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Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia
Hee Young Na, Miyoko Higuchi, Shinya Satoh, Kaori Kameyama, Chan Kwon Jung, Su-Jin Shin, Shipra Agarwal, Jen-Fan Hang, Yun Zhu, Zhiyan Liu, Andrey Bychkov, Kennichi Kakudo, So Yeon Park
J Pathol Transl Med. 2024;58(6):331-340.   Published online November 7, 2024
DOI: https://doi.org/10.4132/jptm.2024.10.12
  • 1,391 View
  • 208 Download
AbstractAbstract PDFSupplementary Material
Background
This study was designed to compare diagnostic categories of thyroid fine needle aspiration cytology (FNAC) and incidence of thyroid tumors in the multi-institutional Asian series with a special focus on diagnostic category IV (suspicious for a follicular neoplasm) and follicular thyroid carcinomas (FTCs). Methods: Distribution of FNAC categories, incidence of thyroid tumors in resection specimens and cytologic diagnoses of surgically confirmed follicular adenomas (FAs) and FTCs were collected from 10 institutes from five Asian countries and were compared among countries and between FAs and FTCs. Results: The frequency of category IV diagnoses (3.0%) in preoperative FNAC were significantly lower compared to those in Western countries (10.1%). When comparing diagnostic categories among Asian countries, category IV was more frequent in Japan (4.6%) and India (7.9%) than in Taiwan (1.4%), Korea (1.4%), and China (3.6%). Similarly, incidence of FAs and FTCs in surgical resection specimens was significantly higher in Japan (10.9%) and India (10.1%) than in Taiwan (5.5%), Korea (3.0%), and China (2.5%). FTCs were more commonly diagnosed as category IV in Japan (77.5%) than in Korea (33.3%) and China (35.0%). Nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were more common in FTCs compared with FAs. Conclusions: Our study highlighted the difference in FNAC diagnostic categories of FTCs among Asian countries, which is likely related to different reporting systems and thyroid cancer incidence. Cytologic features such as nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were found to be useful in diagnosing FTCs more effectively.
Endobronchial Smooth Muscle Tumors: A Series of Five Cases Highlighting Pitfalls in Diagnosis
Tripti Nakra, Aanchal Kakkar, Shipra Agarwal, Karan Madan, Suresh C Sharma, Deepali Jain
J Pathol Transl Med. 2018;52(4):219-225.   Published online July 11, 2018
DOI: https://doi.org/10.4132/jptm.2018.05.16
  • 6,407 View
  • 108 Download
  • 7 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
Primary endobronchial smooth muscle tumors (SMTs), which are extremely rare, include endobronchial leiomyomas and leiomyosarcomas. Clinically, SMTs present with signs and symptoms of bronchial obstruction, and lack specific radiological findings. Thus, histopathological examination is required for accurate diagnosis as well as for tumor grading. We examined the histomorphological and immunohistochemical features of endobronchial SMTs and highlighted pitfalls in diagnosis, particularly when using small biopsies.
Methods
Cases of primary endobronchial SMTs diagnosed at our Institute over the last 6 years (2012–2017) were retrieved from the departmental archives. Histopathological features and immunohistochemistry performed for establishing the diagnosis were reviewed.
Results
Five cases of SMTs occurring in endobronchial locations were identified. These included three cases of leiomyoma, and two cases of leiomyosarcoma. The age distribution of patients ranged from 13 to 65 years. Leiomyomas showed more consistent staining with smooth muscle markers (smooth muscle actin, desmin, and smooth muscle myosin heavy chain), while tumors of higher grade showed variable, focal staining, leading to erroneous diagnosis, especially on small biopsies.
Conclusions
The diagnosis of endobronchial SMTs relies on histopathological examination, for both confirmation of smooth muscle lineage and determination of the malignant potential of the lesion. Appropriate immunohistochemical panels including more than one marker of smooth muscle differentiation are extremely valuable for differential diagnosis from morphological mimics, which is necessary for instituting appropriate management.

