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Patología Revista Latinoamericana

2011, Number 4

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Patol Rev Latinoam 2011; 49 (4)

Thyroid follicular lesion: cyto-histological correlation and analysis of conflicting cases

Rodríguez RFE, Córdova RS

Language: Spanish
References: 31
Page: 243-250
PDF size: 856.96 Kb.


ABSTRACT

Background: Fine needle aspiration of thyroid is a useful diagnostic procedure for the evaluation of thyroid nodules. It is necessary for deciding the most appropriate treatment. Follicular lesions represent the “gray zone” of thyroid cytopathology and constitute a diagnosis challenge because of different factors that influence its correct identification.
Objective: To establish that the lack of correlation is due to cytohistological misinterpretation of the cytopathologist and overlapping cytologic criteria.
Material and method: A 5-year retrospective study of patients with cytological diagnosis of follicular lesion that subsequently underwent thyroidectomy was done. It was established cyto-histological correlation, analysis of discordant cases and description of cases of misdiagnosis.
Results: We found 212 cases with cytological diagnosis of follicular lesion and only 46 had histopathologic examination. The concordance was 69.6% corresponding most of them to malignant neoplasms. 57.2% of discordant cases were histologically diagnosed as papillary carcinoma, followed by medullary carcinoma (14.3%), undifferentiated carcinoma (14.3%), poorly differentiated carcinoma (7.1%) and Hashimoto thyroiditis (7.1%).
Conclusions: The lack of cyto-histological correlation was due to misinterpretation of the cytopathologist in 85.7% of cases and overlapping cytologic criteria in 14.3%. We identified no errors due to poor quality material. The sampling error is difficult to evaluate due to insufficient clinical data.


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