Fine needle aspiration cytology (FNAC) is a widely employed tool in the investigative work-up of patients with single thyroid nodules. Background. A 24-year-old female (euthyroid and asymptomatic) presented with a solitary mass in the right lobe of thyroid for 2 years. National Library of Medicine Res. histopathological analysis is still remaining essential to distinguish follicular adenoma from follicular carcinoma. N-RAS and K-RAS mutations may be present in patients with follicular adenoma and have been implicated in the evolution of follicular adenoma to follicular carcinoma 4. Experience with FNAC in 150 patients with solitary thyroid nodules is presented, highlighting the pitfalls of this technique. Although its advantages are well documented, the limitations and problems in interpretation of FNAC in this condition are not well known. FNAC. RESULTS: In the 67 patients receiving ultrasonography with FNAC, 23 were preoperatively diagnosed as having papillary thyroid carcinoma and 1 as having follicular carcinoma. The sensitivity of FNAC in diagnosing benign nodules is 92% and specificity is 71.6%. 5 (5.8%) follicular neoplasm without atypia, 2 (2.3%) as ultrasonography and FNAC. A patient under our observation displayed left submandibular swelling. This site needs JavaScript to work properly. Metab. 37.1% were benign (nodular goiter – 31.4% and lymphocytic thyroiditis-5.7%). ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Fine needle aspiration of a thyroid mass cannot diagnosis follicular thyroid cancer because it can only provide analysis of the cells themselves (which have the same appearance of normal follicular cells of the thyroid). Functioning follicular adenomas occur as a result of a monoclonal expansion of thyroid follicular cells with a high prevalence of activating mutations in the gene for the TSH receptor 1. The mass was surgically removed and histopatology showed a follicular adenoma in the contest of the capsulated lesion. Ultrasound features of follicular adenomas share many features with follicular carcinomas. It is impossible to distinguish between follicular adenoma and carcinoma on cytological grounds. The diagnosis of follicular thyroid cancer within a thyroid gland can only be made by On histology, 57.1% of these were follicular neoplasm’s (follicular adenoma-37.1% and follicular carcinoma-20%). (HN), 14 follicular adenoma (FA), 16 classical papillary carcinoma (cPTC), 15 follicular variant of papillary carcinoma (FVPTC), 4 follicular carcinoma (FC) and 1 medullary carcinoma (MC) were included in the study. Based on the cytology findings, patients can be followed in cases of benign diagnosis and subjected to surgery in cases of malignant diagnosis thereby decreasing the rate of unnecessary surgery. Endocrinol. AFIP images. In general follicular thyroid adenomas: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. FNAC in 35 patients yielded the report of follicular neoplasia. There was an inadequate specimen rate of 22.7% which declined with increasing experience. On histology, 57.1% of these were follicular neoplasm’s (follicular adenoma-37.1% and follicular carcinoma-20%). Fine-needle aspiration cytology (FNAC) cannot differentiate follicular adenoma from follicular carcinoma since this distinction can only be based on the presence of … Clin. Hofstädter F, Schullian W, Unterkircher S. Wien Klin Wochenschr. Challeton C, Bounacer A, Du Villard JA et-al. We performed a retrospective analysis of follicular neoplasm data obtained from frozen section examinations of thyroid nodules. A total of 5,660 patients underwent preoperative neck ultrasonography and fine-needle aspiration cytology (FNAC), surgical treatment, and follow-up at a medical institute. Histopathological examination showed follicular adenoma in four cases and colloid goiter with a … Fine needle aspiration biopsy of thyroid nodules. Marked fibrosis and stromal hyalinization. Please enable it to take advantage of the complete set of features! Purpose of the presen… Fine-needle aspiration cytology (FNAC) has become a well-established modality in the diagnosis, staging and follow-up of thyroid nodules. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2008;22 (6): 901-11. The FNAC test report described a follicular adenoma. Semin Diagn Pathol. The thyroid gland: recurring problems in histologic and cytologic evaluation. FOIA 2008 Apr;132(4):622-32. doi: 10.1043/1543-2165(2008)132[622:TTGRPI]2.0.CO;2. •. Capsular vessel with smooth muscle cells. Reanalysis of the FNAC diagnosis for this case revealed no evidence of follicular neoplasm. Follicular adenoma was the second commonest one. Follicular thyroid adenoma is a commonly found benign neoplasm of the thyroid consisting of differentiated follicular cells. False positivity is, however, much rarer and is generally due to cellular adenomatous goitres with marked papillary activity. 