Cytologic criteria of cystic papillary carcinoma of the thyroid.
OBJECTIVE
To establish differential cytologic criteria between benign and malignant thyroid cysts.


METHODS
The study was a retrospective, transverse, analytic, comparative one of 3 groups of patients with nonfunctional thyroid nodules subjected to fine needle aspiration biopsy (FNAB) and surgical resection of the lesions, with histologic study as the diagnostic gold standard. Fifteen cases of cystic papillary carcinomas (group 1) with initial false negative diagnoses, 42 goiters accompanied by cystic degeneration (group 2) and 15 noncystic papillary carcinomas (group 3) were studied. Independent variables were age and sex; dependent variables were the presence of tridimensional fragments, papillae, anisonucleosis, nuclear bars, pseudoinclusions, powdery chromatin, cytoplasmic vacuoles, metaplastic cytoplasm, psammoma bodies, autolysis, multinucleated giant cells, spindle cells, colloid, monolayered laminae and macrophages in FNAB specimens. Statistical analysis was performed by central tendency measures and the chi 2 test.


RESULTS
The chi 2 test revealed a statistically significant difference between group 2 and the groups with papillary carcinoma based on the presence of tridimensional fragments, anisonucleosis, nuclear bars, pseudoinclusions, powdery chromatin, cytoplasmic vacuoles, metaplastic cytoplasm and autolysis.


CONCLUSIONS
The above cytologic characteristics must be searched for systematically in the FNAB of every cystic lesion of the thyroid to rule out the presence of cystic papillary thyroid carcinoma and to decrease the rate of false negative results.
Castro-Gómez
Lisset
L
Pathology Unit, School of Medicine, Hospital General de Mexico Organismo Descentralizado, Universidad Nacional Autónoma de México, Dr. Balmis 148 col Doctores, C.P. 06726, Mexico D.F., Mexico.
Córdova-Ramírez
Susana
S
Duarte-Torres
Reyna
R
Alonso de Ruiz
Patricia
P
Hurtado-López
Luis Mauricio
LM
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000473:pathology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006042:Goiter / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology*