Papillary thyroid carcinoma: how much should the surgeon read from fine needle aspiration cytology reports?
OBJECTIVE
During routine fine needle aspiration cytodiagnosis of papillary thyroid carcinoma (PTC), a number of cases are diagnosed as suspicious; or it is suggested that PTC or a neoplasm be ruled out by histopathology. Since these diagnostic labels are likely to put the clinicians in a difficult situation while planning the management, this study aims to find out how much the surgeon should read from these reports.


METHODS
The patients were divided into two groups. Group A included 38 cases diagnosed as PTC or suspicious of PTC. Group B included 40 cases in which it was suggested that PTC/a neoplasm to be ruled out and non-neoplastic lesions with one or more cytologic features of PTC. The two groups were compared with clinical, imaging and cytomorphologic features.


RESULTS
A significant difference was observed with respect to age between Group A and Group B (P<0.001). The frequency of the following five cytologic features was significantly higher in Group A: papillary formation (P<0.001), psammoma bodies (P=0.054), fine nuclear chromatin (P=0.010), frequent nuclear grooves (P<0.001) and intra-nuclear cytoplasmic inclusion (P<0.001). Three or more of the five cytologic features were also reported in significantly higher number of Group A cases (P<0.001). Majority (81.8%) of the cases with subsequent histology in Group A were confirmed as PTC as opposed to 7.7% in Group B (P<0.001).


CONCLUSIONS
Thus, cases with definitive cytodiagnosis of PTC and suggestive of PTC (Group A) should be taken much more seriously by the surgeons as compared to Group B cases.
Department of Pathology, Center for Research, Faculty of Medicine, Kuwait University, Safat, Kuwait. dilip76@hotmail.com
Dilip K
DK
Das
Mehraj
M
Sheikh
Mrinmay K
MK
Mallik
Prem N
PN
Sharma
Abul A S R
AA
Mannan
Zafar A
ZA
Sheikh
Bahia I
BI
Haji
Shirly S
SS
George
John P
JP
Madda
Sundus
S
Hussein
Issam M
IM
Francis
D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002277:Carcinoma; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000166:cytology*; D013964:Thyroid Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000601:surgery*; D055815:Young Adult