8600 Rockville Pike Zhang JZ, Hu B. Sonographic features of thyroid follicular carcinoma in comparison with thyroid follicular adenoma. Would you like email updates of new search results? J Ultrasound Med. It cannot be differentiated from follicular carcinoma on cytologic, sonographic or clinical features alone 1. 95.8%. In each case, gender and age of the patient, pre-operative FNAC results, tumour size, multifocality,extra-thyroid Bethesda, MD 20894, Copyright Marked hyaline thickening of vessel walls. Follicular patterned lesions (nodular goiter, follicular adenoma, follicular variant of papillary carcinoma, follicular carcinoma and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)) have overlapping cytomorphologic features and cannot be accurately distinguished by fine needle aspiration alone iodinated contrast-induced thyrotoxicosis, primary idiopathic hypothyroidism with thyroid atrophy, American Thyroid Association (ATA) guidelines, British Thyroid Association (BTA) U classification, Society of Radiologists in Ultrasound (SRU) guidelines, American College of Radiology: ACR TI-RADS, Korean Society of Thyroid Radiology: K-TIRADS, postoperative assessment after thyroid cancer surgery, ultrasound-guided fine needle aspiration of the thyroid, predominantly cystic or mixed cystic and solid lesions, absence of internal flow or predominantly peripheral flow indicates is associated with reduced probability of thyroid follicular malignancy. Follicular thyroid adenoma is a commonly found benign neoplasm of the thyroid consisting of differentiated follicular cells. To distinguish follicular adenoma (FA) and follicular carcinoma (FC) of thyroid in fine needle aspiration cytology (FNAC) is a challenging problem. Abstract Background: To distinguish follicular adenoma (FA) and follicular carcinoma (FC) of thyroid in fine needle aspiration cytology (FNAC) is a challenging problem. Thyroid aspiration cytology: a "cell pattern" approach to interpretation. Four cases of false positive and 6 cases of false negative were observed. •. Among malignant conditions papillary carcinoma was the commonest one in our FNAC samples, follicular carcinoma was the commonest in our histopathology samples. Careers. (FNAC – Follicular Neoplasm) Age and sex distribution of the patients with HASHIMOTOS 0 0.5 1 1.5 2 2.5 3 age 11-20 20-30 30-40 40-50 50-60 above 60 male REFERENCES 1. In view of these cytologic limitations, care must be exercised by the treating physician in interpreting cytological results. The sensitivity of FNAC in diagnosing benign nodules is 92% and specificity is 71.6%. Conclusion: Our results indicate that the FNAC is very accurate and a reliable test in the diagnosis of thyroid pathology, however, to distinguish follicular adenoma from follicular carcinoma final histology is required. A follicular adenoma is a benign tumor of the thyroid that is entirely enclosed by the capsule. They typically range in size between 1 and 3 cm, and changes including cystic degeneration, hemorrhage, ossification, calcification and fibrosis can be seen 2. Check for errors and try again. 4, pp. Follicular adenoma was the second commonest one. Use of color Doppler ultrasonography for the prediction of malignancy in follicular thyroid neoplasms: systematic review and meta-analysis. Fine needle aspiration cytology (FNAC), being reliable, minimally invasive, cost effective, having high sensitivity and specificity, has been applied routinely as a useful and indispensable method to diagnose thyroid lesions. Cellular follicular adenoma. Macroscopically follicular adenomas are round to oval, with a surrounding fibrous capsule that is usually regular and thin. Diagnostic image studies and a FNAC were performed. Bethesda categories III and IV encompass varying risks of malignancy. Arch Pathol Lab Med. Privacy, Help Follicular carcinomas could not be differentiated from follicular adenomas by cytology. 1983 Jul;198(1):70-3. doi: 10.1097/00000658-198307000-00014. Vyas CS, Vijayvargiya SC, Porwal S, Gupta R, Swarnkar M. diagnostic criteria of cytology diagnosis, FNAC may become the method of choice for most thyroid gland lesions. Unable to process the form. Sampling 132, No. William C. Faquin (2008) The Thyroid Gland: Recurring Problems in Histologic and Cytologic Evaluation. 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. Trabecular type. The sensitivity of FNAC Thin and uniform fibrous capsule. ... Age and sex distribution of the patients with FOLLICULAR ADENOMA. Papillary thyroid carcinoma (PTC) arising within follicular adenoma is a rare histological subset of papillary carcinoma. [Aspiration biopsy cytology of the thyroid gland: results and critical evaluation (author's transl)]. 6. Unable to load your collection due to an error, Unable to load your delegates due to an error. 1979 Nov 23;91(22):748-51. Fine needle aspiration cytology is considered the gold standard diagnostic test for the diagnosis of thyroid nodules. 5. Fine-needle aspiration cytology (FNAC… •. 622-632. FNAC outcomes are routinely classified using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), facilitating appropriate clinical management. 