Detection of BRAF mutation in the cytocentrifugation supernatant fluid from fine-needle aspiration of thyroid lesions may enhance the diagnostic yield.
OBJECTIVE
BRAF mutations using cellular DNA from fine-needle aspiration (FNA) specimens are commonly used to support the diagnosis of papillary thyroid carcinoma (PTC). The goal of this study was to preliminarily evaluate the diagnostic utility of detecting BRAF mutations in the routinely discarded FNA specimen supernatant fluid.


METHODS
Seventy-eight FNAs of thyroid lesions were evaluated for BRAF mutations using both cellular and supernatant DNA. BRAF mutation data were correlated with cytology and surgical pathology.


RESULTS
Of the 78 samples evaluated, 68 (87%) had amplifiable DNA in the supernatant with 2 (3%) positive for BRAF mutations. These two samples showed no mutations in the cellular counterpart. Among the 11 samples showing morphologic findings (FNA/surgical pathology) suspicious/diagnostic of PTC, 6 (55%) samples (one supernatant and five cellulars) were positive for BRAF mutations. This suggests that testing supernatant DNA in FNA specimens may increase the diagnostic yield by 1/11 (9%) in this setting.


CONCLUSIONS
The vast majority of routinely discarded FNA supernatants contain amplifiable DNA. In addition, profiling the mutations of BRAF and other genes using supernatant DNA may provide valuable diagnostic information to assist the diagnosis of PTC in patients with clinical/morphologic findings suspicious for malignancies and cellular DNA showing no mutations.
Address: Department of Pathology University of Central Florida College of Medicine, Orlando, FL, USA.
Ashley E
AE
Brown
Department of Internal Medicine, Florida Hospital, Orlando, FL, USA.
Khin Sandar
KS
Lim
Department of Pathology and Laboratory Medicine, Florida Hospital, Orlando, FL, USA.
George
G
Corpus
Department of Pathology and Laboratory Medicine, Florida Hospital, Orlando, FL, USA.
Martha T
MT
Hustek
Department of Pathology and Laboratory Medicine, Florida Hospital, Orlando, FL, USA.
Tien Anh N
TA
Tran
Address: Department of Pathology University of Central Florida College of Medicine, Orlando, FL, USA; Department of Pathology and Laboratory Medicine, Florida Hospital, Orlando, FL, USA.
Chung-Che
CC
Chang
BRAF; fine-needle aspirate; fine-needle aspiration supernatant; papillary thyroid carcinoma