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Malignancy risk and characteristics of thyroid nodules with two consecutive results of atypia of undetermined significance or follicular lesion of undetermined significance on cytology

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Abstract

Purpose

To evaluate the malignancy risk and characteristics of thyroid nodules with two “Atypia of Undetermined Significance” or “Follicular Lesion of Undetermined Significance” (AUS/FLUS) results, and compare characteristics of malignancies with two AUS/FLUS results to those with one AUS/FLUS result.

Methods

Of 441 thyroid nodules with initial AUS/FLUS results, 236 underwent repeat fine-needle-aspiration (FNA), with 58 obtaining repeated AUS/FLUS results. Thyroid Imaging Reporting and Data System (TIRADS) categories were assigned, and clinico-pathological characteristics were compared between benign and malignant nodules and between malignancies with two consecutive AUS/FLUS results and those with one AUS/FLUS result.

Results

Thirty-one percent (18/58) of nodules with two AUS/FLUS results and 58.1 % (18/31) of confirmed nodules were malignant. Age, gender, nodule size, ultrasound features and TIRADS categories did not differ between benign and malignant nodules or between malignancies with one and two AUS/FLUS results. Malignancies with two AUS/FLUS results had a higher proportion of a follicular variant of papillary thyroid carcinoma (PTC) (46.7 % vs. 13.6 %, P = 0.009).

Conclusions

Thyroid nodules with two AUS/FLUS results had a high malignancy risk of at least 31.0 % and a higher proportion of a follicular variant of PTC. Surgery should be considered regardless of ultrasound features.

Key Points

• Thyroid nodules with two consecutive AUS/FLUS results had a high malignancy risk.

• Ultrasound features are less useful in nodules with two AUS/FLUS results.

• The follicular variant of PTC is more frequent in malignancies with two AUS/FLUS results.

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Abbreviations

AUS/FLUS:

Atypia of undetermined significance or follicular lesion of undetermined significance

FNA:

Fine-needle aspiration

PTC:

Papillary thyroid carcinoma

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Acknowledgments

The scientific guarantor of this publication is Hee Jung Moon. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Study subjects or cohorts were not previously reported. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 120-752

    Vivian Youngjean Park, Eun-Kyung Kim, Jin Young Kwak, Jung Hyun Yoon & Hee Jung Moon

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  1. Vivian Youngjean Park
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  2. Eun-Kyung Kim
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  3. Jin Young Kwak
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  4. Jung Hyun Yoon
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Correspondence to Hee Jung Moon.

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Park, V.Y., Kim, EK., Kwak, J.Y. et al. Malignancy risk and characteristics of thyroid nodules with two consecutive results of atypia of undetermined significance or follicular lesion of undetermined significance on cytology. Eur Radiol 25, 2601–2607 (2015). https://doi.org/10.1007/s00330-015-3668-5

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  • DOI: https://doi.org/10.1007/s00330-015-3668-5

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