Thyroid Cytology Prepared by Kurt Schaberg Adequacy Criteria Benign Follicular Nodule Lymphocytic Thyroiditis Histologically represent nodular goiter, adenomatoid nodules, and colloid nodules. To evaluate the role of ultrasonography (US), US-guided fine-needle aspiration (USFNA) and intraoperative frozen section (FS) in follicular neoplasm. Clear-cell change in follicular adenoma mimicking Hürthle-cell tumor on thyroid aspiration biopsy cytology. Follicular Adenoma. A cytological diagnosis of PDTC, ATC, or certain variants of PTC can trigger more extensive surgery (eg, tumor debulking, tracheostomy, modified radical neck dissection), and in certain cases—such as those of ATC patients—they may receive adjuvant chemoradiotherapy, including immunotherapy. Designation "benign follicular nodule" applies to a cytologic sample that is adequate for evaluation and consists of colloid and benign appearing follicular cells in varying proportions (Ali: The Bethesda System for Reporting Thyroid Cytopathology, 2nd Edition, 2017) Most common fine needle aspiration (FNA) interpretation (60 - 70% of all cases) (Clin Lab Med … Introduction. slide 1 of 4. Can be mistaken for thyroid follicular neoplasm by fine needle aspiration. Follicular adenoma is the most common type of thyroid adenoma. However, it is almost impossible to preoperatively diagnose follicular tumors (FTs) by fine-needle aspiration cytology (FNAC) because these lesions can be distinguished based on histological criteria, such as capsular/vascular invasion or metastasis … Diagnosis confirmed by a drop in parathyroid hormone (PTH) after surgical removal. Expression of ARE-binding proteins AUF1 and HuR in follicular adenoma and carcinoma of thyroid gland. Clinical features [9] Often presents as a slow-growing solitary nodule; Patients are typically euthyroid. We report the fourth case of mucinous variant of follicular carcinoma displaying a minimally invasive tumor with diffuse expression of thyroglobulin, TTF-1, CD56, PAX-8, cytokeratins 7 and 19, in the absence of monoclonal carcinoembryonic antigen (CEA), cytokeratin 20, chromogranin, HBME-1, P63 expression, and BRAF gene mutation, in a 51-year-old woman who is alive … FVPTC was identified in 35/52 cases (67%). A follicular adenoma is a benign encapsulated tumor of the thyroid gland. Author information: (1)Laboratory for Electron Paramagnetic Resonance Dosimetry and Cytology, Belarusian State Medical University, Minsk, Belarus. 135 Moreover, these patients also require closer surveillance. The concepts of “follicular‐patterned lesions” in surgical pathology and “follicular neoplasm” in cytopathology have engendered much interest in the literature. Follicular thyroid cancer accounts for 15% of thyroid cancer and occurs more commonly in women over 50 years of age. There are several studies on the cytologic clues improving the diagnostic accuracy. Follicular tumors concern proliferation of well-differentiated follicular cells and include follicular adenoma as well as follicular carcinoma. Microfollicles. Comments: Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com; Used with permission. 1-8 Certain other features such as intranuclear pseudo‐inclusions are rare in FVPTC, and papillary … A lobectomy and isthmusectomy are adequate for such lesions. Using this selection criterion, we collected 8 follicular adenoma (FA) and 7 parathyroid adenoma … Follicular lesions, which comprise both follicular adenoma and well-differentiated follicular carcinoma, represent approximately 5% of all thyroid aspirates. A neoplastic nodule was confirmed in 45/52 cases (86%), of which 40 were malignant (77%). Aims and objectives. 21 year old man with multifocal follicular thyroid carcinoma following radiotherapy for Hodgkin disease (Postgrad Med J 1982;58:180) 30 year old woman with mucin producing microfollicular adenoma of the thyroid (J Clin Pathol 1985;38:277) 39 year old woman with follicular thyroid adenoma showing numerous intracytoplasmic lumina mimicking yellow bodies (Cytopathology … Contributed by Ayana Suzuki, C.T., Xiaoyin "Sara" Jiang, M.D., Jose Mellado, M.D. Second examination 2 years later (third and fourth row of images): Clinical data, palpation and functional state: unchanged. A definitive diagnosis is by a tissue biopsy specimen. Considering the lack of halo sign and perinodular blood flow and the lack of cytologial atypia we offered follow-up examinations instead of an immediate surgery. Trojanowicz B, Sekulla C, Dralle H, Hoang-Vu C Neoplasma 2016;63(3):371-7. doi: 10.4149/305_150819N450. Clear‐cell change in follicular adenoma mimicking hurthle‐cell tumor on thyroid aspiration biopsy cytology Christine A. Orlando D.O. 1. Jung YY, Kim MK, Lee TJ, Lee CH, Lee CY, Lee H, Ryu HS Acta Cytol 2013;57(1):100-6. To distinguish follicular adenoma (FA) and follicular carcinoma (FC) of thyroid in fine needle aspiration cytology (FNAC) is a challenging problem. (B) Follicular cells exhibit mild anisocytosis … Thyroid follicular carcinoma (FC) must be differentiated from the more common follicular adenoma (FA). Diagn Cytopathol. Our previous study showed that certain gray-scale US features may help differentiate pathologically confirmed follicular thyroid cancer (FTC) from follicular adenoma (FA) . 