Premium
Cytological evaluation by fine needle aspiration biopsy of incidental focal increased fluorodeoxyglucose uptake in thyroid on positron emission tomography scan
Author(s) -
Li Yanchun,
Cui Min,
Azar Nami,
Nakamoto Dean,
Michael Claire W.
Publication year - 2017
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.23695
Subject(s) - medicine , malignancy , atypia , adenoma , radiology , standardized uptake value , biopsy , fine needle aspiration , thyroid , incidentaloma , positron emission tomography , fluorodeoxyglucose , thyroid nodules , adenocarcinoma , pathology , cancer
Background With the increased use of whole body fluorodeoxyglucose positron emission tomography (PET) scan for staging/restaging or primary diagnosis of neoplasia, thyroid incidentalomas have become more common. The limited reports of PET‐positive thyroid incidentalomas showed incidence of malignancy ranging from 14 to 66%, and there is discrepancy in terms of the diagnostic significance of the standard uptake value (SUV) value. Methods This is a retrospective study of 20 PET incidentalomas which had cytological evaluation from October 2009 to February 2015 at a tertiary care university medical center, M:F = 8:12. Results Of the 20 cases, 14 (70%) had a cytological diagnosis of atypia or suspicious for neoplasia. Eleven of those (55%) underwent surgical resection with final diagnosis of PTC in 8 cases, follicular carcinoma in one case (5%), follicular adenoma in one case (5%), and Hurthle cell adenoma in one case (5%). There was good correlation between cytological and histological diagnosis. For two cases with cytological diagnosis of suspicious for follicular neoplasm, no further histological diagnosis was obtained. One patient had direct cytological diagnosis of PTC also did not undergo surgical resection/diagnosis due to the advanced primary pancreatic adenocarcinoma. The remaining 6 (30%) cases had a cytological diagnosis of benign follicular nodule. Furthermore, no significant difference between malignant SUV and benign SUV was observed. Conclusions Malignancy was identified in 50% of the PET‐positive incidentalomas in our series. PTC constitutes the major malignant diagnosis. No diagnostic value of SUV was observed to differentiate malignant from benign lesions. Diagn. Cytopathol. 2017;45:501–506. © 2017 Wiley Periodicals, Inc.