Citations

Citations to this article as recorded by  
  • Case report: Successful bronchoscopic interventional treatment of endobronchial leiomyomas
    Yinfeng Wang, Yixiang Zhang, Ruirui Tong
    Open Life Sciences.2024;[Epub]     CrossRef
  • Pediatric endobronchial tumors with a mimicker: A case series
    Kulwiwat Promsawasdi, Teerasak Phewplung
    Pediatric Pulmonology.2024; 59(10): 2669.     CrossRef
  • Smooth Muscle Conditions of the Chest
    Matthew R. McCann, Lucas R. Massoth, Carlos A. Rojas, Yin P. Hung, John P. Lichtenberger, Gerald F. Abbott, Justin T. Stowell
    Journal of Thoracic Imaging.2021; 36(5): 263.     CrossRef
  • A Well-Defined Endobronchial Tumor in a 26-Year-Old Man
    Christina Triantafyllidou, Petros Effraimidis, Mirjam Schimanke, Simone Ignatova, Anders Ringman, Susann Skoog, Farkas Vánky, Miklós Boros, Karin Cederquist
    Chest.2021; 159(5): e313.     CrossRef
  • Primary Pulmonary Leiomyoma
    Mohammad Abu-Hishmeh, Gowthami Kobbari, Fouzia Shakil, Oleg Epelbaum
    Journal of Bronchology & Interventional Pulmonology.2020; 27(4): e54.     CrossRef
Review
Thyroid Cytology in India: Contemporary Review and Meta-analysis
Shipra Agarwal, Deepali Jain
J Pathol Transl Med. 2017;51(6):533-547.   Published online October 5, 2017
DOI: https://doi.org/10.4132/jptm.2017.08.04
  • 10,797 View
  • 215 Download
  • 15 Web of Science
  • 18 Crossref
AbstractAbstract PDF
Fine-needle aspiration cytology (FNAC) is a screening test for triaging thyroid nodules, aiding in subsequent clinical management. However, the advantages have been overshadowed by the multiplicity of reporting systems and a wide range of nomenclature used. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formulated in 2007, to give the world a uniform thyroid cytology reporting system, facilitating easy interpretation by the clinicians. Here, we review the status of thyroid FNAC in India in terms of various reporting systems used including a meta-analysis of the previously published data. An extensive literature search was performed using internet search engines. The reports with detailed classification system used in thyroid cytology were included. The meta-analysis of published data was compared with the implied risk of malignancy by TBSRTC. More than 50 studies were retrieved and evaluated. TBSRTC is currently the most widely used reporting system with different studies showing good efficacy and interobserver concordance. Ancillary techniques have, as of now, limited applicability and acceptability in thyroid cytology in India. Twenty-eight published articles met the criteria for inclusion in the meta-analysis. When compared with TBSRTC recommendations, the meta-analysis showed a higher risk of malignancy for categories I and III. Thyroid FNAC is practiced all over India. TBSRTC has found widespread acceptance, with most institutions using this system for routine thyroid cytology reporting. However, reasons for a high malignancy risk for categories I and III need to be looked into. Various possible contributing factors are discussed in the review.

