FN) or HN remains a diagnostic challenge. Often, surgery is recommended for such lesions. A retrospective analysis was performed on 80 patients who underwent thyroid surgery following a diagnosis of indeterminate FN and indeterminate HN in thyroid fine-needle aspiration biopsy. Sex; age; family history of thyroid cancer and radiation exposure; coexisting thyroid conditions, such as solitary nodule; multinodularity; cytologic diagnosis; sonographic features; type of surgical treatment; and histopathologic results were recorded. Of the 80 patients, 52 (65%) had FN on fine-needle aspiration biopsy cytology and 28 (35%) had HN. A total of 23 patients (28.7%) had primary thyroid cancers on surgical pathology, and 57 (71.3%) had benign diagnoses. Univariate analysis showed no differences between the benign and malignant groups by sex, nodule size, family history of thyroid cancer, history of radiation exposure, presence of solitary nodule or multinodularity in the nodular features. In multivariate binary logistic regression analysis, the factors that were statistically significant predictors of malignancy were microcalcification [odds ratio (OR), 10.9; 95% confidence interval (CI), 2.18–54.7; P = 0.004], being older than 45 years (OR, 4.2; 95% CI, 1.25–14.63; P = 0.02]. The independent predictors of malignancy in FN and HN are micorcalcification and being older than 45 years, the use of which may predict the risk of thyroid cancer.

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