Skip to main content

Follicular Neoplasia

  • Chapter
  • First Online:
Thyroid and Parathyroid Diseases

Abstract

The term “follicular neoplasia” encompasses a spectrum of diseases ranging from benign to malignant nature. It includes benign follicular adenoma, follicular carcinoma, and follicular variant of papillary cancer. Since the preoperative diagnosis addresses both benign and malignant lesions, gray zones exist and diagnostic surgery is generally required for a definitive diagnosis. Herein, we focus on the clinical presentation, management strategies, and histopathologic architecture of a case with a preoperative diagnosis of “follicular neoplasia” taking into account the current guidelines, promising molecular markers and future directives.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. McHenry CR, Phitayakorn R. Follicular adenoma, and carcinoma of the thyroid gland. Oncologist. 2011;16:585–93. https://doi.org/10.1634/theoncologist.2010-0405.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Mathur A, Olson MT, Zeiger MA. Follicular lesions of the thyroid. Surg Clin North Am. 2014;94:499–513. https://doi.org/10.1016/j.suc.2014.02.005.

    Article  PubMed  Google Scholar 

  3. Iared W, Shigueoka DC, Cristófoli JC, Andriolo R, Atallah AN, Ajzen SA, et al. Use of color Doppler ultrasonography for the prediction of malignancy in follicular thyroid neoplasms: systematic review and meta-analysis. J Ultrasound Med. 2010;29:19–25.

    Article  Google Scholar 

  4. Kalra N, Ahuja CK, Dutta P, Rajwanshi A, Mittal BR, Bhansali A, et al. Comparison of Sonographically guided percutaneous sodium tetradecyl sulfate injection with ethanol injection in the treatment of benign nonfunctioning thyroid nodules. J Vasc Interv Radiol. 2014;25:1218–24. https://doi.org/10.1016/j.jvir.2014.04.026.

    Article  PubMed  Google Scholar 

  5. Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011;260:892–9. https://doi.org/10.1148/radiol.11110206.

    Article  PubMed  Google Scholar 

  6. Baloch ZW, Fleisher S, LiVolsi VA, Gupta PK. Diagnosis of “follicular neoplasm”: a gray zone in thyroid fine-needle aspiration cytology. Diagn Cytopathol. 2002;26:41–4.

    Article  PubMed  Google Scholar 

  7. Baloch ZW, Cibas ES, Clark DP, Layfield LJ, Ljung BM, Pitman MB, et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal. 2008;5:6. https://doi.org/10.1186/1742-6413-5-6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Castro MR, Gharib H. Thyroid fine-needle aspiration biopsy: progress, practice, and pitfalls. Endocr Pract. 2003;9:128–36.

    Article  PubMed  Google Scholar 

  9. Lloyd RV, Erickson LA, Casey MB, Lam KY, Lohse CM, Asa SL, et al. Observer variation in the diagnosis of follicular variant of papillary thyroid carcinoma. Am J Surg Pathol. 2004;28:1336–40.

    Article  PubMed  Google Scholar 

  10. Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;36:425–37. https://doi.org/10.1002/dc.20830.

    Article  PubMed  Google Scholar 

  11. Paphavasit A, Thompson GB, Hay ID, Grant CS, van Heerden JA, Ilstrup DM, et al. Follicular and Hurthle cell thyroid neoplasms. Is frozen-section evaluation worthwhile? Arch Surg. 1997;132:674–8. discussion 678–80.

    Article  CAS  PubMed  Google Scholar 

  12. LiVolsi VA, Baloch ZW. Use and abuse of frozen section in the diagnosis of follicular thyroid lesions. Endocr Pathol. 2005;16:285–93.

    Article  PubMed  Google Scholar 

  13. Nikiforov YE, Ohori NP, Hodak SP, Carty SE, LeBeau SO, Ferris RL, et al. Impact of mutational testing on the diagnosis and management of patients with cytologically indeterminate thyroid nodules: a prospective analysis of 1056 FNA samples. J Clin Endocrinol Metab. 2011;96:3390–7. https://doi.org/10.1210/jc.2011-1469.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Nikiforov YE, Steward DL, Robinson-Smith TM, Haugen BR, Klopper JP, Zhu Z, et al. Molecular testing for mutations in improving the fine-needle aspiration diagnosis of thyroid nodules. J Clin Endocrinol Metab. 2009;94:2092–8. https://doi.org/10.1210/jc.2009-0247.

    Article  CAS  PubMed  Google Scholar 

  15. Alexander EK, Kennedy GC, Baloch ZW, Cibas ES, Chudova D, Diggans J, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;23(367):705–15. https://doi.org/10.1056/NEJMoa1203208.

    Article  CAS  Google Scholar 

  16. Aragon Han P, Olson MT, Fazeli R, Prescott JD, Pai SI, Schneider EB, et al. The impact of molecular testing on the surgical management of patients with thyroid nodules. Ann Surg Oncol. 2014;21:1862–9. https://doi.org/10.1245/s10434-014-3508-x.

    Article  PubMed  Google Scholar 

  17. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133. https://doi.org/10.1089/thy.2015.0020.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Goffredo P, Cheung K, Roman SA, Sosa JA. Can minimally invasive follicular thyroid cancer be approached as a benign lesion?: a population-level analysis of survival among 1,200 patients. Ann Surg Oncol. 2013;20:767–72. https://doi.org/10.1245/s10434-012-2697-4.

    Article  PubMed  Google Scholar 

  19. Nikiforov YE, Carty SE, Chiosea SI, Coyne C, Duvvuri U, Ferris RL, et al. Impact of the multi-gene ThyroSeq next-generation sequencing assay on Cancer diagnosis in thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance cytology. Thyroid. 2015;25:1217–23. https://doi.org/10.1089/thy.2015.0305.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Nikiforov YE. Role of molecular markers in thyroid nodule management: then and now. Endocr Pract. 2017;23:979–88. https://doi.org/10.4158/EP171805.RA.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Uğurlu, M.Ü., Güllüoğlu, B.M. (2019). Follicular Neoplasia. In: Özülker, T., Adaş, M., Günay, S. (eds) Thyroid and Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-78476-2_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-78476-2_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-78475-5

  • Online ISBN: 978-3-319-78476-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics