Lu Zhang1, Marco Castellana2, Camilla Virili3, Anna Crescenzi4, Francesco Giorgino2, Emanuele Zucca5,6,7, Luca Ceriani8, Franco Cavalli7, Luca Giovanella8, Pierpaolo Trimboli8. 1. Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. 2. Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy. 3. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. 4. Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy. 5. Division of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. 6. Medical Oncology, University of Bern, Bern, Switzerland. 7. Institute of Oncology Research. 8. Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
Abstract
BACKGROUND: Primary thyroid lymphoma (PTL) is a rare malignancy, and its prognosis depends significantly on its early diagnosis. While fine-needle aspiration (FNA) represents the gold standard to identify differentiated thyroid carcinoma, its reliability for the detection of PTL is still unclear. Here, we conducted a systematic review and meta-analysis to evaluate the diagnostic performance of FNA in PTL. RESEARCH DESIGN AND METHODS: A comprehensive literature search of PubMed/MEDLINE and Scopus databases was conducted to retrieve papers reporting histologically proven PTL undergone FNA. The last search was performed in February 2018 without language and time restrictions. RESULTS: Thirty-two studies describing 593 PTL were included and the pooled FNA sensitivity was 0.48 (95% CI = 0.38-0.58). FNA sensitivity was 0.51 in 20 studies published before 2010 and 0.39 in those published later, 0.50 in six articles with at least 20 cases and 0.44 in nine series enrolled after 2000. This performance was similar in 12 articles including diffuse large B-cell lymphoma (0.54) and those six on marginal zone lymphoma (0.56). Remarkably, FNA sensitivity increased to 0.72 when considering also FNA reports suspicious for PTL reported in 14 articles. Heterogeneity among the series was found. Publication bias was not always detected. CONCLUSIONS: The present meta-analysis demonstrated that FNA has low sensitivity in diagnosing PTL. However, this rate increased when considering also FNA reports suspicious for PTL, which is relevant from a clinical standpoint. This result could support indirectly the use of additional imaging and/or core biopsy when PTL is suspected.
BACKGROUND: Primary thyroid lymphoma (PTL) is a rare malignancy, and its prognosis depends significantly on its early diagnosis. While fine-needle aspiration (FNA) represents the gold standard to identify differentiated thyroid carcinoma, its reliability for the detection of PTL is still unclear. Here, we conducted a systematic review and meta-analysis to evaluate the diagnostic performance of FNA in PTL. RESEARCH DESIGN AND METHODS: A comprehensive literature search of PubMed/MEDLINE and Scopus databases was conducted to retrieve papers reporting histologically proven PTL undergone FNA. The last search was performed in February 2018 without language and time restrictions. RESULTS: Thirty-two studies describing 593 PTL were included and the pooled FNA sensitivity was 0.48 (95% CI = 0.38-0.58). FNA sensitivity was 0.51 in 20 studies published before 2010 and 0.39 in those published later, 0.50 in six articles with at least 20 cases and 0.44 in nine series enrolled after 2000. This performance was similar in 12 articles including diffuse large B-cell lymphoma (0.54) and those six on marginal zone lymphoma (0.56). Remarkably, FNA sensitivity increased to 0.72 when considering also FNA reports suspicious for PTL reported in 14 articles. Heterogeneity among the series was found. Publication bias was not always detected. CONCLUSIONS: The present meta-analysis demonstrated that FNA has low sensitivity in diagnosing PTL. However, this rate increased when considering also FNA reports suspicious for PTL, which is relevant from a clinical standpoint. This result could support indirectly the use of additional imaging and/or core biopsy when PTL is suspected.
Authors: Sami Akbulut; Khaled Demyati; Ridvan Yavuz; Nilgun Sogutcu; Emine Turkmen Samdanci; Yusuf Yagmur Journal: Ann Med Surg (Lond) Date: 2022-06-02
Authors: Vincent Vander Poorten; Nathan Goedseels; Asterios Triantafyllou; Alvaro Sanabria; Paul M Clement; Oded Cohen; Pawel Golusinski; Orlando Guntinas-Lichius; Cesare Piazza; Gregory W Randolph; Alessandra Rinaldo; Ohad Ronen; Maria E Cabanillas; Ashok R Shaha; Yong Teng; Ralph P Tufano; Michelle D Williams; Mark Zafereo; Alfio Ferlito Journal: Front Endocrinol (Lausanne) Date: 2022-09-20 Impact factor: 6.055