1991;7(3):273-6. It is a firm or rubbery, homogeneous, round or oval tumor that is surrounded by a thin fibrous capsule. Orlando CA(1), Salman K, Miller JL, Naryshkin S. Author information: (1)Department of Pathology and Laboratory Medicine, Hahnemann University, Philadelphia, PA. We present a case of follicular adenoma with clear … Cytology resulted in suspicion of a follicular tumor. kirillov@bsmu.by (A) Follicular adenoma confirmed by histologic diagnosis shows many small follicles composed of bland - looking follicular cells. Fig. Kirillov V(1), Emeliyanova O. Cytological diagnosis form the right nodule : follicular tumor … FTA, follicular thyroid adenoma; FTC, follicular thyroid carcinoma; PTC, papillary thyroid carcinoma. Fine-needle aspiration (FNA) is a frequently utilized method for the diagnosis of thyroid nodules. Follicular adenomas are common and usually present as solitary thyroid nodules. Diagnosis of follicular variant (FV) of papillary carcinoma (PC) of the thyroid is considered difficult on cytology. 17 Although the differential diagnosis for these lesions—hyperplastic (adenomatoid) nodules, follicular adenoma, FC, and FVPTC—is well accepted, the demarcations between these entities are not. Differential diagnosis of follicular tumor by expert systems based on a set of quantitative features of thyrocyte nuclei and aggregates. Within these cases, atypical follicular tumors (i.e. 1 Fine needle aspiration cytology of the follicular adenoma. Methods . Parathyroid adenoma arising within the thyroid gland can mimic follicular adenoma of the microfollicular, clear tell or oncocytic type. INTRODUCTION. Herein, we report a case of follicular adenoma showing histological alterations possibly caused by FNA biopsy. Thyroid follicular cells are the thyroid cells responsible for the production and secretion of thyroid hormones. To distinguish follicular adenoma (FA) and follicular carcinoma (FC) of thyroid in fine needle aspiration cytology (FNAC) is a challenging problem. Epidemiology. Four cases were usual papillary carcinoma, 3 were follicular adenoma, 2 were Hürthle‐cell adenoma, and … This category should not include the follicular variant of papillary carcinoma (FVPC), but due to the frequent lack of atypia suggestive for papillary carcinoma in this variant, this may happen. Slides stained in our cytology laboratory using the Papanicolaou staining method (Richard‐Allan Scientific, Kalamazoo, Mich) were utilized for review and image acquisition. Cannot distinguish between follicular adenoma and carcinoma by fine needle aspiration since there needs to be evidence of capsular invasion, vascular invasion or invasion of adjacent parenchyma Cytology images. The follicular lesions include follicular adenoma and follicular carcinoma. Cytological signs of follicular tumors. A follicular adenoma is a common neoplasm of the thyroid gland. Hürthle cell lesions make up between 1 and 3% of cases. Atypical parathyroid adenoma displays histology concerning for but not diagnostic of malignancy and requires clinical follow up after excision. US features, USFNA cytology, and FS results were compared based on the pathology results of patients with follicular adenoma (FA), follicular carcinoma (FC), and follicular variant of papillary thyroid … Anal Quant Cytol Histol. Variable amounts of: colloid, bland follicular cells, Hürthle cells, and macrophages. Should be sparse to moderately cellular with a good The cytology (such as presence of water-clear cells) should provide an important cluue to the correct diagnosis, which can be further confirmed by positive immunostaining for parathyroid hormone and chromogranin. Papillary carcinoma also derives from follicular cells, but it is distinguished from the other lesions by its characteristic nuclear features. Cytology was performed from the nodule is the right lobe (first row of cytological images) and from the lesion presenting microcalcifications in the left lobe (second row of cytological images). Follicular variant of papillary thyroid carcinoma (FVPTC) is a tumor with a follicular growth pattern and with nuclear features such as enlargement, pallor, crowding, and grooves that are characteristic of papillary thyroid carcinoma (PTC). 1 reported “tumor cellularity,” arrangement in empty follicles, … 1. In a typical (theoretical case) a follicular tumor is characterized by a background without colloid, and by the presence of uniform follicular cells forming folliculi of various sizes. 2012 Apr;34(2):86-95. Aims and objectives. Home Endocrine Thyroid Follicular Adenoma Follicular Adenoma. In two autopsy series, the incidence of thyroid adenoma was 3 and 4.3% [1, 2]. 1-8 In Diff‐Quik (Baxter Diagnostics, McGaw Park, IL)‐stained smears of 63 cases of FVPC, Gallagher et al. [9] 10–15% of follicular neoplasms are malignant. Departments of Pathology and Laboratory Medicine and Internal Medicine, Hahnemann Univeristy, Philadelphia, PA The unique liquid-based cytologic findings of thyroid signet-ring follicular adenoma: a report of two cases with fine needle aspiration cytology. Follicular thyroid adenoma is more commonly found in women, increases in incidence with increasing age and in regions in which the diet is iodine deficient 3.. Follicular adenomas are encountered approximately 5 times more frequently than follicular carcinomas 2.. … Background. However, tumors with Bethesda category IV cytology do not always result in a histologic diagnosis of FTC and FA, and it remains uncertain whether they can be used to differentiate this category … Papillary carcinoma, the most frequently encountered malignancy, accounts for 2 to 3% of cases. Although the technique has clear advantages, the injury caused by the aspiration needle can induce various histological alterations. Ethics Approval and Informed Consent This study was approved by Medical Ethics Committee of Chinese PLA General Hospital (S2019-178-02) and the requirement for informed consent was waived because the patients’ data were evaluated retrospectively and anonymously. Fine needle aspiration cytology cannot differentiate between a follicular adenoma or carcinoma. Thyroglobulin (Tg) can be used as a tumor marker for well-differentiated follicular thyroid cancer.
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