scholarly journals Diagnostic tactics for thyroid nodules

2012 ◽  
Vol 93 (1) ◽  
pp. 103-107
Author(s):  
L A Timofeeva
Keyword(s):  
Thyroid Gland ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Malignant Tumors ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Regional Lymph Nodes ◽  
Fine Needle ◽  
Cut Surface ◽  
Ultrasound Investigation

Aim. To determine the optimal diagnostic tactics for nodules of the thyroid gland. Methods. Examined were 1124 patients with thyroid nodules in the age from 14 to 60 years and older, of whom 159 - with malignant tumors, 180 - with adenomas, 620 - with colloid nodes, 165 - with cysts. Among the surveyed group were 844 women and 280 men. The group of healthy individuals included 400 people. The material for cytology was obtained by fine-needle aspiration biopsy (1004 studies), from smears from the cut surface of the tumor (76 studies) and from puncture biopsies of enlarged regional lymph nodes (44 studies). Results. During ultrasound investigation hypoechoic, heterogeneity, roughness and blurred contours, the presence of the internal structure of small echo-negative inclusions are characteristic for thyroid cancer. As the number of these features increases the likelihood of confirmation of a malignant tumor of the thyroid increases as well. The ultrasound picture of nodular colloid goiter is characterized by a single nodule or multiple nodules in the tissue of the thyroid gland of low or isoechoic density, sometimes with a limiting «rim». The presence of the latter feature causes difficulties in the differential diagnosis between nodular goiter and thyroid adenoma. Out of the 907 informative cases in 144 patients (15.8%) cancer was diagnosed cytologically. Conclusion. A complex diagnostic approach to the examination of thyroid nodules using fine-needle aspiration puncture biopsy of the nodules under the control of ultrasound and subsequent cytological investigation of the punctate provides valuable information on the nature of pathological changes of the thyroid gland.

scholarly journals Combined quantitation of HMGA2 mRNA, microRNAs, and mitochondrial-DNA content enables the identification and typing of thyroid tumors in fine-needle aspiration smears

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sergei E. Titov ◽  
Mikhail K. Ivanov ◽  
Pavel S. Demenkov ◽  
Gevork A. Katanyan ◽  
Eugenia S. Kozorezova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Molecular Markers ◽  
Fine Needle Aspiration ◽  
Real Time Pcr ◽  
Thyroid Nodules ◽  
Nuclear Dna ◽  
Malignant Tumors ◽  
Needle Aspiration ◽  
Thyroid Tumors ◽  
Fine Needle

Abstract Background Analysis of molecular markers in addition to cytological analysis of fine-needle aspiration (FNA) samples is a promising way to improve the preoperative diagnosis of thyroid nodules. Nonetheless, in clinical practice, applications of existing diagnostic solutions based on the detection of somatic mutations or analysis of gene expression are limited by their high cost and difficulties with clinical interpretation. The aim of our work was to develop an algorithm for the differential diagnosis of thyroid nodules on the basis of a small set of molecular markers analyzed by real-time PCR. Methods A total of 494 preoperative FNA samples of thyroid goiters and tumors from 232 patients with known histological reports were analyzed: goiter, 105 samples (50 patients); follicular adenoma, 101 (48); follicular carcinoma, 43 (28); Hürthle cell carcinoma, 25 (11); papillary carcinoma, 121 (56); follicular variant of papillary carcinoma, 80 (32); and medullary carcinoma, 19 (12). Total nucleic acids extracted from dried FNA smears were analyzed for five somatic point mutations and two translocations typical of thyroid tumors as well as for relative concentrations of HMGA2 mRNA and 13 microRNAs and the ratio of mitochondrial to nuclear DNA by real-time PCR. A decision tree–based algorithm was built to discriminate benign and malignant tumors and to type the thyroid cancer. Leave-p-out cross-validation with five partitions was performed to estimate prediction quality. A comparison of two independent samples by quantitative traits was carried out via the Mann–Whitney U test. Results A minimum set of markers was selected (levels of HMGA2 mRNA and miR-375, − 221, and -146b in combination with the mitochondrial-to-nuclear DNA ratio) and yielded highly accurate discrimination (sensitivity = 0.97; positive predictive value = 0.98) between goiters with benign tumors and malignant tumors and accurate typing of papillary, medullary, and Hürthle cell carcinomas. The results support an alternative classification of follicular tumors, which differs from the histological one. Conclusions The study shows the feasibility of the preoperative differential diagnosis of thyroid nodules using a panel of several molecular markers by a simple PCR-based method. Combining markers of different types increases the accuracy of classification.

