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Thyroid fine needle aspiration: the morphological features on ThinPrep slide preparations. Eighty cases with
B Cochand-Priollet1, J-J Prat, M Polivka
1Department of Pathology, Lariboisiere Hospital, Paris, France. beatrix.cochand-priollet@lrb.ap-hop-paris.fr
Summary
Conventional smears for thyroid fine needle aspiration (FNA) show higher diagnostic accuracy than liquid-based ThinPrep slides. Alcohol fixation in ThinPrep may alter cell morphology, impacting sensitivity and specificity for thyroid nodule diagnosis.
Area of Science:
- Cytopathology
- Surgical Pathology
- Thyroidology
Background:
- Liquid-based cytology methods like ThinPrep (TP) are increasingly used for fine needle aspiration (FNA).
- Optimizing staining and understanding cytomorphological changes are crucial for accurate thyroid nodule diagnosis.
Purpose of the Study:
- To define alcohol fixation effects on thyroid cell morphology.
- To optimize May-Grünwald-Giemsa (MGG) staining on TP slides.
- To compare diagnostic accuracy of TP versus conventional smears (CS) for thyroid FNA.
Main Methods:
- 120 ultrasound-guided thyroid FNAs and 55 FNAs from resected specimens were analyzed.
- A split-sample technique compared TP and CS, with histological correlation in 80 cases.
- Cytomorphological features and diagnostic accuracy (sensitivity, specificity) were assessed.
Main Results:
- TP slides had a higher unsatisfactory rate (22%) than CS (8%).
- Conventional smears demonstrated higher sensitivity (94% vs. 81%) and specificity (67% vs. 60%) than TP.
- MGG staining quality was comparable, but TP induced uncommon morphological changes, especially in oncocytic tumors and lymphocytic thyroiditis.
Conclusions:
- Conventional smears are superior to ThinPrep for thyroid FNA, offering better diagnostic accuracy.
- Alcohol-based fixation in TP can induce cytomorphological alterations, potentially affecting diagnostic interpretation.
- Further research is needed to refine liquid-based techniques for thyroid FNA analysis.