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Pathology Reporting of Thyroid Core Needle Biopsy: A Proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group.

Jung CK, Min HS, Park HJ, Song DE, Kim JH, Park SY, Yoo H, Shin MK, Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Gro - J Pathol Transl Med (2015)

Bottom Line: However, there is no consensus on the pathology reporting system for thyroid CNB.The Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group held a conference on thyroid CNB pathology and developed guidelines through contributions from the participants.This article discusses the outcome of the discussions that led to a consensus on the pathology reporting of thyroid CNB.

View Article: PubMed Central - PubMed

Affiliation: Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
In recent years throughout Korea, the use of ultrasound-guided core needle biopsy (CNB) has become common for the preoperative diagnosis of thyroid nodules. However, there is no consensus on the pathology reporting system for thyroid CNB. The Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group held a conference on thyroid CNB pathology and developed guidelines through contributions from the participants. This article discusses the outcome of the discussions that led to a consensus on the pathology reporting of thyroid CNB.

No MeSH data available.


Related in: MedlinePlus

(A, B) The ultrasound images show well-circumscribed solid, homogeneous, nodules with peripheral hypoechoic rims. (C, D) The core needle biopsies show only microfollicular proliferation. These specimens do not contain a fibrous capsule or adjacent normal tissue that is required to make a diagnosis of follicular neoplasm. (E, F) Images are the high-power views of Fig. 2C and D, respectively. No nuclear atypia is present. The left and right columns show the conventional and Hürthle cell types, respectively. Typical ultrasound features of follicular neoplasms, when present, can lead to the diagnosis of follicular neoplasms, even when specimens are not contained in a fibrous capsule.
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f2-jptm-49-4-288: (A, B) The ultrasound images show well-circumscribed solid, homogeneous, nodules with peripheral hypoechoic rims. (C, D) The core needle biopsies show only microfollicular proliferation. These specimens do not contain a fibrous capsule or adjacent normal tissue that is required to make a diagnosis of follicular neoplasm. (E, F) Images are the high-power views of Fig. 2C and D, respectively. No nuclear atypia is present. The left and right columns show the conventional and Hürthle cell types, respectively. Typical ultrasound features of follicular neoplasms, when present, can lead to the diagnosis of follicular neoplasms, even when specimens are not contained in a fibrous capsule.

Mentions: The diagnosis of category III is appropriate when a follicular proliferative lesion shows focal nuclear atypia such as nuclear enlargement with pale chromatin, irregular nuclear membranes, and nuclear grooves in a background of predominantly benign-appearing follicles. If a microfollicular proliferative lesion is separated by a fibrous capsule from the surrounding normal parenchyma it is diagnosed as a follicular neoplasm (see category IV). If a fibrous capsule or adjacent nonlesional tissue is not identified in a CNB specimen that shows a predominantly microfollicular or trabecular growth pattern, it is reasonable to classify the lesion as diagnostic category III because it cannot be determined whether the nodule has a fibrous capsule. However, if sonographic features suggest a follicular neoplasm in such lesions, the sample can be considered a category IV, “follicular neoplasm” (Fig. 2) [15]. A multidisciplinary approach to a thyroid nodule can improve the preoperative diagnostic accuracy of FNAC and CNB specimens [16].


Pathology Reporting of Thyroid Core Needle Biopsy: A Proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group.

Jung CK, Min HS, Park HJ, Song DE, Kim JH, Park SY, Yoo H, Shin MK, Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Gro - J Pathol Transl Med (2015)

(A, B) The ultrasound images show well-circumscribed solid, homogeneous, nodules with peripheral hypoechoic rims. (C, D) The core needle biopsies show only microfollicular proliferation. These specimens do not contain a fibrous capsule or adjacent normal tissue that is required to make a diagnosis of follicular neoplasm. (E, F) Images are the high-power views of Fig. 2C and D, respectively. No nuclear atypia is present. The left and right columns show the conventional and Hürthle cell types, respectively. Typical ultrasound features of follicular neoplasms, when present, can lead to the diagnosis of follicular neoplasms, even when specimens are not contained in a fibrous capsule.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508566&req=5

f2-jptm-49-4-288: (A, B) The ultrasound images show well-circumscribed solid, homogeneous, nodules with peripheral hypoechoic rims. (C, D) The core needle biopsies show only microfollicular proliferation. These specimens do not contain a fibrous capsule or adjacent normal tissue that is required to make a diagnosis of follicular neoplasm. (E, F) Images are the high-power views of Fig. 2C and D, respectively. No nuclear atypia is present. The left and right columns show the conventional and Hürthle cell types, respectively. Typical ultrasound features of follicular neoplasms, when present, can lead to the diagnosis of follicular neoplasms, even when specimens are not contained in a fibrous capsule.
Mentions: The diagnosis of category III is appropriate when a follicular proliferative lesion shows focal nuclear atypia such as nuclear enlargement with pale chromatin, irregular nuclear membranes, and nuclear grooves in a background of predominantly benign-appearing follicles. If a microfollicular proliferative lesion is separated by a fibrous capsule from the surrounding normal parenchyma it is diagnosed as a follicular neoplasm (see category IV). If a fibrous capsule or adjacent nonlesional tissue is not identified in a CNB specimen that shows a predominantly microfollicular or trabecular growth pattern, it is reasonable to classify the lesion as diagnostic category III because it cannot be determined whether the nodule has a fibrous capsule. However, if sonographic features suggest a follicular neoplasm in such lesions, the sample can be considered a category IV, “follicular neoplasm” (Fig. 2) [15]. A multidisciplinary approach to a thyroid nodule can improve the preoperative diagnostic accuracy of FNAC and CNB specimens [16].

Bottom Line: However, there is no consensus on the pathology reporting system for thyroid CNB.The Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group held a conference on thyroid CNB pathology and developed guidelines through contributions from the participants.This article discusses the outcome of the discussions that led to a consensus on the pathology reporting of thyroid CNB.

View Article: PubMed Central - PubMed

Affiliation: Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
In recent years throughout Korea, the use of ultrasound-guided core needle biopsy (CNB) has become common for the preoperative diagnosis of thyroid nodules. However, there is no consensus on the pathology reporting system for thyroid CNB. The Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group held a conference on thyroid CNB pathology and developed guidelines through contributions from the participants. This article discusses the outcome of the discussions that led to a consensus on the pathology reporting of thyroid CNB.

No MeSH data available.


Related in: MedlinePlus