Thyroid peroxidase immunodetection as a tool to assist diagnosis of thyroid nodules on fine-needle aspiration biopsy

1994 ◽  
Vol 131 (5) ◽  
pp. 474-479 ◽  
Author(s):  
Catherine De Micco ◽  
Patricia Zoro ◽  
Stéphane Garcia ◽  
Lambert Skoog ◽  
Edneia M Tani ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Malignant Tumors ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Thyroid Peroxidase ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Benign Nodules

De Micco C, Zoro P, Garcia S, Skoog L, Tani EM, Carayon P, Henry J-F. Thyroid peroxidase immunodetection as a tool to assist diagnosis of thyroid nodules on fine-need aspiration biopsy. Eur J Endocrinol 1994;131:474–9. ISSN 0804–4643 In a previous work we have reported the presence in 96.9% of malignant and 4.2% of benign thyroid tumors of an immunological abnormality of the enzyme thyroid peroxidase, impeding the fixation of the anti-thyroid peroxidase monoclonal antibody termed "MoAb47". The present study has been designed to establish the ability of thyroid peroxidase immunodetection to assist the diagnosis of malignancy in fine-needle aspiration of thyroid nodules. The fixation of anti-thyroid peroxidase monoclonal antibody was investigated by immunohistochemistry on fine-needle aspirates of 150 surgically removed thyroid nodules (20 papillary carcinomas, five follicular carcinomas, 90 colloid adenomas, nine fetal adenoma, 13 atypical adenomas, five oncocytic adenomas, six Hashimoto's thyroiditis and two Graves' disease). The percentage of positive cells has been compared to the final histological diagnosis. In samples from 113/125 benign nodules 80–100% cells presented a positive immunoreaction, whereas all samples from malignant tumors yielded less than 80% positive cells. Benign nodules exhibiting less than 80% positive cells corresponded to three degenerative colloid nodules, five atypical follicular adenomas, two oncocytomas and two thyroiditis. According to results obtained in this series, with the value of 80% as the limit for discrimination between benign and highrisk nodules, the sensitivity of thyroid peroxidase staining for diagnosis of malignancy would be 100%, its specificity 90% and its overall accuracy 92%. Thyroid peroxidase staining with monoclonal antibody MoAb47 on fine-needle aspirates is a useful adjunct to conventional cytology for the investigation of patients with thyroid nodules. Catherine De Micco, Laboratoire d'Anatomie Pathologique, Faculté de Médecine Nord, Bd Pierre Dramard, 13916 Marseille Cedex 20, France

scholarly journals Biochemical Markers in Nodular Goiter in Children Indications, methods and outcome of the Surgical Treatment

2019 ◽  
Vol 70 (3) ◽  
pp. 996-999
Author(s):  
Flore Varcus ◽  
Gabriela Delia Ciobanu ◽  
Alexandru Grigorovici ◽  
Marius Valeriu Hinganu ◽  
Delia Hinganu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Pediatric Population ◽  
Follicular Adenoma ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Fine Needle

Nodular goiter is a rare condition in children and adolescents and compared with adults, thyroid nodules are more frequent malignant in pediatric population. We have investigated the prevalence of thyroid carcinoma among the thyroid disorder emphasizing on the surgical treatment in term of indication, methods and complications. Retrospective study of 35 children and adolescents with nodular goiter. Demographic data, thyroid ultrasonographic features, fine needle biopsy aspiration, hormonal profile, surgical treatment procedure as well as histological aspects were recorded. Study included 26 (74%) girls and 9 (26%) boys with a mean age of 11.66 years. Fine needle aspiration biopsy was performed in 10 cases due to the TIRADS score � 4 with Bethesda II in 3 cases, Bethesda III in 4 cases and Bethesda V in 3 cases. The surgical treatment was performed in 16 (45.7%) cases due to fine needle aspiration biopsy results or due to the relapse after medical treatment. Lobectomy was performed in 7 (43.7%) cases while total thyroidectomy was the final option for the rest of 9 (56.3%) patients. As a result of pathological examination in 8 cases the thyroid carcinoma has been found. The rest of 8 patients presented benign thyroid findings (follicular adenoma, toxic adenoma and Graves� disease with follicular adenoma). The prevalence of thyroid carcinoma among the pediatric population with thyroid nodules was 22.8% most affected being the female gender.