37.1% were benign (nodular goiter – 31.4% and lymphocytic thyroiditis-5.7%). Fine needle aspiration cytology is a cost effective procedure that provides specific diagnosis rapidly with minimal complications. Fine needle aspiration cytology (FNAC) is a widely employed tool in the investigative work-up of patients with single thyroid nodules. of diagnosis with FNAC, in that both false-negative and false-positive results can occur.3 The most signif-icant difficulty in making a diagnosis is the overlap-ping features of different lesions such as nodular goitre and follicular neoplasms.1 The current study was undertaken to evaluate the correlation between thryoid FNAC and histology and Unable to differentiate between Follicular adenoma and Follicular carcinoma is inevitable part of FNAC for which histology examination is absolute. Although US-guided FNAC is significantly accurate in distinguishing between papillary thyroid carcinoma (PTC) and benign disease, it is difficult to distinguish follicular thyroid carcinoma (FTC) and follicular variant papillary thyroid carcinoma (fvPTC) from benign follicular adenoma … Ectopic thyroid is thyroidal tissue located far from its anatomic place. 2011;16 (5): 585-93. Among malignant conditions papillary carcinoma was the commonest one in our FNAC samples, follicular carcinoma was the commonest in our histopathology samples. What is Follicular Adenoma Follicular neoplasm or follicular lesion of undetermined significance; Cannot distinguish between follicular adenoma and carcinoma; Confirmatory test. Suspicious for malignancy includes the FNACs in which Based on the FNAC diagnosis, we surgically removed the mass. Follicular adenoma 8 5.1% Maligna nt (n=46) Pappilary carcinoma 21 45.6% Follicular carcinoma 13 28.2% Anaplastic carcinoma 7 15.2% Medullary carcinoma 5 10.8% The validity of FNAC in terms of sensitivity and specificity was assessed by comparing it with the histopathological examination. 2. A carcinoma is a malignant tumor of the thyroid that invades the capsule. McHenry CR, Phitayakorn R. Follicular adenoma and carcinoma of the thyroid gland. 2014;33 (2): 221-7. Marked fibrosis, hyalinization and calcium deposition. 2010;29 (3): 419-25. 2001 May;18(2):81-98. J Ultrasound Med. Diagnostic accuracy of thyroid aspirative cytology in view of cumulative experience. Four cases of false positive and 6 cases of false negative were observed. Cytologic diagnosis of thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma (FACHAC) is challenging due to cytomorphologic features that overlap with other follicular-patterned lesions. {"url":"/signup-modal-props.json?lang=us\u0026email="}. The post-operative follow-up was uneventful. FNAC in 35 patients yielded the report of follicular neoplasia. The last FN case was a follicular adenoma (the tumor having a diameter of 35 mm) and had been reported as nodular goiter during FNAC. It cannot be differentiated from follicular carcinoma on cytologic, sonographic or clinical features alone 1. 4. Pattern of ras and gsp oncogene mutations in radiation-associated human thyroid tumors. If fine needle aspiration cytology (FNAC) suggests follicular neoplasm, thyroid lobectomy should be performed to establish the histopathological diagnosis. Best Pract. Although its advantages are well documented, the limitations and problems in interpretation of FNAC in this condition are not well known. Archives of Pathology & Laboratory Medicine: April 2008, Vol. •. Prinz RA, O'Morchoe PJ, Barbato AL, Braithwaite SS, Brooks MH, Emanuele MA, Lawrence AM, Paloyan E. Ann Surg. Dean DS, Gharib H. Epidemiology of thyroid nodules. The tumor size of these 24 preoperative FNAC-proven OTC was 0.81 +/- 0.23 cm (mean +/- SD). However, the FNAC is follicular neoplasm with atypia, 2 (2.3%) as suspicious of regarded as the single most accurate and cost-effective 3. Marked vascularization. Analysis for diagnostic value was done for ultrasonography and FNAC. FNAC led to an uninformative diagnosis in 15 out of 50 (30%) as follows: Six cases were diagnosed as hyperplastic follicular cells by FNAC. Prevention and treatment information (HHS). 1995;11 (3): 601-3. Follicular adenomas are encountered approximately 5 times more frequently than follicular carcinomas 2. Oncologist. Lared W, Shigueoka DC, Cristófoli JC et-al. Neoplastic FNACs belong to the suspicious for malignancy or malignant categories. (follicular proliferations) FNAC includes a hyperplastic nodules and follicular neoplasms (follicular adenoma or follicular carcinoma) which could be either neoplastic or non-neoplastic. Oncogene. Difficulties may arise in the detection of papillary carcinomas due to occult lesions, mixed papillary and follicular carcinomas or due to associated thyroid pathology. 1. Follicular thyroid lesions such as follicular adenomas/carcinomas, FVPTC, and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) pose some diagnostic challenges for FNAC.
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