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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2018.01.17    [Epub ahead of print]
Cytological features that differentiate follicular neoplasm from mimicking lesions
Kanghee Han1, Hwa-Jeong Ha1, Joon Seog Kong1, Jung-Soon Kim1, Jae Kyung Myung2, Jae Soo Koh1, Sunhoo Park2, Myung-Soon Shin1, Woo-Tack Song1, Hye Sil Seol1, Seung-Sook Lee2
1Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Korea
2Laboratory of Radiation Pathology, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Korea
Corresponding Author: Seung-Sook Lee ,Tel: 82-2-970-1268, Fax: 82-2-970-2430, Email: sslee@kirams.re.kr
Received: August 30, 2017;  Revised: January 12, 2018  Accepted: January 17, 2018.  Published online: January 29, 2018.

It is difficult to correctly diagnose follicular neoplasms (FNs) using FNAC because it shares many cytological features with other mimicking lesions. The aim of this study was to identify the cytological features that differentiate FNs from mimicking lesions.
We included the cytological slides from 116 cases of thyroid FN diagnosed using FNAC, and included their subsequent histological diagnoses. We evaluated the cytological architectural pattern and nuclear features of the lesions according to their histological groups.
The final histological diagnoses of the 116 cases varied, and included fifty-one follicular neoplasms (44%), forty-seven papillary thyroid carcinomas (40%) including follicular variant, and seventeen cellular nodular hyperplasias (NH; 15%). Regardless of the final histological diagnosis, microfollicular pattern was observed in most cases. On the other hand, trabecular pattern was identified in 34% of FNs, but was not observed in any other lesions. Additionally, elongated nuclei and ground glass chromatin were only found in some of papillary thyroid carcinomas.
This study shows that the trabecular pattern is a representative cytological feature of FNs that can be used to distinguish FNs from mimicking lesions. In addition, nuclear shape and chromatin pattern can be used to further confirm the diagnosis of FNs from mimicking lesions through FNAC.
Key Words: follicular neoplasm, fine needle aspiration cytology, differential diagnosis