Morphologic and planimetric diagnosis of follicular thyroid lesions on fine needle aspiration cytology.
During 1989-1992, 2,729 fine needle aspiration biopsies were performed; 585 with histologic controls were reviewed. The aim of the study was to demonstrate the incidence of carcinoma in follicular-structured smears without nuclear enlargement, evaluated with planimetric techniques, and to suggest a new cytodiagnostic classification. Of 398 follicular-structured smears, 188 were colloid nodules, 38 were thyreocytic hyperplasias without nuclear atypia, 146 were predominantly follicular lesions (PFL) and 26 were follicular lesions with nuclear pleomorphism. The last showed a high incidence of neoplasia (69.2%) and carcinoma (46.1%) and the largest planimetric values for nuclear area, perimeter and maximum diameter. The second and third categories showed only a difference in the incidence of benign neoplasms (32.9 vs. 15.8%). These results suggest that six months of expectant management might be useful in simple follicular lesions, whereas a follicular pattern with nuclear enlargement requires surgical treatment for the strong possibility of carcinoma.
Fadda
G
G
Department of Anatomic Pathology and Histology, A. Gemelli School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
Rabitti
C
C
Minimo
C
C
Ieraci
A
A
Verzì
A
A
Bianchi
A
A
Lancia
M
M
Gullotta
G
G
Capelli
A
A
D000236:Adenoma / Q000473:pathology; D000328:Adult; D001707:Biopsy, Needle; D002467:Cell Nucleus / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology*