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The Nightmare of Indeterminate Follicular Proliferations: When Liquid-Based Cytology and Ancillary Techniques are not a Moon Landing but a Realistic Plan

The Nightmare of Indeterminate Follicular Proliferations: When Liquid-Based Cytology and... Objective: Thyroid nodules are a common finding in the general population, including both nonneoplastic and neoplastic entities. Fine-needle aspiration cytology (FNAC) is the first tool for evaluating thyroid nodules. In spite of its high diagnostic accuracy, 25% of nodules result in the category of follicular neoplasms (FN), with varying risk of malignancy and different management strategies. Study Design: The use of ancillary techniques is reshaping the practice of FNAC. These tools can significantly empower the morphological diagnosis and prognosis of thyroid nodules, allowing a more accurate prediction of the nature of the lesion. Several studies have underlined the role of single or multiple testing for the category of FN as strong indicators of cancer. Every cytological preparation can be used for the application of ancillary techniques but the introduction of liquid-based cytology (LBC) might facilitate the application. Results: Our experience involving an immunocytochemical panel made up of HBME-1 and galectin-3 pointed to an 81% overall diagnostic accuracy in discriminating between low and high risk of malignancy in FN. Conclusions: The application of these techniques on LBC represents an adjunct to the morphological evaluation of FN. They represent a critical and challenging, but also a feasible, tool in the preoperative diagnoses, allowing specific prognostic and predictive details regardless of the cytological preparation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Cytologica Karger

The Nightmare of Indeterminate Follicular Proliferations: When Liquid-Based Cytology and Ancillary Techniques are not a Moon Landing but a Realistic Plan

Rossi, Esther Diana; Fadda, Guido; Schmitt, Fernando
Acta Cytologica , Volume 58 (6): 9 – Jan 1, 2014
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Publisher
Karger
Copyright
© 2014 S. Karger AG, Basel
ISSN
0001-5547
eISSN
1938-2650
DOI
10.1159/000363439
Publisher site
See Article on Publisher Site

Abstract

Objective: Thyroid nodules are a common finding in the general population, including both nonneoplastic and neoplastic entities. Fine-needle aspiration cytology (FNAC) is the first tool for evaluating thyroid nodules. In spite of its high diagnostic accuracy, 25% of nodules result in the category of follicular neoplasms (FN), with varying risk of malignancy and different management strategies. Study Design: The use of ancillary techniques is reshaping the practice of FNAC. These tools can significantly empower the morphological diagnosis and prognosis of thyroid nodules, allowing a more accurate prediction of the nature of the lesion. Several studies have underlined the role of single or multiple testing for the category of FN as strong indicators of cancer. Every cytological preparation can be used for the application of ancillary techniques but the introduction of liquid-based cytology (LBC) might facilitate the application. Results: Our experience involving an immunocytochemical panel made up of HBME-1 and galectin-3 pointed to an 81% overall diagnostic accuracy in discriminating between low and high risk of malignancy in FN. Conclusions: The application of these techniques on LBC represents an adjunct to the morphological evaluation of FN. They represent a critical and challenging, but also a feasible, tool in the preoperative diagnoses, allowing specific prognostic and predictive details regardless of the cytological preparation.

Journal

Acta Cytologica – Karger

Published: Jan 1, 2014

Keywords: Fine-needle aspiration; Liquid-based cytology; Follicular nodules; Immunocytochemistry; Molecular analysis

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