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The Thyroid Gland

The Thyroid Gland

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.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

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The histopathologic checkpoints for thyroid core needle biopsy compared with resection sections.

Tugce Kiran¹, Beril Guler¹

¹Department of Pathology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

Polish Journal of Pathology : Official Journal of the Polish Society of Pathologists

|March 22, 2023

Summary

Histopathological differences exist between core needle biopsies (CNB) and resection sections of thyroid nodules. Nuclear contour irregularity in CNB is a reliable predictor of papillary carcinoma, aiding diagnosis.

Keywords:

core needle biopsy histopathological evaluation.malignant thyroid benign

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Area of Science:

Pathology
Oncology
Surgical Pathology

Background:

Classic nuclear features for thyroid nodule diagnosis are often subtle in core needle biopsies (CNB).
Understanding these differences is crucial for accurate thyroid nodule assessment.

Purpose of the Study:

To evaluate and compare histopathological differences in nuclear and architectural parameters between CNB and resection specimens of thyroid nodules.
To identify reliable diagnostic features in CNB for thyroid cancer.

Main Methods:

Retrospective analysis of hematoxylin and eosin-stained CNB and resection sections from 80 thyroid nodules (37 benign, 43 papillary carcinoma/suspicious).
Evaluation by two pathologists focusing on nuclear and architectural features.
Statistical analysis to determine the significance of observed differences.

Main Results:

Nuclear features were more subtle in CNB compared to resection sections, with smaller nuclei observed in CNB.
Hypochromia was present in 46.5% of papillary carcinoma cases; grooves and pseudoinclusions were also noted.
Nuclear contour irregularity was the most significant predictor of papillary carcinoma in CNB specimens (v: 0.82, p < 0.001).

Conclusions:

Histopathological differences between CNB and resection sections are significant for thyroid nodule diagnostics.
Nuclear contour irregularity is a key feature for diagnosing papillary carcinoma in CNB.
Development of new diagnostic algorithms incorporating these findings is recommended.