Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2009, Vol 25, Num, 1     (Pages: 038-044)

Follicular-patterned thyroid lesions

F. Fulya KÖYBAŞIOĞLU 1, Özgür İlhan ÇELİK 1, Nuray Güneri TOSUNOĞLU 2, Binnur ÖNAL 1, Ayşegül ADABAĞ 1

1 TC SB Ankara Dışkapı YB Eğitim ve Araştırma Hastanesi, 1. Patoloji Bölümü Sitopatoloji Ünitesi, ANKARA, TÜRKİYE
2 Gazi Üniversitesi, Ticaret ve Turizm Eğitim Fakültesi Bilgisayar Uygulamaları Eğitimi, ANKARA, TÜRKİYE

DOI: 10.5146/tjpath.2009.00959
Viewed: 5882
 - 
Downloaded : 3465

Aim: Our aim is to determine the minimal cytopathologic criteria needed to make differential diagnosis in follicular-patterned lesions of the thyroid gland.

Materials and Methods: We reviewed 56 fine needle aspiration cytology specimens which were reported as “suspicious for follicular-patterned lesions of thyroid” between years 2001 and 2005 in our hospital and their histological slides. Parameters for cytopathologic assesment are cellularity, colloid formation, multilayered rosette formation, follicular cell rings, monolayered sheets, intact follicles, hyperplastic papillae, hyaline stromal fragments, intranuclear inclusions, nuclear grooves, angulated nuclei, nucleoli, cerebriform nuclei, nuclear size, macrophages, flame cells and Hurthle cells. Statistical analysis was performed using χ2 and Fisher's-exact tests and Kolmogorov-Simirnov test.

Results: Four cytopathologic features–cerebriform nuclei, angulated nuclei, nuclear grooves and intranuclear inclusion- were constantly observed in the follicular variant of papillary carcinoma (p< 0.05). Diluted colloid, monolayered sheet, nuclear size, macrophage and nucleoli were frequently seen in nodular hyperplasia (p< 0.05). The nuclear size was the sole differential cytopathologic criteria between follicular adenoma and follicular carcinoma (p<0.05).

Conclusion: Detailed cytopathologic examination was found to be important in differentiating follicular variant of papillary carcinoma from nodular hyperplasia. On the other hand, none of the cytopathologic findings were sufficient to distinguish follicular adenoma from follicular carcinoma. Therefore, cytopathologists should report such lesions as “follicular neoplasms”.

Keywords : Follicular lesion, thyroid, cytopathologic criteria, cerebriform nucleus, fine needle aspiration cytology