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Morphological and immunocytochemical diagnosis of thyroiditis: Comparison between conventional and liquid-based
Esther Diana Rossi1, Gian Franco Zannoni, Celestino Pio Lombardi
1Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, Agostino Gemelli School of Medicine, Rome, Italy.
Insights
Liquid-based cytology (LBC) is effective for diagnosing Hashimoto
Area of Science:
- Cytopathology
- Endocrinology
- Surgical Pathology
Background:
- Hashimoto's thyroiditis (HT) diagnosis relies on fine-needle aspiration biopsy (FNAB).
- Evaluating diagnostic methods for HT, especially differentiating hyperplastic nodules (HN) from mimics, is crucial.
- Conventional smear (CS) and liquid-based cytology (LBC) are common FNAB processing techniques.
Purpose of the Study:
- To evaluate the efficacy of LBC for thyroid FNAB in Hashimoto's thyroiditis.
- To compare LBC with conventional smear (CS) in diagnosing HT and hyperplastic nodules (HN).
- To assess the role of immunocytochemistry (ICC) in differentiating HN in HT.
Main Methods:
- Retrospective analysis of 820 thyroid FNAB cases from two periods: 150 CS (1996-1998) and 670 LBC (2005-2007).
- Cyto-histological comparison and morphologic feature analysis.
- Immunocytochemistry (ICC) for HBME-1 and Galectin-3 performed on selected HN cases.
Main Results:
- In the LBC group (2005-2007), 94% of FNABs were benign (including HT and HN), with 6% malignancy.
- ICC for HBME-1 and Galectin-3 was negative in 93.5% of 30 evaluated HN cases, with 10 showing concordant benign histology.
- LBC demonstrated efficacy in diagnosing HT and HN, with ICC aiding in preoperative lesion selection.
Conclusions:
- Liquid-based cytology (LBC) is a valid method for thyroid fine-needle aspiration biopsy (FNAB) in Hashimoto's thyroiditis (HT).
- LBC facilitates accurate preoperative selection of thyroid lesions, including hyperplastic nodules (HN).
- Immunocytochemistry (ICC) can be a valuable adjunct in evaluating HN within the context of HT.
Abstract:
The efficacy of thyroid (FNAB) processed by liquid-based cytology (LBC) in Hashimoto's Thyroiditis (HT) in two reference periods, is evaluated. The morphologic features of 820 cases with both methods and the cyto-histological comparison are analyzed. The diagnosis of hyperplastic nodules (HN) in HT, its mimickers especially in presence of oxyphilic cells and the role of immunocytochemistry (IHC) are studied. 150 cases of HT processed by conventional smear (CS) in 1996-98 and 670 with LBC in 2005-2007,were included. The majority of FNAB were carried out under USguidance and fixed with ethyl alcohol for the CS. LBC material was rinsed in the Cytolit solution, processed according to the manufacturer's recommendations. Among the 150 CS, 83 were HT while 67 were HN in HT; in the second triennium 245 LBC were HT and 425 were HN in HT. In the first period a follow-up (including a second FNA or surgery) was done in 92 cases, in the second period in 116. In the surgical group 97.1% in the first period were benign (all HT and 34/36 HN) and 2.8% malignant(all HN). In 2005-2007, 94% were benign (15 HT and 45/49 HN) and 6%malignant. Thirty HN from the second triennium had ICC for HBME-1 and Galectin-3 resulting negative in 93.5%. Among these cases, 10 had a benign histology and a concordant negative ICC. LBC can be used as a valid method for HT, especially for the possible application of ICC to HN, and it allows a correct preoperative selection of lesions
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