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Review
Thyroid Fine-Needle Aspiration Cytology Practice in Korea
Yoon Jin Cha, Ju Yeon Pyo, SoonWon Hong, Jae Yeon Seok, Kyung-Ju Kim, Jee-Young Han, Jeong Mo Bae, Hyeong Ju Kwon, Yeejeong Kim, Kyueng-Whan Min, Soonae Oak, Sunhee Chang
J Pathol Transl Med. 2017;51(6):521-527.   Published online October 11, 2017
DOI: https://doi.org/10.4132/jptm.2017.09.26
  • 6,540 View
  • 224 Download
  • 8 Citations
AbstractAbstract PDF
We reviewed the current status of thyroid fine-needle aspiration cytology (FNAC) in Korea. Thyroid aspiration biopsy was first introduced in Korea in 1977. Currently, radiologists aspirate the thyroid nodule under the guidance of ultrasonography, and cytologic interpretation is only legally approved when a cytopathologist makes the diagnosis. In 2008, eight thyroid-related societies came together to form the Korean Thyroid Association. The Korean Society for Cytopathology and the endocrine pathology study group of the Korean Society for Pathologists have been updating the cytologic diagnostic guidelines. The Bethesda System for Reporting Thyroid Cytopathology was first introduced in 2009, and has been used by up to 94% of institutions by 2016. The average diagnosis rates are as follows for each category: I (12.4%), II (57.9%), III (10.4%), IV (2.9%), V (3.7%), and VI (12.7%). The malignancy rates in surgical cases are as follows for each category: I (28.7%), II (27.8%), III (50.6%), IV (52.3%), V (90.7%), and VI (100.0%). Liquid-based cytology has been used since 2010, and it was utilized by 68% of institutions in 2016. The categorization of thyroid lesions into “atypia of undetermined significance” or “follicular lesion of undetermined significance” is necessary to draw consensus in our society. Immunocytochemistry for galectin-3 and BRAF is used. Additionally, a molecular test for BRAF in thyroid FNACs is actively used. Core biopsies were performed in only 44% of institutions. Even the institutions that perform core biopsies only perform them for less than 3% of all FNACs. However, only 5% of institutions performed core biopsies up to three times more than FNAC.

Citations

Citations to this article as recorded by  
  • Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules
    Liuxi Wu, Hua Shu, Wenqin Chen, Yingqian Gao, Ya Yuan, Xiao Li, Wenjuan Lu, Xinhua Ye, Hongyan Deng
    Scientific Reports.2022;[Epub]     CrossRef
  • Contribution of cytologic examination to diagnosis of poorly differentiated thyroid carcinoma
    Na Rae Kim, Jae Yeon Seok, Yoo Seung Chung, Joon Hyop Lee, Dong Hae Chung
    Journal of Pathology and Translational Medicine.2020; 54(2): 171.     CrossRef
  • Systematic thyroid screening in myotonic dystrophy: link between thyroid volume and insulin resistance
    Adrien Ben Hamou, Stéphanie Espiard, Christine Do Cao, Miriam Ladsous, Camille Loyer, Alexandre Moerman, Samuel Boury, Maéva Kyheng, Claire-Marie Dhaenens, Vincent Tiffreau, Pascal Pigny, Gilles Lebuffe, Robert Caiazzo, Sébastien Aubert, Marie Christine V
    Orphanet Journal of Rare Diseases.2019;[Epub]     CrossRef
  • The History of Korean Thyroid Pathology
    Soon Won Hong, Chan Kwon Jung
    International Journal of Thyroidology.2018; 11(1): 15.     CrossRef
  • BRAFV600E Mutation is a Strong Preoperative Indicator for Predicting Malignancy in Thyroid Nodule Patients with Atypia of Undetermined Significance Identified by Fine Needle Aspiration
    Hye Rang Choi, Bo-Yoon Choi, Jae Hoon Cho, Young Chang Lim
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2018; 61(11): 600.     CrossRef
  • The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
    Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
    Journal of Pathology and Translational Medicine.2018; 52(6): 404.     CrossRef
  • Thyroid FNA cytology in Asian practice-Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
    K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
    Cytopathology.2017; 28(6): 455.     CrossRef
  • The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
    Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
    Journal of Pathology and Translational Medicine.2017; 51(6): 571.     CrossRef
Brief Case Report
Bronchial Washing Cytology of Pulmonary Langerhans Cell Histiocytosis: A Case Report
Taeyeong Kim, Hyeong Ju Kwon, Minseob Eom, Sang Wook Kim, Min Hi Sin, Soon-Hee Jung
J Pathol Transl Med. 2017;51(4):444-447.   Published online July 14, 2017
DOI: https://doi.org/10.4132/jptm.2017.02.15
  • 6,950 View
  • 108 Download
PDF
Original Article
The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists
Mimi Kim, Hyo Jin Park, Hye Sook Min, Hyeong Ju Kwon, Chan Kwon Jung, Seoung Wan Chae, Hyun Ju Yoo, Yoo Duk Choi, Mi Ja Lee, Jeong Ja Kwak, Dong Eun Song, Dong Hoon Kim, Hye Kyung Lee, Ji Yeon Kim, Sook Hee Hong, Jang Sihn Sohn, Hyun Seung Lee, So Yeon Park, Soon Won Hong, Mi Kyung Shin
J Pathol Transl Med. 2017;51(4):410-417.   Published online June 14, 2017
DOI: https://doi.org/10.4132/jptm.2017.04.05
  • 7,492 View
  • 205 Download
  • 18 Citations
AbstractAbstract PDF
Background
The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea.
Methods
Questionnaire surveys were used for data collection on the fine needle aspiration (FNA) of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed.
Results
Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN), 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%.
Conclusions
More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.

