ECE2006 Poster Presentations Thyroid (174 abstracts)
University of Pisa, Pisa, Italy.
Aim of the study was to establish the diagnostic value of nuclear atypia thyroid nodules with cytological diagnosis of follicular (FOL) and Hv¨rthle cell (HC) neoplasia. 1039/23.313 fine needle aspiration (FNA) performed in January 2002 June 2005 in the Department of Endocrinology, University of Pisa had cytological diagnosis of FOL e CH. FNA was performed under echo guidance, using 23 gauge needle attached to 10 mL syringe. The material was air-dryed and stained with Papanicolau e Giemsa. Cytological criteria used for diagnosis of follicular nodule included hypercellularity with small, uniform cells and poor and watery colloid content. The presence of nuclear enlargement and hypercromic nuclei with irregular / coarse chromatin was defined as atypia. 495 patients (388 F: mean age 45±14 yr; 107 M: mean age 46±14 yr) with cold nodule at scintiscan underwent thyroidectomy at the Department of Surgery, University of Pisa. Histology was made according to the World Health Organization guide lines.
Results: 418/ 495 patients had a cytological diagnosis of FOL: 82 with nuclear atypia and 336 without nuclear atypia; 77/495 had HC diagnosis: 18 with nuclear atypia and 59 without nuclear atypia. CA hystological diagnosis was made in 45/100 (45%) nodules with nuclear atypia and in 79/395 (20%) nodules without nuclear atypia (X2=26.5; P<0.0001).
Atipia + (n=100) | Atipia - (n=395) | P | |
Follicular | |||
Benign | 43 | 260 | |
CA | 39 | 76 | <0.0001 |
Hürthle | |||
Benign | 12 | 56 | |
CA | 6 | 3 | <0.0001 |
Total | |||
Benign | 55 | 316 | |
CA | 45 | 79 | <0.0001 |
In conclusion, nuclear atypia characterized by nuclear enlargement and hypercromic nuclei with irregular/coarse chromatin is a pattern predictive of malignancy in follicular/Hürthle neoplasia at cytology.