Follicular neoplasms of the thyroid. Decision tree approach using morphologic and morphometric parameters.
OBJECTIVE
Fine needle aspiration of the thyroid is limited in differentiating hyperplastic nodular goiters from true follicular neoplasms and in separating follicular adenomas from follicular carcinomas. The present study was done to evaluate if a panel of morphologic and morphometric parameters of the thyroid and ploidy status, either alone or in combination, would help differentiate hyperplastic nodular goiters from follicular adenomas and carcinomas.


METHODS
Fine needle aspiration smears of 75 cases classified as follicular neoplasms of the thyroid were studied for morphologic (cellularity, colloid and cellular patterns) and morphometric parameters (nuclear diameters and nucleoli).


RESULTS
Of the large number of parameters utilized in this study, only two of the cellular patterns (honeycomb and single dispersed) and the average maximum nuclear diameter showed trends in differentiating these lesions.


CONCLUSIONS
Based on these patterns and nuclear diameter (9 microns), we developed a decision tree classification that separated the benign from malignant lesions (follicular carcinomas) with a sensitivity and specificity of 92.8% and 57.4%, respectively.
Deshpande
V
V
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Kapila
K
K
Sai
K S
KS
Verma
K
K
D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000473:pathology*; D000236:Adenoma / Q000175:diagnosis / Q000473:pathology*; D001707:Biopsy, Needle; D002466:Cell Nucleolus / Q000473:pathology; D003102:Colloids / Q000032:analysis; D003663:Decision Trees; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005189:False Positive Reactions; D005434:Flow Cytometry; D006044:Goiter, Nodular / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D011003:Ploidies; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology*
D003102:Colloids