title: Role of cytological and ultrasonographic features in predicting the risk of malignancy in thyroid nodules with indeterminate cytology.
abstract: OBJECTIVE
  The aim of this paper was to examine the diagnostic value of several cytological and ultrasonographic features in predicting malignancy in thyroid follicular neoplasms.
  
  
  METHODS
  The sample of the study consisted of 145 patients, who have had the diagnosis of follicular neoplasm on US guided fine-needle aspiration (FNA), and had undergone thyroidectomy. The cytological slides and the ultrasonographic images were reviewed, and several ultrasonographic and cytological features were evaluated and correlated with final histology.
  
  
  RESULTS
  Histological diagnosis of malignancy was obtained in 14.5% of the patients, papillary carcinoma being the most frequent (66% of malignancies). The cytological and ultrasonographic features that have been associated with malignancy were: micro-fragments (P<0.00001), overlapping (P<0.005), hypercellularity (P<0.009), micronucleoli (P<0.013), atypical features (P<0.027), nodule size larger than 2 cm (P<0.029) and micro-calcifications (P<0.0002). Using the features that were statistically independent ones, which included two cytological features: micro-fragments and micronuclei, and one ultrasonographic feature: micro-calcifications, a statistical model for predicting malignancy was constructed. According to this model, it was found that the risk for malignancy is 2.65% in the absence of the three parameters, and amounts to 93.93% in the presence of all three of them.
  
  
  CONCLUSIONS
  In a thyroid follicular neoplasm, the cytological and ultrasonographic features that were associated with malignancy were: micro-fragments, overlapping, hypercellularity, micronucleoli, atypical features, nodule size larger than 2 cm and micro-calcifications. In an attempt to predict malignancy, we proposed a simple statistical model using only three features derived from cytological and ultrasonographic tests.
authors: Endocrinology Department Bnai‑Zion Medical Center, Haifa, Israel - leonard.saiegh@gmail.com.
authors: L
authors: L
authors: Saiegh
authors: C
authors: C
authors: Shechner
authors: G
authors: G
authors: Dickstein
authors: M
authors: M
authors: Sheikh-Ahmad
authors: M
authors: M
authors: Reut
authors: M
authors: M
authors: Odeh
authors: A
authors: A
authors: Toubi
authors: J
authors: J
authors: Bejar
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D044963:Biopsy, Fine-Needle; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002452:Cell Count; D002467:Cell Nucleus / Q000648:ultrastructure; D048429:Cell Size; D003102:Colloids; D003937:Diagnosis, Differential; D006801:Humans; D008954:Models, Biological; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012306:Risk; D013959:Thyroid Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
chemical_list: D003102:Colloids