scholarly journals Fine needle aspiration cytological diagnosis of thyroid nodule with its clinical correlation

2016 ◽  
Vol 6 (2) ◽  
pp. 108 ◽  
Author(s):  
M. Q. Hassan ◽  
M.A. Hasanat ◽  
M. Fariduddin ◽  
M. S. Emran ◽  
Marufa Mustari ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Regional Lymph Node ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Clinical Findings ◽  
Low Risk ◽  
Risk Category ◽  
Chi Square ◽  
Fine Needle

<p><strong>Background:</strong> Nodular goiter is common in Bangladesh. Thyroid nodules are important for their malignant potential especially the solitary and cold ones and when functionally euthyroid. <strong></strong></p><p><strong>Objectives:</strong> This study was designed to investigate the frequency of malignancy and cellular aberration detected by fine needle aspiration cytology (FNAC) in euthyroid nodules and its correlation with clinical findings.<strong> </strong></p><p><strong>Methods:</strong> Subjects with nodular goiter attending Endocrine out patient department [n=150, nonpregnant, age (mean± SD): 37±12 years; sex (male: female): 21:129] were recruited for this study. All subjects underwent clinical risk stratification, estimation ofFT4 and TSH as well as ultrnsonogram (USG) and isotope scan of thyroid. Thyroid nodules were categorized into malignant, suspicious, benign and indeterminant on the basis of cellular character by FNAC. Statistical analysis was done by Chi-square and multiple regression analysis.<strong> </strong></p><p><strong>Results:</strong> Patients were mostly females (86%) and 4.7% had family history of thyroid problems. Some had recent changes of size (14.7%), pain in the nodule (4%) and dysphagia (6%). Nodules were solitary in 45.3% and the rest (54.7%) had multinodular goiter. Enlarged regional lymph node was found in 12.7% patients. About 41 % were partially-cold followed by cold nodules (26.7%), patchy (16.7%), isoform (12%) and hot (4%) by isotope scan. Frequency of malignant (10%) character was highest in cold nodules followed by uniform (5.6%), patchy (4.0%) and partially cold (1.6%) while none in hot nodules; which were 22.5%, 11.1 %, 4.0%, 9.8% and 16.7% respectively for suspicious nodules. About 17% showed cellular aberration and 4.7% were clearly malignant, whereas 124 (82.7%) were benign. Of the malignant, 4 were solitary and 3 were multinodular; which were 10 and 9 among the suspicious ones. A significant number (77%, 20 out of 26) among the malignant/suspicious nodules fell into moderate to high risk category (x<sup>2</sup>=22.861, p&lt;0.001), while 23.1 % of the FNAC proven malignant/suspicious nodules were of low risk category. Enlarged lymph nodes (p&lt;0.001), increased diameter of nodules of &gt;4 cm (p=0.039) and recent changes in nodular size (p=0.042) were independently and signifi­cantly related to cellular aberration. <strong></strong></p><p><strong>Conclusions:</strong> FNAC is a useful tool for cellular diagnosis of thyroid nodules. Clinical suspicion for malignancy strongly correlates with the FNAC findings. But a good number of clinically Low risk categories would escape malignant cellular character unless FNAC is done.</p>

scholarly journals Role of parathyroid hormone measurement in fine-needle aspiration biopsy washout in diagnosis and treatment of primary hyperparathyroidism

2018 ◽  
Vol 20 (3) ◽  
pp. 108-113
Author(s):  
Dmitry G. Beltsevich ◽  
Valeriy V. Voskoboynikov ◽  
Camila M. Klycheva ◽  
Anna A. Roslyakova ◽  
Daria O. Ladygina
Keyword(s):  
Thyroid Gland ◽  
Primary Hyperparathyroidism ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Parathyroid Glands ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Needle Aspiration Biopsy

