Thyroid cytology
Author:
Mikael Häggström [note 1]
Adequacy
A minimum number of 6 clusters with 10 cells each has been arbitrary established to assume adequacy for a definitive diagnosis.[1] The presence of characteristic cells may still confer a definitive diagnosis, but otherwise, the report will simply state inadequate number of cells.
Risk stratification
Classify findings as per the Bethesda system:
| Category | Description[2] | Example report |
|---|---|---|
| I | Non diagnostic/unsatisfactory | |
| II | Benign (colloid and follicular cells) | Thyroid aspiration, right upper pole:
|
| III | Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) (follicular or lymphoid cells with atypical features) | Thyroid aspiration, right mid pole:
|
| IV | Follicular nodule/suspicious follicular nodule (cell crowding, micro follicles, dispersed isolated cells, scant colloid) | |
| V | Suspicious for malignancy | |
| VI | Malignant |
Cytology of benign follicular epithelial cells (Bethesda category II), Pap stain, showing cells with significant nuclear pleomorphism but otherwise insignificant features.
Thyroid spherules, on the other hand, are benign features. A spherule may mimic a microfollicle, but has a more smooth, round, ball-like contour, and even spacing of the follicular cell nuclei.[4]
Relative incidences of malignant thyroid tumors.
Cytopathology suspicious for Hürthle cell neoplasm (Bethesda category IV), Pap stain. However, it cannot distinguish Hürthle cell adenoma from Hürthle cell carcinoma, which requires histopathologic sections to see transcapsular or vascular invasion. Hürthle cell hyperplasia (as seen in Hashimoto's thyroiditis) may show moderate variation in nuclear sizes and prominent nucleoli, but further findings favoring Hürthle cell neoplasm include a large number of Hürthle cells, and discohesiveness.[5]
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Michael, Claire W.; Pang, Yijun; Pu, Robert T.; Hasteh, Farnaz; Griffith, Kent A. (2007). "Cellular adequacy for thyroid aspirates prepared by ThinPrep: How many cells are needed? ". Diagnostic Cytopathology 35 (12): 792–797. doi:. ISSN 87551039.
- ↑ "The bethesda system for reporting thyroid cytopathology: interpretation and guidelines in surgical treatment ". Indian Journal of Otolaryngology and Head and Neck Surgery 64 (4): 305–311. December 2012. doi:. PMID 24294568.
- ↑ Ayana Suzuki, C.T., Andrey Bychkov, M.D., Ph.D.. Thyroid & parathyroid - Follicular neoplasm. Last author update: 21 April 2022. Last staff update: 12 May 2022
- ↑ Costigan DC, Shaar M, Frates MC, Alexander EK, Barletta JA, Cibas ES (2020). "Defining thyroid spherules: A benign cytomorphologic feature that mimics microfollicles. ". Cancer Cytopathol 128 (3): 171-176. doi:. PMID 31856389. Archived from the original. .
- ↑ Image by Mikael Häggström, MD. References for findings:
- Ayana Suzuki, C.T., Andrey Bychkov, M.D., Ph.D.. Hürthle cell neoplasm. Pathology Outlines. Last author update: 7 May 2020. Last staff update: 12 May 2022
- Shawky M, Sakr M (2016). "Hurthle Cell Lesion: Controversies, Challenges, and Debates. ". Indian J Surg 78 (1): 41-8. doi:. PMID 27186039. PMC: 4848220. Archived from the original. .
Image sources
- ↑ . 4. 2021. Archived from Sharma Avishesh Singh , Ajay Sahu the original. .
- "This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)"
