Fine-needle aspiration of follicular patterned lesions of the thyroid: Diagnosis, management, and follow-up according to thyroid bethesda system


Üstün H., ASTARCI H. M. , Altunkaya C., Ylmaz S., Barn A., Ekici S., ...More

Acta Cytologica, vol.56, no.4, pp.361-369, 2012 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 56 Issue: 4
  • Publication Date: 2012
  • Doi Number: 10.1159/000338218
  • Journal Name: Acta Cytologica
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Page Numbers: pp.361-369
  • Keywords: Bethesda, Fine-needle aspiration, Follicular patterned lesions, Thyroid, PAPILLARY CARCINOMA, SCIENCE CONFERENCE, GRAY-ZONE, VARIANT, CANCER, CYTOLOGY, MALIGNANCY, NODULES, STATE, INTEROBSERVER

Abstract

Objective: The goal of this study was to report an experience with thyroid fine-needle aspiration (FNA) cases that can be placed into National Cancer Institute-designated thyroid FNA diagnostic categories for follicular patterned lesions divided into three diagnostic categories: follicular lesion of undetermined significance/atypia of undetermined significance (AUS/FLUS), suspicious for follicular neoplasm (SFON), and suspicious for malignancy. Study Design: The study cohort included 4,284 cases for the period between January 2007 and July 2011 and all available follow-up data was obtained. All cases classified as 'atypical' and 'rule out follicular neoplasm' were included in the AUS/FLUS category (n = 3,903), whereas cases classified as 'suspicious for' or 'consistent with follicular or Hrthle cell neoplasm' (n = 381) were included in the SFON diagnostic category and compared with histopathologic follow-up. Results: During this period, 14,628 thyroid FNAs were reported in 12,238 patients. Repeat FNA (RFNA) was performed in 1,366/3,903 (35%) patients classified as AUS/FLUS. Histologic outcome data was available in 1,756/3,903 (45%) cases diagnosed as AUS/FLUS and 243/381 (64%) cases diagnosed as SFON. The rate of malignancy in AUS/FLUS cases with and without RFNA was 29 and 14% respectively, and it was 26% in SFON cases. Conclusion: The current data shows that the malignancy rates differ between categories and AUS/FLUS cases are best managed by RFNA for selection of cases that can benefit from surgical excision. Copyright © 2012 S. Karger AG, Basel.