In this article, we discuss difficulties in parathyroid localization modalities in diagnosis of primary hyperparathyroidism. Most often, superior parathyroid glands are located on the posteromedial surface of the right and left lobes of the thyroid gland, however, they also could be found at the carotid bifurcation, behind pharynx and esophagus, as well as inside thyroid gland. Location of the inferior parathyroid glands is more variable: on the side or back surface, or below the lower pole of the thyroid gland, as well as in thymus, posterior or anterior mediastinum, or inside thyroid. Localization modalities of primary hyperparathyroidism are based on neck ultrasonography, scintigraphy with sestamibi, computed tomography of neck and mediastinum. In cases with combination of multinodal goitre and an intrathyroid location of the parathyroid gland, there might be additional difficulties in verification of various patterns (thyroid nodules or parathyroid glands). In this article, we present two clinical cases of intrathyroid location of parathyroid glands. The algorithm of parathyroid adenoma localization is shown. Determination of PTH level in washing liquid after fine-needle aspiration biopsy from necessary punctures of the nodule formations, which can be either intrathyroid parathyroid glands or thyroid nodules, can also help to avoid diagnostic mistakes.

scholarly journals Acute thyroid swelling after fine needle aspiration—a case report of a rare complication and a systematic review

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tiantong Zhu ◽  
Ye Yang ◽  
Hao Ju ◽  
Ying Huang
Keyword(s):  
Thyroid Gland ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Rare Complication ◽  
Needle Aspiration ◽  
Case Presentation ◽  
Fine Needle ◽  
Thyroid Fine Needle Aspiration ◽  
Thyroid Swelling ◽  
New Hypothesis

Abstract Background Thyroid fine needle aspiration (FNA) is the procedure of choice in the management of thyroid nodules. Acute thyroid swelling after FNA is a rare complication and is reported in a finite number of literatures. To the best of our knowledge, only seven reported cases exist in literatures. This study describes an addition case with an acute thyroid swelling after FNA, as well as puts forward a new hypothesis of this phenomenon. Case presentation The case is presented of a 30-year-old female with an acute thyroid swelling after FNA, with funicular hypoechoic lesions in thyroid gland. The size of thyroid was 1.5-fold enlarged in the unilateral thyroid gland. No complains of pain or other discomforts with her and no signs of hemorrhage were found along the passage of the fine needle. The episode was recovered spontaneously. Conclusions An acute thyroid swelling is a rare complication of FNA. A hypothesis of anaphylactic reaction was suggested in our study. Physicians should pay more attention of this phenomenon and more information is needed to support our hypothesis.

scholarly journals Adequacy And Rate Of Atypical Cytology On Fine Needle Aspiration Technique Using Suction (FNA-S) – A Quality Assurance Study At CMCVAMC

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S162-S162
Author(s):  
S Dalal ◽  
D Jhala
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Health Care Cost ◽  
Diagnostic Yield ◽  
Medical Center ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Agent Orange ◽  
Fine Needle ◽  
Undetermined Significance

Abstract Introduction/Objective Thyroid cancer is one of the most common prevailing conditions. Both genetic and environmental risk factors play a role in causation of thyroid cancers, with agent orange being the most documented risk factor in Veteran patient population. Based on the ultrasonographic appearance, thyroid nodules can be further investigated by minimally invasive fine needle cytology. This can be done by either of two available techniques, Fine needle aspiration with suction (FNA-S) and Fine needle capillary cytology without using suction (FNC), depending upon the preference of practicing endocrinologist. We aim to compare both cytology techniques for comparing the diagnostic yield and rate of atypia of undetermined significance (AUS) or Follicular lesion of undetermined significance (FLUS), requiring repeat FNA in approximately three months. Methods Retrospective study was conducted by searching the cases performed by an endocrinologist at Corporal Michael J Crescenz VA Medical Center between the period of January 1, 2015 and July 2, 2015. 30 nodules from 11 patients were tested by Fine needle capillary cytology technique (FNC). Yield for the diagnosis with rates of atypical (AUS) cytology were compared. On second set of the 29 patients with 38 nodules, both techniques - FNA-S versus FNC were carried out. Adequacy and rate of AUS/FLUS were calculated. Results Out of 30 total nodules performed by fine needle aspiration (FNA-S), all cases yielded diagnostic material. Of them, 14 (46.6%) were diagnosed as AUS and 16 (53.33%) were benign. On the follow-up/re-aspiration by FNC technique, all these 14 nodules were diagnosed benign. On second set of patients on whom both techniques (FNA-S and FNC) were used alternatively, 13 of 38 nodules (34.21%) were diagnosed as AUS/FLUS, 23 (60.52%) were benign/nodular goiter and 2 were non-diagnostic/inadequate (5.2%). Conclusion FNA-S (with suction) yields adequate diagnostic material, however, also has greater number of atypical cytology results requiring repeat patient visit which may increase morbidity with a burden on total health care cost. FNC (without suction) has low rates of AUS/FLUS, is diagnostically superior with excellent smear quality, less blood clots, time savings, and less inconvenience of patients/physician. FNC (without suction) is a modality of choice for an effective screening of thyroid nodules in veterans.

