Morphometric Analysis of Thyroid Follicular Cells with Atypia of Undetermined Significance.
BACKGROUND
Atypia of undetermined significance (AUS) is a category that encompasses a heterogeneous group of thyroid aspiration cytology. It has been reclassified into two subgroups based on the cytomorphologic features: AUS with cytologic atypia and AUS with architectural atypia. The nuclear characteristics of AUS with cytologic atypia need to be clarified by comparing to those observed in Hashimoto thyroiditis and benign follicular lesions.


METHODS
We selected 84 cases of AUS with histologic follow-up, 24 cases of Hashimoto thyroiditis, and 26 cases of benign follicular lesions. We also subcategorized the AUS group according to the follow-up biopsy results into a papillary carcinoma group and a nodular hyperplasia group. The differences in morphometric parameters, including the nuclear areas and perimeters, were compared between these groups.


RESULTS
The AUS group had significantly smaller nuclear areas than the Hashimoto thyroiditis group, but the nuclear perimeters were not statistically different. The AUS group also had significantly smaller nuclear areas than the benign follicular lesion group; however, the AUS group had significantly longer nuclear perimeters. The nuclear areas in the papillary carcinoma group were significantly smaller than those in the nodular hyperplasia group; however, the nuclear perimeters were not statistically different.


CONCLUSIONS
We found the AUS group to be a heterogeneous entity, including histologic follow-up diagnoses of papillary carcinoma and nodular hyperplasia. The AUS group showed significantly greater nuclear irregularities than the other two groups. Utilizing these features, nuclear morphometry could lead to improvements in the accuracy of the subjective diagnoses made with thyroid aspiration cytology.
Department of Pathology, Korea University Anam Hospital, Seoul, Korea.
Youngjin
Y
Kang
Department of Pathology, Korea University Anam Hospital, Seoul, Korea.
Yoo Jin
YJ
Lee
Department of Pathology, Korea University Anam Hospital, Seoul, Korea.
Jiyoon
J
Jung
Department of Pathology, Korea University Anam Hospital, Seoul, Korea.
Youngseok
Y
Lee
Department of Pathology, Korea University Anam Hospital, Seoul, Korea.
Nam Hee
NH
Won
Department of Pathology, Korea University Anam Hospital, Seoul, Korea.
Yang Seok
YS
Chae
Atypia of undetermined significance; Morphometric analysis; Thyroid