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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Nuclear morphometry in indeterminate thyroid nodules.

Michael A Razavi1, Johnny Wong1, Mounika Akkera1

  • 1Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

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|May 19, 2020
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Summary
This summary is machine-generated.

Nuclear morphometry analysis did not reliably distinguish malignant from non-malignant thyroid nodules with indeterminate fine needle aspiration (FNA) results. Further research is needed to improve diagnostic accuracy for these thyroid nodules.

Keywords:
Fine needle aspiration (FNA)indeterminate thyroid nodulenuclear morphometry

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Area of Science:

  • Endocrinology
  • Cytopathology
  • Surgical Pathology

Background:

  • Indeterminate results in thyroid fine needle aspiration (FNA) affect up to 30% of cases.
  • Nuclear morphometry is being explored as an objective method to improve FNA diagnostic accuracy.
  • This study evaluated nuclear morphometry's association with malignancy in indeterminate thyroid nodules.

Purpose of the Study:

  • To assess the diagnostic value of nuclear morphometry in differentiating malignant from benign thyroid nodules.
  • To investigate the association between nuclear morphometric parameters and final surgical pathology outcomes.

Main Methods:

  • Retrospective review of 45 patients with indeterminate FNA results (Bethesda III & IV) who underwent thyroid surgery.
  • Analysis of 100 nuclei per FNA using ImageJ software to measure 8 morphometric parameters.
  • Statistical analysis (Student's t-test) to compare parameters between malignant and non-malignant groups.

Main Results:

  • The study included 45 patients (68.9% female, mean age 56.31 years); 22 had malignant nodules.
  • No significant differences were found in the 8 measured nuclear morphometric parameters (area, perimeter, circularity, etc.) between malignant and non-malignant thyroid nodules.
  • Average nuclear perimeter was 18.48 µm, area was 22.19 µm², and max Feret's diameter was 6.67 µm.

Conclusions:

  • Nuclear morphometry, as applied in this study, is not a reliable tool for diagnosing malignancy in indeterminate thyroid nodules.
  • Further research is required to identify objective parameters that can enhance the diagnostic accuracy of FNA cytology.
  • Improved diagnostic accuracy could reduce the need for unnecessary diagnostic thyroid surgeries.