Thyroid fine-needle aspiration cytology: performance data of neoplastic and malignant cases as identified from 1558 responses in the ASCP Non-GYN Assessment program thyroid fine-needle performance data.
By individual diagnosis, the group rates were 86.5%, 0%, 11%, and 2.5% for anaplastic thyroid carcinoma; 83%, 5.5%, 4.25%, and 7.25% for papillary thyroid carcinoma; 79%, 7%, 6%, and 8% for medullary thyroid carcinoma; 83.5% 6.75%, 0%, and 9.75% for Hürthle cell neoplasm; and 61%, 22%, 0%, and 17% for follicular neoplasm in groups A, B, C, and D respectively.Data from a large group of cytology professionals showed good performance; however, there is room for improvement, especially in making specific diagnoses.In particular, follicular neoplasm and follicular variant of papillary thyroid carcinoma were challenging diagnoses for participants.
Affiliation: Mercy Medical Center, Cedar Rapids, Iowa.
- Biopsy, Fine-Needle/methods*
- Databases, Factual*
- Thyroid Neoplasms/diagnosis/pathology*/surgery
- Adenocarcinoma, Follicular/pathology/surgery
- Adenoma, Oxyphilic/pathology/surgery
- Carcinoma, Neuroendocrine
- Diagnosis, Differential
- Neoplasm Invasiveness/pathology
- Neoplasm Staging
- Risk Assessment
- Societies, Medical
- Thyroid Nodule/pathology/surgery
© Copyright Policy
fig01: (A and B) Aspirates from anaplastic thyroid carcinoma show large pleomorphic cells with variable cytoplasm, marked nuclear pleomorphism, and prominent irregular nucleoli (panel A: Rapid Romanowsky, high power; panel B: Papanicolaou, high power. (C and D) Aspirates from papillary thyroid carcinoma show large flat sheets and 3-dimensional structures with crowded, overlapping nuclei. The nuclei are ovoid with clear chromatin, nuclear grooves, and inclusions (C, Rapid Romanowsky, low power; panel; D, Papanicolau, medium power). (E and F) Aspirates from medullary thyroid carcinoma show a dyscohesive to loosely cohesive architecture with granular cytoplasm, eccentric nuclei, and nuclear pleomorphism (E, Rapid Romanowsky, low power; F, Papanicolaou, medium power). (G and H) Aspirates from Hürthle cell neoplasm show cells with abundant granular cytoplasm, low n/c ratios, and relatively uniform round nuclei and nucleoli (G, Rapid Romanowsky, medium power; H, Papanicolaou, medium power). (I and J) Aspirates from follicular neoplasm are cellular with follicular cells arranged in monotonous microfollicular or trabecular structures with little to absent colloid. The cells have uniform round nuclei and indistinct cytoplasm (I, Rapid Romanowsky, medium power; J, Papanicolaou, low power).
Representative images of each diagnostic category are depicted in Figure 1.