Non-papillary thyroid carcinoma diagnoses in The Bethesda System for Reporting Thyroid Cytopathology categories V and VI: An institutional experienceopen access
- Authors
- Kang, Myunghee; Kim, Na Rae; Seok, Jae Yeon
- Issue Date
- Aug-2024
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- Thyroid; Cytology; Medullary Thyroid Carcinoma; Anaplastic Thyroid Carcinoma; Metastasis; Differential Diagnosis; High -Grade
- Citation
- ANNALS OF DIAGNOSTIC PATHOLOGY, v.71
- Journal Title
- ANNALS OF DIAGNOSTIC PATHOLOGY
- Volume
- 71
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/91503
- DOI
- 10.1016/j.anndiagpath.2023.152263
- ISSN
- 1092-9134
1532-8198
- Abstract
- Background: The non-papillary thyroid carcinoma (PTC) subgroups of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) categories V (Suspicious for malignancy) and VI (Malignant) are rare, and specific tumor typing is difficult. We aimed to analyze histologic outcomes and to investigate the points of caution. Methods: We reviewed the electronic database and identified 12,215 cases of thyroid fine-needle aspiration cytology between 2013 and 2022. In total, 2783 patients were diagnosed with TBSRTC V or VI. Of these, 51 patients with non-PTC diagnosis were identified. Histological outcomes were analyzed with the cytologic findings. Results: The subgroups of non-PTC diagnoses in TBSRTC category V or VI consisted of medullary thyroid carcinoma (MTC) (13/51, 25.5 %), anaplastic thyroid carcinoma (3/51, 5.9 %), lymphoma (2/51, 3.9 %), metastatic tumor (4/51, 7.8 %), and malignant, not otherwise specified (NOS) (29/51, 56.9 %). The concordance rate of the histological outcomes was 30 % (12/40), predominantly comprising MTC cases. The obscuring factors for specific tumor typing in the suspicious for malignancy/malignant NOS cytology diagnosis group was mixed pattern of well differentiated thyroid carcinoma and less differentiated carcinoma cells (9/24, 37.5 %), low cellularity (7/24, 29.2 %) and a history of non-thyroid organ malignancy (6/24, 25 %). The less differentiated carcinoma component in mixed pattern consisted of 2 poorly differentiated thyroid carcinomas, 2 anaplastic thyroid carcinomas, 4 high-grade PTCs and 1 high-grade MTC. Conclusion: The high-grade feature of PTC or MTC cytology is a noteworthy obscuring factor in specific tumor typing of non-PTC cytology diagnosis.
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