Journal of Pathology and Translational Medicine

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

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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

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State of the art of thyroid pathology: FNA diagnostic accuracy in an intermediate center in Ibagué
Daniel Javier Velez Bohorquez, Nohora Bibiana Varon Arce, Sandra Milena Tellez Olaya, Sebastian Camilo Mora Garcia, Anggi Margarita Velez Bohorquez, Mabel Elena Bohorquez Lozano
Universitas Médica.2023;[Epub] CrossRef
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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
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The History of Korean Thyroid Pathology
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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

Original Article

Cytological Findings of the Micropapillary Variant of Urothelial Carcinoma: A Comparison with Typical High-Grade Urothelial Carcinoma: Kyu-Ho Kim, Chang-Hwan Choi, Jee-Young Han, Lucia Kim, Suk-Jin Choi, In-Suh Park, Joon-Mee Kim, Young-Chae Chu; Korean J Pathol. 2013;47(4):365-371. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.365

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Abstract PDF

Background

Micropapillary variant of urothelial carcinoma (MPUC) showed distinct pathologic features and aggressive behavior. The cytologic findings of MPUC are still indistinct. In this study, we evaluated the cytological findings of MPUC compared with those of high-grade urothelial carcinoma (HGUC).

Methods

The voided urine cytology of 8 cases of MPUC and 8 cases of HGUC was reviewed. Following cytological parameters were evaluated: cellularity, background, number of small, tight papillary clusters, small acinar structure, scattered single cells, cytoplasmic features, nuclear-to-cytoplasmic ratio, nuclear pleomorphism, nuclear membrane irregularity, hyperchromasia, chromatin pattern and nucleoli.

Results

Compared to that of HGUC, cytology of MPUC showed large numbers of small, tight papillary clusters, small acinar structure, few numbers of single cells, and hyperchromatic nuclei. Other parameters were similar between the two groups; both groups showed similar cellularity, dense or vacuolated cytoplasm, moderate to severe nuclear pleomorphism, irregular nuclear membrane, coarse granular chromatin, and small and prominent nucleoli.

Conclusions

The urine cytology of MPUCs showed smaller and tighter papillary cell clusters, more small acinar structures, fewer numbers of scattered single cells, and more hyperchromatic nuclei than that of HGUC. These features can help to distinguish MPUC and HGUC and offer an early cytological diagnosis of MPUC.

Citations

Citations to this article as recorded by

Cytologic features of micropapillary variant urothelial carcinoma in urinary tract cytology: Case series and review of literature
Nancy Y. Greenland, Yue Peng, Poonam Vohra, Z. Laura Tabatabai
Diagnostic Cytopathology.2022;[Epub] CrossRef
Cyto-histo correlations of plasmacytoid and micropapillary variants of high-grade urothelial carcinoma: do they fit well in The Paris System for reporting urinary cytology?
Liye Suo, Ivonne Vega, Michael Thrall
Journal of the American Society of Cytopathology.2021; 10(1): 20. CrossRef
A case report of urothelial carcinoma with combined micropapillary and plasmacytoid morphology in the urinary bladder
Sanghui Park, Min‐Sun Cho, Kwang Hyun Kim
Diagnostic Cytopathology.2016; 44(2): 124. CrossRef
Two cases with the micropapillary variant of urothelial carcinoma of the urinary bladder
Akiko KAGOTANI, Mitsuaki ISHIDA, Muneo IWAI, Nozomi IWAMOTO, Nozomi KASUGA, Yuji HAYASHI, Yoshimitsu MIYAHIRA, Ryoji KUSHIMA
The Journal of the Japanese Society of Clinical Cytology.2016; 55(3): 165. CrossRef

Case Report

Cytologic Findings of Clear Cell Adenocarcinoma of the Urethra: A Case Report: Jee-Young Han, Kyu-Ho Kim, Lucia Kim, Suk-Jin Choi, In-Suh Park, Joon-Mee Kim, Young-Chae Chu, Sang-Min Yoon; Korean J Pathol. 2012;46(2):210-214. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.210

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Abstract PDF

Clear cell adenocarcinoma of the urethra is a rare disease entity with an uncertain histogenesis. Here, we present a case of primary clear cell adenocarcinoma of the female urethra with its cytological findings. A 54-year-old woman presented with a painless gross hematuria lasting 3 months. On vaginal sonography, there was a sausage-like, elongated mass in the urethra, measuring 3.8×4.3 cm. The voided urine cytology revealed small clusters of rounded or papillary cells. The necrotic debris and inflammatory cells were present within some clusters of tumor cells. These tumor cells were enlarged and had abundant clear or granular cytoplasm with cytoplasmic vacuoles. The nucleus was granular and contained vesicular chromatin with prominent nucleoli. The hobnail cells and hyaline globules were also present as in a histologic section. The histologic findings were compatible with clear cell adenocarcinoma. The tumor showed distinctive cytological features. Cytologically, however, it is necessary to make a differential diagnosis from other adenocarcinoma or high-grade urothelial carcinoma.

Citations

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Cytological and histological findings of upper tract mucinous urothelial carcinoma with clear cell component: A case report and review of literature
Go Kobayashi, Naohiro Uraoka, Kazuhiro Sentani, Jun Shibata, Ryosuke Nobuhiro, Yoichi Saito, Daiki Taniyama, Masanori Hanamoto, Hiroyuki Nose, Naohide Oue
Diagnostic Cytopathology.2022;[Epub] CrossRef
Presentación de reporte de caso: adenocarcinoma de célula clara de uretra
Nataly González, Yuly Ramirez, Jose Szelezsán, Daniel Rojas
Revista Urología Colombiana / Colombian Urology Journal.2018; 27(02): 191. CrossRef
Clear Cell Adenocarcinoma of the Urethra: Review of the Literature
Anthony Kodzo-Grey Venyo
International Journal of Surgical Oncology.2015; 2015: 1. CrossRef

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