Papillary thyroid carcinoma: How much should the surgeon read from Fine needle aspiration cytology reports?

• Main Authors: Das Dilip, Sheikh Mehraj, Mallik Mrinmay, Sharma Prem, Mannan Abul, Sheikh Zafar, Haji Bahia, George Shirly, Madda John, Hussein Sundus, Francis Issam
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2010-10-01
• Series: Indian Journal of Pathology and Microbiology
• Subjects: Fine needle aspiration cytology; papillary thyroid carcinoma; solitary thyroid nodules
• Online Access: http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2010;volume=53;issue=4;spage=686;epage=691;aulast=Das
• ISSN: 0377-4929; 0974-5130

<b>Objective:</b> During routine fine needle aspiration cytodiagnosis of papillary thyroid carcinoma (PTC), a number of cases are diagnosed as suspicious; or it is suggested that PTC or a neoplasm be ruled out by histopathology. Since these diagnostic labels are likely to put the clinicians in a difficult situation while planning the management, this study aims to find out how much the surgeon should read from these reports. <b>Materials and Methods:</b> The patients were divided into two groups. Group A included 38 cases diagnosed as PTC or suspicious of PTC. Group B included 40 cases in which it was suggested that PTC/a neoplasm to be ruled out and non-neoplastic lesions with one or more cytologic features of PTC. The two groups were compared with clinical, imaging and cytomorphologic features. <b>Results:</b> A significant difference was observed with respect to age between Group A and Group B (<i>P</i>&lt;0.001). The frequency of the following five cytologic features was significantly higher in Group A: papillary formation (<i>P</i>&lt;0.001), psammoma bodies (<i>P</i>=0.054), fine nuclear chromatin (<i>P</i>=0.010), frequent nuclear grooves (<i>P</i>&lt;0.001) and intra-nuclear cytoplasmic inclusion (<i>P</i>&lt;0.001). Three or more of the five cytologic features were also reported in significantly higher number of Group A cases (<i>P</i>&lt;0.001). Majority (81.8&#x0025;) of the cases with subsequent histology in Group A were confirmed as PTC as opposed to 7.7&#x0025; in Group B (<i>P</i>&lt;0.001). <b>Conclusions:</b> Thus, cases with definitive cytodiagnosis of PTC and suggestive of PTC (Group A) should be taken much more seriously by the surgeons as compared to Group B cases.