Histhopathological verification of atypia of undetermined significance in Bethesda system

Sevilay Ozmen; Ilknur Calik; Ahmet Erkan Bilici; Ozge Timur; Ayse Carlioglu; Senay Arikan Durmaz; Fazli Erdogan; Ali Kurt

doi:10.1530/endoabs.37.EP879

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Endocrine Abstracts (2015) 37 EP879 | DOI: 10.1530/endoabs.37.EP879

ECE2015 Eposter Presentations Thyroid cancer (90 abstracts)

Histhopathological verification of atypia of undetermined significance in Bethesda system

Sevilay Ozmen ¹ , Ilknur Calik ¹ , Ahmet Erkan Bilici ¹ , Ozge Timur ² , Ayse Carlioglu ³ , Senay Arikan Durmaz ³ , Fazli Erdogan ¹ & Ali Kurt ¹

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¹Department of Pathology, Training and Research Hospital, Erzurum, Turkey; ²Department of Internal Medicine, Training and Research Hospital, Erzurum, Turkey; ³Department of Endocrinology, Training and Research Hospital, Erzurum, Turkey.

The pathologist cannot easily decide some thyroid fine-needle aspiration biopsy (FNA) into the benign, suspicious, or malignity and this condition are reported as ‘atypia of undetermined significance’ (AUS) or ‘follicular lesion of undetermined significance’ in the Bethesda system. Diagnosis of AUS of a thyroid nodule is leaved an endocrinologist as well as the patients in a difficult situation. However, the risk of malignancy at AUS is ~5–15%. Our aimed to this study is to determined histhopathological verification of atypia of undetermined significance according to Bethesda system.

Materials and methods: Results of FNA were used totally in 402 patients with nodular goitre from our hospital records from 2012 to 2014. Twenty people (19 women and one man) out of this study population were diagnosed AUS. All the patients had undergone total or subtotal thyroidectomy. We retrospectively re-evaluated postoperative biopsy results and compared with those histhopathological diagnoses.

Results: It was found that postoperative biopsy results of the patients who were diagnosed AUS were adenomatous hyperplasia (5%, n=1), nodular goitre (65%, n=14), papillary carcinoma (5%, n=1), Hashimoto’s thyroiditis (15%, n=3), and microfolliculary adenoma (5%, n=1).

Conclusions: Our finding demonstrated that AUS category substantially indicated to benign cellular change. This date was found in accordance with prediction of Bethesda system. Therefore, a repeated FNA should be performed after an appropriate period of time. The factors including follicular lesion in part suspicious follicular neoplasia, existence of lymphoid cell, hypocellularity and artefact of sample preparation may lead to misdiagnosis of malignity in patients with AUS.