Management and Malignancy Rate of Thyroid Nodules with a Cytologic Diagnosis of Atypia or Follicular Lesion of Undetermined Significance

Authors

  • Armi Dianne Carlos Section of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, St. Luke’s Medical Center, Quezon City, Philippines
  • Roberto Mirasol Section of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, St. Luke’s Medical Center, Quezon City, Philippines
  • Eduardo Thomas Aquino Section of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, St. Luke’s Medical Center, Quezon City, Philippines
  • Maria Lourdes Goco Department of Pathology, St. Luke’s Medical Center, Quezon City, Philippines
  • Pauline Rizelle Toledo Department of Radiology, St. Luke’s Medical Center, Quezon City, Philippines
  • Kevin Carl Santos School of Statistics, University of the Philippines, Diliman, Quezon City, Philippines

Abstract

Objective. This study describes the clinical data of adult patients who underwent Fine Needle Aspiration Biopsy (FNAB) of thyroid nodule(s) with a cytologic diagnosis of Atypia or Follicular Lesion of Undetermined Significance (AUS or FLUS) at St. Luke’s Medical Center from January 2012 to October 2013.

 

Methodology. Adult patients who underwent FNAB of the thyroid nodule with a cytologic diagnosis of AUS or FLUS were studied retrospectively using the ultrasound result, initial consultation form and operative techniques of these patients.  The cytologic and histopathologic diagnoses were retrieved through the electronic Healthcare-Results Management System.

 

Results and Conclusion.  A third (34%) of the patients with a cytologic diagnosis of AUS or FLUS (8.9%) underwent surgery.  Of the 68 patients who underwent surgery, 44 were benign and 24 were malignant with a malignancy rate of 35.3%.  Preoperatively, there were no ultrasound characteristics or microscopic descriptions significantly associated with malignancy.  The recommendation of the Bethesda System to do a repeat FNAB in these thyroid nodules should, therefore, be reconsidered.

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References

Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocrine Practice. 2011;16 (Suppl 1):1-43.

Carlos-Raboca J, Jimeno C, Kho S, et al. The Philippine Society of Endocrinology and Metabolism PhilTidDes Working Group, The Philippine Thyroid Disease Study (PhilTiDes 1): Prevalence of thyroid disorders among adults in the Philippines. Journal of the ASEAN Federation of Endocrine Societies. 2012;27(2):27-33.

Melmed S, Polonsky K, Larsen P, Kronenberg H. Williams Textbook of Endocrinology 12th ed. Elsevier Saunders, Philadelphia, PA.; 2011:445.

Cooper D, Doherty G, Haugen B, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19(11):1167-1214.

Cibas E, Ali S. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132:658-665.

Teixeira G, Chikota H, et al. Incidence of malignancy in thyroid nodules determined to be follicular lesions of undetermined significance on fine-needle aspiration. World J Surg. 2012;36:69-74.

Shi Y, Ding X, Klein M, et al. Thyroid fine-needle aspiration with atypia of undetermined significance: A necessary or optional category? Cancer Cytopathology. 2009;299-304.

Bonzaninm M, Amadori P, et al. Subclassification of the “Grey Zone” of thyroid cytology, a retrospective descriptive study with clinical cytological and histological corrrelation. Journal of Thyroid Research. 2011:1-8.

Rabaglia J, Kabbani W, et al. Effect of the Bethesda system for reporting thyroid cytopathology on thyroidectomy rates and malignancy risk in cytologically indeterminate lesions. Surgery. 2010;148:1267-73.

Chen J, Pace C, et al. Yield of repeat fine-needle aspiration biopsy and rate of malignancy in patients with atypia or follicular lesion of undetermined significance: The impact of the Bethesda system for reporting thyroid cytopathology. Surgery. 2012;152:1037-44.

Nagarkatii S, Faquin W, Lubitz C, et al. Management of thyroid nodules with atypical cytology on fine-needle aspiration biopsy. Ann Surg Oncol. 2013;20:60-65.

Theoharis C, Schofield K, et al. The Bethesda thyroid fine-needle aspiration classification system: Year 1 at an academic institution. Thyroid. 2009;1(11):1215-1223.

Yoon J, Kwak J, Kim E, et at. How to approach thyroid nodules with indeterminate cytology. Ann Surg Oncol. 2010;17:2147-2155.

VanderLaan P, Marqusee E, Krane J. Usefulness of diagnostic qualifiers for thyroid fine-needle aspirations with atypia of undetermined signifiance. Am J Clin Pathol. 2011;136:572-577.

Kim D, Lee E, et.al. Role of sonographic diagnosis in managing Bethesda class III nodules. Am J Neuroradiol. 2011;32:2136-2141.

Yang J, Schnadig V, Logrono R, Wasserman P. Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations. Cancer Cythopathol. 2007;111:306-315.

Yassa L, Cibas E, Benson C, et.al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer Cytopathol. 2007;111:508-516.

Published

2014-05-31

How to Cite

Carlos, A. D., Mirasol, R., Thomas Aquino, E., Lourdes Goco, M., Rizelle Toledo, P., & Carl Santos, K. (2014). Management and Malignancy Rate of Thyroid Nodules with a Cytologic Diagnosis of Atypia or Follicular Lesion of Undetermined Significance. Journal of the ASEAN Federation of Endocrine Societies, 29(1), 78. Retrieved from https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/120

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