Citations

Citations to this article as recorded by  
  • Spinal metastases in primary thyroid malignancies: Single center experience of 44 cases
    Basir Ahmed, Edmond Jonathan, M. J. Paul, Krishna Prabhu
    World Journal of Surgery.2025; 49(2): 409.     CrossRef
  • Thermal imaging based pre-diagnostics tool for Graves’ disease
    Vaishali Sharma, Vandana K Dhingra, Snehlata Shakya, Ashok Kumar, Mayank Goswami
    Measurement Science and Technology.2024; 35(3): 035702.     CrossRef
  • High Malignancy Risk and Its Predictors in South Indian Patients With Bethesda II Thyroid Nodules
    Sunanda Tirupati, Pradeep Puthenveetil, Shilpa Lakkundi, Anudeep Gaddam, Vijaya Sarathi
    Cureus.2024;[Epub]     CrossRef
  • Nuclear features in thyroid cytology: features helpful for a morphological diagnosis in routine practice
    Priya Bhagwat, Sabine Pomplun
    Diagnostic Histopathology.2024; 30(6): 312.     CrossRef
  • DIAGNOSTIC EFFICACY OF FNAC IN THYROID LESIONS, CLASSIFIED ACCORDING TO BETHESDA SYSTEM WITH CYTOHISTOLOGICAL CORRELATION
    KIRAN KUMARI MEENA, SANDHYA BORDIA, POOJA KANWAT, SEEMA MEENA, PRAGYA JAKHAR
    Asian Journal of Pharmaceutical and Clinical Research.2024; : 125.     CrossRef
  • Evaluation of Thyroid Lesions by the Bethesda System for Reporting Thyroid Cytopathology
    Syed Asif Hashmi, Monika Aggrawal, Rahul Pandey, Deepika Gulati, Inam Danish Khan
    Journal of Marine Medical Society.2023; 25(1): 73.     CrossRef
  • Incidence and Malignancy Rates in Thyroid Nodules in North-East Indian Population by Bethesda System: A Single Institutional Experience of 3 Years
    Suvamoy Chakraborty, Manu C. Balakrishnan, Vandana Raphael, Prachurya Tamuli, Anuradha Deka
    South Asian Journal of Cancer.2023; 12(02): 166.     CrossRef
  • Evaluation of Concordance of Ultrasound, Cytology, and Histopathology in Solitary Thyroid Nodules
    Sunil Chumber, Surabhi Vyas, Kamal Kataria, Shipra Agarwal, Yashwant S Rathore, Gopal Puri, Sushma Yadav, Kanika Sharma, Amit Patidar
    Indian Journal of Endocrine Surgery and Research.2023; 18(1): 17.     CrossRef
  • Cytomorphological Spectrum of Head and Neck Lesions by Fine Needle Aspiration Cytology in a Tertiary Care Center
    Amandeep Kaur, Sonali Poonia, Karandeep Singh, Dalbir Kaur, Mohit Madhukar, Ravish Godara
    Journal of Pharmacy and Bioallied Sciences.2023; 15(Suppl 1): S315.     CrossRef
  • The Asian Thyroid Working Group, from 2017 to 2023
    Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
    Journal of Pathology and Translational Medicine.2023; 57(6): 289.     CrossRef
  • Cytomorphological Categorization of Thyroid Lesions according to The Bethesda System for Reporting Thyroid Cytology and Correlation with their Histological Outcome
    Meenakshi Kamboj, Anurag Mehta, Sunil Pasricha, Gurudutt Gupta, Anila Sharma, Garima Durga
    Journal of Cytology.2022; 39(1): 44.     CrossRef
  • Is Surgery Necessary in Benign Thyroid Lesions?
    Pushkar Chaudhary, Naseem Noorunnisa
    Journal of Datta Meghe Institute of Medical Sciences University.2022; 17(3): 799.     CrossRef
  • Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice
    Chanchal Rana, Pooja Ramakant, Divya Goel, Akanksha Singh, KulRanjan Singh, Suresh Babu, Anand Mishra
    American Journal of Clinical Pathology.2021; 156(2): 320.     CrossRef
  • The combination of ACR‐Thyroid Imaging Reporting and Data system and The Bethesda System for Reporting Thyroid Cytopathology in the evaluation of thyroid nodules—An institutional experience
    Shanmugasundaram Sakthisankari, Sreenivasan Vidhyalakshmi, Sivanandam Shanthakumari, Balalakshmoji Devanand, Udayasankar Nagul
    Cytopathology.2021; 32(4): 472.     CrossRef
  • Differentiated Thyroid Cancer
    Anita M. Borges
    Journal of Head & Neck Physicians and Surgeons.2021; 9(2): 69.     CrossRef
  • Risk of malignancy in Thyroid “Atypia of undetermined significance/Follicular lesion of undetermined significance” and its subcategories – A 5-year experience
    Abha Thakur, Haimanti Sarin, Dilpreet Kaur, Deepak Sarin
    Indian Journal of Pathology and Microbiology.2019; 62(4): 544.     CrossRef
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    Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
    Journal of Pathology and Translational Medicine.2017; 51(6): 571.     CrossRef

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