Citations

Citations to this article as recorded by  
  • Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III
    Xiaoli Liu, Jingjing Wang, Wei Du, Liyuan Dai, Qigen Fang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Risk stratification of indeterminate thyroid nodules by novel multigene testing: a study of Asians with a high risk of malignancy
    Chunfang Hu, Weiwei Jing, Qing Chang, Zhihui Zhang, Zhenrong Liu, Jian Cao, Linlin Zhao, Yue Sun, Cong Wang, Huan Zhao, Ting Xiao, Huiqin Guo
    Molecular Oncology.2022; 16(8): 1680.     CrossRef
  • CD56 Expression in Papillary Thyroid Carcinoma Is Highly Dependent on the Histologic Subtype: A Potential Diagnostic Pitfall
    Uiju Cho, Yourha Kim, Sora Jeon, Chan Kwon Jung
    Applied Immunohistochemistry & Molecular Morphology.2022; 30(5): 389.     CrossRef
  • Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients
    M Grussendorf, I Ruschenburg, G Brabant
    European Thyroid Journal.2022;[Epub]     CrossRef
  • Subclassification of the Bethesda Category III (AUS/FLUS): A study of thyroid FNA cytology based on ThinPrep slides from the National Cancer Center in China
    Huan Zhao, HuiQin Guo, LinLin Zhao, Jian Cao, Yue Sun, Cong Wang, ZhiHui Zhang
    Cancer Cytopathology.2021; 129(8): 642.     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
  • Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
    Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
    Thyroid.2020; 30(2): 192.     CrossRef
  • Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
    Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
    Cancer Cytopathology.2020; 128(4): 238.     CrossRef
  • Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic
    Butheinah A. Al-Sharafi, Jamila A. AlSanabani, Ibraheem M. Alboany, Amani M. Shamsher
    Thyroid Research.2020;[Epub]     CrossRef
  • Is Bethesda classification sufficient to predict thyroid cancer in endemic regions?
    Gamze ÇITLAK, Bahar CANBAY TORUN
    Journal of Surgery and Medicine.2020; 4(9): 794.     CrossRef
  • Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
    Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
    PLOS ONE.2020; 15(11): e0241597.     CrossRef
  • Nuclear features of papillary thyroid carcinoma: Comparison of Core needle biopsy and thyroidectomy specimens
    Jae Yeon Seok, Jungsuk An, Hyun Yee Cho, Younghye Kim, Seung Yeon Ha
    Annals of Diagnostic Pathology.2018; 32: 35.     CrossRef
  • Clinical utility of EZH1 mutations in the diagnosis of follicular-patterned thyroid tumors
    Chan Kwon Jung, Yourha Kim, Sora Jeon, Kwanhoon Jo, Sohee Lee, Ja Seong Bae
    Human Pathology.2018; 81: 9.     CrossRef
  • The History of Korean Thyroid Pathology
    Soon Won Hong, Chan Kwon Jung
    International Journal of Thyroidology.2018; 11(1): 15.     CrossRef
  • Thyroid FNA cytology in Asian practice-Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
    K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
    Cytopathology.2017; 28(6): 455.     CrossRef
  • Thyroid Fine-Needle Aspiration Cytology Practice in Korea
    Yoon Jin Cha, Ju Yeon Pyo, SoonWon Hong, Jae Yeon Seok, Kyung-Ju Kim, Jee-Young Han, Jeong Mo Bae, Hyeong Ju Kwon, Yeejeong Kim, Kyueng-Whan Min, Soonae Oak, Sunhee Chang
    Journal of Pathology and Translational Medicine.2017; 51(6): 521.     CrossRef
  • Current Practices of Thyroid Fine-Needle Aspiration in Asia: A Missing Voice
    Andrey Bychkov, Kennichi Kakudo, SoonWon Hong
    Journal of Pathology and Translational Medicine.2017; 51(6): 517.     CrossRef
  • Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand
    Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov
    Journal of Pathology and Translational Medicine.2017; 51(6): 565.     CrossRef
Case Study
Anaplastic Transformation of Papillary Thyroid Carcinoma in a Young Man: A Case Study with Immunohistochemical and BRAF Analysis
Ji Hye Park, Hyeong Ju Kwon, Cheong Soo Park, SoonWon Hong
Korean J Pathol. 2014;48(3):234-240.   Published online June 26, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.3.234
  • 6,549 View
  • 52 Download
  • 4 Citations
AbstractAbstract PDF

