World Journal of Surgery

, Volume 36, Issue 1, pp 69–74

Incidence of Malignancy in Thyroid Nodules Determined to be Follicular Lesions of Undetermined Significance on Fine-Needle Aspiration

  • Gilberto V. Teixeira
  • Horacio Chikota
  • Thiago Teixeira
  • Gabriel Manfro
  • Sara I. Pai
  • Ralph P. Tufano
Article

Abstract

Background

Fine-needle aspiration (FNA) for thyroid nodules is the most important method for determining a diagnosis. The system for reporting results is based on a cytopathologic classification that stratifies the risk of malignancy.

Methods

We retrospectively studied 197 patients who underwent FNA for diagnostic evaluation of a thyroid nodule and had their results reported as a follicular lesion of undetermined significance (FLUS) using the Bethesda classification system. The objective of the study was to analyze the incidence and histopathologic types of malignancy in these cases.

Results

The final histopathologic breakdown is as follows: 65 cases (32.9%) of follicular adenoma, 81 cases (41.1%) of microfollicular adenomatoid nodule, 19 cases (9.6%) of microfollicular adenomatoid nodule on the background of thyroiditis, 17 cases (8.6%) of follicular carcinoma, 9 cases (4.6%) of follicular variant papillary carcinoma, and 6 cases (3.1%) of classic papillary carcinoma, for a 16.2% incidence of malignancy. Beyond these diagnoses in the FNA-biopsied nodules, we observed 29 cases (14.7%) of incidental ipsilateral papillary thyroid microcarcinoma (PTM) and 13 cases (6.6%) of incidental contralateral thyroid lobe PTM.

Conclusions

This study observed a 16.2% incidence of thyroid cancer in the nodule designated FLUS compared to the 5 to 15% rate reported by the Bethesda FNA classification. The overall incidence of incidental PTM in the thyroid gland was 21.3%. These data support considering surgical intervention for at least diagnostic purposes in a patient with the FNAB diagnosis of FLUS.

Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Gilberto V. Teixeira
    • 1
    • 4
  • Horacio Chikota
    • 2
  • Thiago Teixeira
    • 1
  • Gabriel Manfro
    • 3
  • Sara I. Pai
    • 4
  • Ralph P. Tufano
    • 4
  1. 1.Department of Oncologic Surgery/Head and Neck Surgery CEPONR. Presidente CoutinhoFlorianopolisBrazil
  2. 2.IMP LaboratoryR. Menino DeusFlorianopolisBrazil
  3. 3.University Hospital UNOESC, R. Getulio VargasJoacabaBrazil
  4. 4.Department of Otolaryngology/Head and Neck SurgeryJohns Hopkins Medical InstitutionsBaltimoreUSA

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