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A large series of hyalinizing trabecular tumors: Cytomorphology and ancillary techniques on fine needle aspiration
Author(s) -
Dell’Aquila Marco,
Gravina Carmen,
Cocomazzi Alessandra,
Capodimonti Sara,
Musarra Teresa,
Sfregola Stefania,
Fiorentino Vincenzo,
Revelli Luca,
Martini Maurizio,
Fadda Guido,
Pantanowitz Liron,
Larocca Luigi Maria,
Rossi Esther Diana
Publication year - 2019
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.22139
Subject(s) - medicine , atypia , pathology , cytopathology , thyroid , cytology , malignancy , fine needle aspiration , thyroid nodules , thyroidectomy , thyroid cancer , follicular cell , biopsy
Background Hyalinizing trabecular tumors (HTTs) are rare, essentially benign, follicular cell–derived thyroid neoplasms characterized by a trabecular growth pattern and nuclear pseudoinclusions. Their cytological findings are misleading, because these tumors are often misinterpreted on fine needle aspirate cytology as malignant lesions, such as papillary thyroid cancer and/or medullary thyroid cancer, leading to unnecessary total thyroidectomy. The aim of this study was to analyze the cytomorphological features and application of ancillary techniques in a series of HTTs. Methods Of 26 histological cases of HTT collected from September 2001 to December 2018, 18 cases had concomitant cytopathology. Cytological cases were processed with liquid‐based cytology (LBC). Immunocytochemistry for HBME‐1 and galectine‐3 as well as molecular testing for BRAF V600E mutation were performed on both LBC and histological specimens. Results The 18 lesions with fine needle aspirate cytology ranged in size from 5 to 45 mm. Cytological diagnoses included: 1 benign lesion favoring goiter (5.5%), 4 atypia of undetermined significance (22.2%), 6 follicular neoplasms (33.3%), 5 suspicious for malignancy favoring papillary thyroid cancer (28%), and 2 malignant (11%). Hence, 89% HTT had a negative concordant immunopanel, and they were 100% wild‐type BRAF V600E . Conclusion The majority of our HTTs (83.3%) were diagnosed in the indeterminate Bethesda categories, suggesting that their cytomorphological features pose issues for reaching a conclusive cytological diagnosis. The ancillary test results in our series support the fact that HTT is a benign neoplasm.