scholarly journals RESULTS OF RESEARCH OF GALECTIN-3 AND THYROGLOBULIN IN PATIENTS WITH THYROID NODULES

2015 ◽  
Vol 174 (2) ◽  
pp. 81-83
Author(s):  
O. S. Olifirova ◽  
S. V. Knalyan
Keyword(s):  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Fine Needle ◽  
Galectin 3 ◽  
Benign Nodules

An investigation of galectin-3 and thyroglobulin using IFA was conducted in 80 patients. A lavage of aspirate from the thyroid gland was obtained by fine-needle aspiration biopsy. It was stated that significant increase of galectin-3 and thyroglobulin was noted in case of high differentiated thyroid carcinoma in comparison with benign nodules. Galectin-3 and thyroglobulin from the lavage of thyroid gland aspirate could be used as an oncological marker for complex differentiated diagnostics of high differentiated thyroid carcinoma and benign nodules.

scholarly journals MicroRNAs – promising molecular markers for detecting cancer in thyroid nodules

2018 ◽  
Vol 14 (3) ◽  
pp. 140-148
Author(s):  
Olga S. Serdyukova ◽  
Sergei E. Titov ◽  
Ekaterina S. Malakhina ◽  
Oksana D. Rymar
Keyword(s):  
Thyroid Cancer ◽  
Molecular Markers ◽  
Thyroid Nodule ◽  
Molecular Analysis ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Malignant Tumors ◽  
Needle Aspiration ◽  
Fine Needle

Thyroid nodules are one of the most common thyroid diseases. The prevalence of thyroid nodules is estimated to be 2–65% depending on the detection methods. Yet despite the high frequency of thyroid nodules only about 5–10% of such nodules are malignant. Fine needle aspiration cytology of the thyroid nodule is currently the primary diagnostic tool for determining the nature of a thyroid nodule. Now, the fine needle aspiration biopsy is the gold standard for diagnosing thyroid cancer but in 30% of cases the cytological conclusion is uncertain. Cytological research is not enough to diagnose benign and malignant tumors. The need to improve the effectiveness of fine needle aspiration biopsy findings led to the search for new diagnostic biomarkers and the creation of diagnostic panels on their basis for their application in the diagnosis of uncertain nodules. Determination of molecular markers in the thyroid aspirate will allow to differentiate benign and malignant tumors more accurately at the preoperative stage and reduce the number of inappropriate surgery. The review article presents the characteristics of MicroRNAs, allowing them to be used in preoperative diagnosis of thyroid nodules. Diagnostic panels based on gene mutations and MicroRNA expression demonstrating high sensitivity and specificity of these methods are also indicated. Analysis of literature indicates that molecular analysis of fine needle aspiration genetic material from thyroid nodal formations demonstrates great prospects of prognosis, diagnosis and treatment of thyroid cancer. However, there is no sufficient evidence to recommend or to prohibit of utilization this molecular testing during the cytological conclusion of indeterminate thyroid nodules. Molecular analysis (MicroRNA) is a perspective method for evaluation of thyroid nodal formations with indeterminate cytology, however, this method requires further study and improvement.

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