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.
Department of Anatomic Pathology and Histology, A. Gemelli School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
G
G
Fadda
C
C
Rabitti
C
C
Minimo
A
A
Ieraci
A
A
Verzì
A
A
Bianchi
M
M
Lancia
G
G
Gullotta
A
A
Capelli
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*