This study reports a case of anaplastic transformation from a well-differentiated thyroid carcinoma in a young patient. The first recurrent tissue contained poorly differentiated foci that revealed lower thyroglobulin, thyroid transcription factor 1 (TTF-1), and galectin-3 expression than the well-differentiated area. However there was no increased p53 or Ki-67 expression in the poorly differentiated foci, nor in the well-differentiated area. The tissue subsequently relapsed and revealed only anaplastic features, complete loss of thyroglobulin, TTF-1, and galectin-3 expression and revealed an increase in p53 and Ki-67 expression. The BRAF V600E and BRAF V600V mutation were found in the initially diagnosed papillary thyroid carcinoma and the poorly differentiated foci of the recurring papillary thyroid carcinoma; however, only the BRAF V600V mutation was found in the anaplastic carcinoma. These results suggest that overexpression of p53 and Ki-67 contributed to the anaplastic transformation. We also found that the BRAF type changed during the tumor relapse.

Citations

Citations to this article as recorded by  
  • Coexisting well-differentiated and anaplastic thyroid carcinoma in the same primary resection specimen: immunophenotypic and genetic comparison of the two components in a consecutive series of 13 cases and a review of the literature
    Moira Ragazzi, Federica Torricelli, Benedetta Donati, Alessia Ciarrocchi, Dario de Biase, Giovanni Tallini, Eleonora Zanetti, Alessandra Bisagni, Elisabetta Kuhn, Davide Giordano, Andrea Frasoldati, Simonetta Piana
    Virchows Archiv.2021; 478(2): 265.     CrossRef
  • HDAC Inhibition Induces PD-L1 Expression in a Novel Anaplastic Thyroid Cancer Cell Line
    Luca Hegedűs, Dominika Rittler, Tamás Garay, Paul Stockhammer, Ildikó Kovács, Balázs Döme, Sarah Theurer, Thomas Hager, Thomas Herold, Stavros Kalbourtzis, Agnes Bankfalvi, Kurt W. Schmid, Dagmar Führer, Clemens Aigner, Balázs Hegedűs
    Pathology & Oncology Research.2020; 26(4): 2523.     CrossRef
  • EWSR1 rearrangement is a frequent event in papillary thyroid carcinoma and in carcinoma of the thyroid with Ewing family tumor elements (CEFTE)
    G. Oliveira, A. Polónia, J. M. Cameselle-Teijeiro, D. Leitão, S. Sapia, M. Sobrinho-Simões, C. Eloy
    Virchows Archiv.2017; 470(5): 517.     CrossRef
  • Anaplastic carcinoma of the thyroid in a 12-year old girl
    Rodrigo Mon, James Newlon
    Journal of Pediatric Surgery Case Reports.2015; 3(9): 404.     CrossRef

JPTM : Journal of Pathology and Translational Medicine