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“Colloid‐Rich” follicular neoplasm/suspicious for follicular neoplasm thyroid fine‐needle aspiration specimens: Cytologic, histologic, and molecular basis for considering an alternate view
Author(s) -
Ohori N. Paul,
Wolfe Jenna,
Hodak Steven P.,
LeBeau Shane O.,
Yip Linwah,
Carty Sally E.,
Duvvuri Umamaheswar,
Schoedel Karen E.,
Nikiforova Mari.,
Nikiforov Yuri E.
Publication year - 2013
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.29
H-Index - 57
eISSN - 1934-6638
pISSN - 1934-662X
DOI - 10.1002/cncy.21333
Subject(s) - medicine , cytopathology , cytology , colloid , pathology , neoplasm , surgical pathology , thyroid neoplasm , thyroid , thyroid carcinoma , chemistry
BACKGROUND Typically, thyroid follicular neoplasm/suspicious for follicular neoplasm (FN/SFN) cases show moderate to marked cellularity and scant or absent colloid. Recently, cases have been noted with microfollicular cellularity in the background of moderate to abundant amount of colloid. The purpose of this study was to compare these “colloid‐rich” FN/SFN cases to the typical FN/SFN cases. METHODS Thyroid cytology specimens with the features of FN/SFN were searched in cytopathology files from September 2008 to June 2012. Cases with absent or minimal colloid were designated “typical colloid‐poor” FN/SFN and cases with moderate to abundant colloid were designated “colloid‐rich” FN/SFN. From these cases, those with surgical pathology resection follow‐up were identified. Cytologic, surgical pathology resection, and molecular features ( BRAF , RAS , RET/PTC , and PAX8‐PPARγ ) were investigated for the typical colloid‐poor FN/SFN cases and were compared with those of the colloid‐rich FN/SFN cases. RESULTS Of 431 FN/SFN cases with surgical pathology resection follow‐up, 360 (83.5%) cases showed features of typical colloid‐poor FN/SFN and 71 (16.5%) cases showed features of colloid‐rich FN/SFN. Papillary carcinoma was the most common malignant outcome for the 2 groups. Although the proportion of malignant outcome was similar for the 2 groups, the “colloid‐rich” FN/SFN cases showed a greater proportion of nodular hyperplasia among the cases with benign outcome. In addition, the “colloid‐rich” FN/SFN cases demonstrated a greater proportion of cases with a mutation. CONCLUSIONS Approximately one‐sixth of cases of FN/SFN show “colloid‐rich” features. Comparison to the typical colloid‐poor FN/SFN demonstrated similar risk for malignancy but contrasting resection outcome and molecular characteristics. Cancer (Cancer Cytopathol) 2013;121:718–728 . © 2013 American Cancer Society .