BACKGROUND: Fine-needle aspiration (FNA) for thyroid nodules is the most important method for determining a diagnosis. The system for reporting results is based on a cytopathologic classification that stratifies the risk of malignancy. METHODS: We retrospectively studied 197 patients who underwent FNA for diagnostic evaluation of a thyroid nodule and had their results reported as a follicular lesion of undetermined significance (FLUS) using the Bethesda classification system. The objective of the study was to analyze the incidence and histopathologic types of malignancy in these cases. RESULTS: The final histopathologic breakdown is as follows: 65 cases (32.9%) of follicular adenoma, 81 cases (41.1%) of microfollicular adenomatoid nodule, 19 cases (9.6%) of microfollicular adenomatoid nodule on the background of thyroiditis, 17 cases (8.6%) of follicular carcinoma, 9 cases (4.6%) of follicular variant papillary carcinoma, and 6 cases (3.1%) of classic papillary carcinoma, for a 16.2% incidence of malignancy. Beyond these diagnoses in the FNA-biopsied nodules, we observed 29 cases (14.7%) of incidental ipsilateral papillary thyroid microcarcinoma (PTM) and 13 cases (6.6%) of incidental contralateral thyroid lobe PTM. CONCLUSIONS: This study observed a 16.2% incidence of thyroid cancer in the nodule designated FLUS compared to the 5 to 15% rate reported by the Bethesda FNA classification. The overall incidence of incidental PTM in the thyroid gland was 21.3%. These data support considering surgical intervention for at least diagnostic purposes in a patient with the FNAB diagnosis of FLUS.
BACKGROUND: Fine-needle aspiration (FNA) for thyroid nodules is the most important method for determining a diagnosis. The system for reporting results is based on a cytopathologic classification that stratifies the risk of malignancy. METHODS: We retrospectively studied 197 patients who underwent FNA for diagnostic evaluation of a thyroid nodule and had their results reported as a follicular lesion of undetermined significance (FLUS) using the Bethesda classification system. The objective of the study was to analyze the incidence and histopathologic types of malignancy in these cases. RESULTS: The final histopathologic breakdown is as follows: 65 cases (32.9%) of follicular adenoma, 81 cases (41.1%) of microfollicular adenomatoid nodule, 19 cases (9.6%) of microfollicular adenomatoid nodule on the background of thyroiditis, 17 cases (8.6%) of follicular carcinoma, 9 cases (4.6%) of follicular variant papillary carcinoma, and 6 cases (3.1%) of classic papillary carcinoma, for a 16.2% incidence of malignancy. Beyond these diagnoses in the FNA-biopsied nodules, we observed 29 cases (14.7%) of incidental ipsilateral papillary thyroid microcarcinoma (PTM) and 13 cases (6.6%) of incidental contralateral thyroid lobe PTM. CONCLUSIONS: This study observed a 16.2% incidence of thyroid cancer in the nodule designated FLUS compared to the 5 to 15% rate reported by the Bethesda FNA classification. The overall incidence of incidental PTM in the thyroid gland was 21.3%. These data support considering surgical intervention for at least diagnostic purposes in a patient with the FNAB diagnosis of FLUS.
Authors: David S Cooper; Gerard M Doherty; Bryan R Haugen; Bryan R Hauger; Richard T Kloos; Stephanie L Lee; Susan J Mandel; Ernest L Mazzaferri; Bryan McIver; Furio Pacini; Martin Schlumberger; Steven I Sherman; David L Steward; R Michael Tuttle Journal: Thyroid Date: 2009-11 Impact factor: 6.568
Authors: T S Greaves; M Olvera; B D Florentine; A S Raza; C J Cobb; D D Tsao-Wei; S Groshen; P Singer; J Lopresti; S E Martin Journal: Cancer Date: 2000-12-25 Impact factor: 6.860
Authors: Jennifer L Rabaglia; Wareef Kabbani; Lucy Wallace; Shelby Holt; Lori Watumull; Jeffrey Pruitt; William H Snyder; Fiemu E Nwariaku Journal: Surgery Date: 2010-12 Impact factor: 3.982
Authors: Zubair Baloch; Virginia A LiVolsi; Pooja Jain; Rishi Jain; Ibrahim Aljada; Susan Mandel; Jill E Langer; Prabodh K Gupta Journal: Diagn Cytopathol Date: 2003-10 Impact factor: 1.582
Authors: Zubair W Baloch; Edmund S Cibas; Douglas P Clark; Lester J Layfield; Britt-Marie Ljung; Martha Bishop Pitman; Andrea Abati Journal: Cytojournal Date: 2008-04-07 Impact factor: 2.091
Authors: M-L Matthey-Gie; S M Walsh; A C O'Neill; A Lowery; D Evoy; D Gibbons; R S Prichard; S Skehan; E W McDermott Journal: Ir J Med Sci Date: 2014-01-09 Impact factor: 1.568
Authors: Marjory Alana Marcello; Elaine Cristina Morari; Lucas Leite Cunha; Aline Carolina De Nadai Silva; Dirce Maria Carraro; André Lopes Carvalho; Fernando Augusto Soares; José Vassallo; Laura Sterian Ward Journal: Clin Dev Immunol Date: 2013-09-19
Authors: J Ratour; M Polivka; H Dahan; L Hamzi; R Kania; M L Dumuis; R Cohen; M Laloi-Michelin; B Cochand-Priollet Journal: J Thyroid Res Date: 2013-03-24