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The Nightmare of Indeterminate Follicular Proliferations: When Liquid-Based Cytology and Ancillary Techniques are not a Moon Landing but a Realistic Plan

Rossi E.D.a · Fadda G.a · Schmitt F.b-d

Author affiliations

aDivision of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Catholic University of Sacred Heart, Rome, Italy; bInstituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal; cDepartment of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, and dDepartment of Pathology, University Health Network, Toronto, Ont., Canada

Keywords: Fine-needle aspirationLiquid-based cytologyFollicular nodulesImmunocytochemistryMolecular analysis

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Acta Cytologica 2014;58:543-551
https://doi.org/10.1159/000363439

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Article / Publication Details

First-Page Preview
Abstract of Review

Received: April 08, 2014
Accepted: May 06, 2014
Published online: July 16, 2014
Issue release date: November – December

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 0

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: https://www.karger.com/ACY

Abstract

Objective: Thyroid nodules are a common finding in the general population, including both nonneoplastic and neoplastic entities. Fine-needle aspiration cytology (FNAC) is the first tool for evaluating thyroid nodules. In spite of its high diagnostic accuracy, 25% of nodules result in the category of follicular neoplasms (FN), with varying risk of malignancy and different management strategies. Study Design: The use of ancillary techniques is reshaping the practice of FNAC. These tools can significantly empower the morphological diagnosis and prognosis of thyroid nodules, allowing a more accurate prediction of the nature of the lesion. Several studies have underlined the role of single or multiple testing for the category of FN as strong indicators of cancer. Every cytological preparation can be used for the application of ancillary techniques but the introduction of liquid-based cytology (LBC) might facilitate the application. Results: Our experience involving an immunocytochemical panel made up of HBME-1 and galectin-3 pointed to an 81% overall diagnostic accuracy in discriminating between low and high risk of malignancy in FN. Conclusions: The application of these techniques on LBC represents an adjunct to the morphological evaluation of FN. They represent a critical and challenging, but also a feasible, tool in the preoperative diagnoses, allowing specific prognostic and predictive details regardless of the cytological preparation.

© 2014 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Review

Received: April 08, 2014
Accepted: May 06, 2014
Published online: July 16, 2014
Issue release date: November – December

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 0

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: https://www.karger.com/ACY

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2014, Vol.58, No. 6

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