Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2014) 35 P539 | DOI: 10.1530/endoabs.35.P539

ECE2014 Poster Presentations Endocrine tumours and neoplasia (99 abstracts)

Follicular lesion of undetermined significance in thyroid nodules fine needle aspiration cytology: a revision of 95 cases

Catarina Moniz , Rute Ferreira , Filipa Serra , Ricardo Fonseca , Hélder Simões , Catarina Saraiva , Carlos Vasconcelos & António Saraiva


Hospital de Egas Moniz, Lisbon, Portugal.


Introduction: The ‘Atypia of Undetermined Significance/Follicular lesion of Undetermined Significance’ (AUS/FLUS) category of the Bethesda Classification for thyroid nodules fine needle aspiration cytology (FNAC) is reserved for specimens that contain cells with architectural and/or nuclear atypia that is not sufficient to be classified as suspicious or malignant. Our objective is to report our experience in the follow-up and outcome of patients with AUS/FLUS in thyroid nodules FNAC.

Methods: From 1529 patients with 1838 thyroid nodules, 11.4% of the nodules was diagnosed as AUS/FLUS. From 111 patients with FLUS, we analyzed 95, 88 females and seven males.

Results: 26 patients (27.4%) had directly undergone to neck surgery and five (19.2%) had malignant nodules. 51 patients (53.7%) repeated FNAC. On the second FNAC, 17 (33.3%) nodules were benign, 22 (43.1%) were AUS/FLUS, 11 (21.6%) were non-diagnostic and 1 (1.9%) was malignant. From the patients who were submitted to a second FNAC, 12 undergone to surgery and two nodules were malignant. 18 patients (18.9%) kept clinical follow up without repeating FNAC or surgery. Six patients (6.3%) repeated FNAC a third time: four nodules were benign and two non-diagnostic.

Among the 95 patients with FLUS, 38 (40%) were submitted to neck surgery and seven had a malignant diagnosis. The malignancy rate in the 95 patients with AUS/FLUS was 7.4%, but 18.4% in the patients who did surgery. The malignancy rate was 16.7% in patients who repeated FNAC and 19.2% in patients who undergone directly to surgery.

Conclusion: In this category the recommendation is to repeat the FNAC rather than excision. We suggest the follow-up of these patients should be individualized and discussed in multidisciplinary teams. The combination of clinical suspicion, ultrasound characteristics and BRAF mutation testing could help in this decision.

Article tools

My recent searches

No recent searches.