Positive (malignant) aspirate
Positive (malignant) aspirate Thyroid cancer (although the most common endocrine malignancy) is rare, accounting for less than 1% of solid tumours. Annual UK incidence of thyroid malignancy is approximately 2.3 per 100,000 women and 0.9 per 100,000 men. Primary thyroid malignancies can be divided into differentiated (papillary and follicular carcinoma), medullary and anaplastic carcinomas, being […]
Cytologically benign follicular lesions
Cytologic diagnostic features low or moderate cellularity cohesive cells predominantly microfollicular pattern uniform, evenly spaced follicular cells round nucleus, finely granular chromatin scanty or moderate cytoplasm few macrophages bare nuclei Colloid is usually abundant, appearing as amorphous blobs or as a thin translucent film with bubbles and linear cracks. Some benign follicular lesions are hypercellular […]
Suspicious aspirate
Suspicious aspirate In some cases it may be difficult to differentiate between a benign and a malignant lesion, particularly as there may be overlapping cytological features. Follicular neoplasms are often reported in this category, it being difficult to differentiate between follicular/Hürthle cell carcinomas and adenomas cytologically. ‘Suspicious’ cases may be: suspicious for papillary carcinoma, suspicious […]
Cytologically suspicious follicular lesions
Cytologic diagnostic features: high cellularity predominantly microfollicular or trabecular pattern crowded, overlapping cells cellular alterations (mild atypia, an uniform enlargement) scanty or absent colloid Several of all of these features should be present to diagnose a follicular lesion as ‘cytologically suspicious’. Marked nuclear atypia is uncommon, and so are mitosis. Macrophages are absent. Bare nuclei […]
The Thy classification adopted by the Royal college of Physicians
Classification: Thy1: Non-diagnostic (inadequate or where technical artefact precludes interpretation; smears must contain 6 or more groups of at least 10 thyroid follicular cells to be considered adequate). Action: FNAC should be repeated with or without ultrasound guidance. Thy2: Non-neoplastic (features consistent with a nodular goitre or thyroiditis). Action: Two diagnostic benign results 3-6 months […]
Malignant tumours
Malignant tumours: Papillary carcinoma Poorly differentiated carcinomas (insular carcinoma) Anaplastic carcinoma Medullary carcinoma Lymphoma Metastatic carcinoma
Benign conditions
Benign conditions Acute thyroiditis Subacute granulomatous (De Quervain`s) thyroiditis Chronic lymphocytic (Hashimoto`s) thyroiditis Riedel`s disease Multinodular goiter Radiation changes
Acute thyroiditis
Acute thyroiditis, a very rare condition due to bacterial infections, is usually diagnosed clinically, without the need for FNA. Aspirates are composed predominantly of neutrophils and inflammatory debris, and thyroid epithelial cells are scanty and degenerated.
Subacute granulomatous (De Quervain`s) thyroiditis
It is a rare self-limited disease, usually lasting several months, characterized by a painful enlargement of the gland. It is a granulomatous inflammatory condition which leads finally to fibrosis of the gland. Cytologic diagnostic features granulomas giant cells lymphocytes and neutrophils The cytologic specimens contain nodular aggregate of hystiocytes, lymphocytes and neutrophils. Epithelioid cells and […]
Chronic lymphocytic (Hashimoto`s) thyroiditis
This is an autoimmune disease in which the parenchima is virtually replaced by a lymphoid infiltrate with germinal centers, sometimes with a prominent fibrosis in longstanding disease. Several autoantibodies are identified in affected patients, such as antibodies against thyroid microsomal antigens and against TSH receptors. The gland is usually enlarged, painless, with or without nodularity. […]