ECE2015 Guided Posters Thyroid – nodule (7 abstracts)
Clinical outcome of thyroid nodules characterised as atypia of undetermined significance or follicular lesion of undetermined significance (The Bethesda System for Reporting Thyroid Cytopathology) after fine-needle aspiration
Fernando García 1 , Mariana Tomé 2 , Guillermo Martínez de Pinillos 1 , Eyveé Arturo Cuéllar 1 , Mariola Méndez 1 , Juan Manuel García de Quirós 1 , Ignacio Fernández Peña 1 , Ignacio Fernández López 1 , Juana Hidalgo 1 , Margarita Rivas 1 , Santiago Durán 1 & María Victoria Cózar 1
1Hospital de Valme, Seville, Spain; 2Hospital Punta Europa, Cádiz, Spain.
Introduction: ‘Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance’ category is established by The Bethesda System for Reporting Thyroid Cytopathology because of the necessity to report those thyroid fine-needle aspiration (FNA) results that are not easily classified into the benign, suspicious or malignant categories. In most cases, a repeated FNA results in a more definitive interpretation. Estimated risk of malignancy for an AUS nodule is 5–15%.
Description of methods: A restrospective study was conducted in which those patients with a result of AUS after thyroid FNA between 2010 and 2013 were included. The following variables were considered: proportion of repeated FNA and average time of delay; consistency between repeated and initial FNA; therapeutical management and malignancy incidence rate.
Results: We studied 59 patients (94.9% females, mean age 48.3±14.3 years). FNA was repeated in 76.3% of patients with an average delay of 195.5±125.4 days between both FNA. We achieved the following interpretations: benign 55.6%; persistent AUS 17.8%; follicular neoplasm or suspicious of folicular neoplasm 17.8%; and suspicious for malignancy 8.9%. Thyroidectomy was performed in 55.2% of all patients (40.6% without repeating FNA and 59.4% after repeating FNA). In all cases lobectomy was the selected procedure. The incidence of malignancy was 10.2% of the total sample (18.2% of patients who underwent surgery).
Conclusion: Repeating FNA in patients with a result of ‘atypia of undetermined significance/folicular lesion of undetermined significance’ may contribute to clarify the diagnosis in a large number of cases, helping in the selection of patients who should undergo surgery or alternatively should be observed clinically. The incidence of malignancy detected in our series is consistent with the incidence expected by The Bethesda System.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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