Indian Journal of Pathology and Microbiology
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Year : 2010  |  Volume : 53  |  Issue : 4  |  Page : 686-691

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

Departments of Pathology and Radiology and Center for Research, Faculty of Medicine, Kuwait University; Cytology Unit, Mubarak Al-Kabeer Hospital, Histopathology Units, Al-Jahra Hospital, Al-Amiri Hospital, Mubarak Al-Kabeer Hospital, and Hussain Makki Al-Juma Center for Specialized Surgery, Kuwait

Correspondence Address:
Dilip K Das
Department of Pathology, Faculty of Medicine, Kuwait University, P.O. Box: 24923, Safat 13110
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.72032

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Objective: 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. Materials and Methods: 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. Results: A significant difference was observed with respect to age between Group A and Group B (P<0.001). The frequency of the following five cytologic features was significantly higher in Group A: papillary formation (P<0.001), psammoma bodies (P=0.054), fine nuclear chromatin (P=0.010), frequent nuclear grooves (P<0.001) and intra-nuclear cytoplasmic inclusion (P<0.001). Three or more of the five cytologic features were also reported in significantly higher number of Group A cases (P<0.001). Majority (81.8%) of the cases with subsequent histology in Group A were confirmed as PTC as opposed to 7.7% in Group B (P<0.001). Conclusions: 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.

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