Nodulo follicolare indeterminato della tiroide: è possibile valutare preoperatoriamente il rischio di malignità?

Lombardi, Celestino Pio and Raffaelli, Marco and De Crea, C. and Oragano, Luigi and D'Amato, G. and Rossi, E.D. and Fadda, Guido and Bellantone, Rocco (2009) Nodulo follicolare indeterminato della tiroide: è possibile valutare preoperatoriamente il rischio di malignità? Il giornale di chirurgia, 30 (5 Supp). pp. 242-243. ISSN 1971-145X

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Aim: Despite fine-needle aspiration biopsy (FNAB) is the cornerstone of assessment of thyroid nodules, when cytology suggests a follicular neoplasm (FN) only histology can differentiate between benign and malignant lesions. Aim of this study was to evaluate factors predictive of malignancy in cytologically indeterminate FN. Methods: All the patients who underwent FNAB between December 2007 and November 2008 were considered. Among them, those with a cytology of FN (Thy3, British Thyroid Association) and with an histological control were included. Age, sex, ultrasound characteristics, nodulÈs size, thyroid disease, HBME-1 and Galectin-3 immunocytochemical stains and histology were registered. Results: Among 1585 FNAB, 261 (16.5%) had a cytology of FN and 195 had an histological control: 146 benign and 49 differentiated thyroid carcinoma (DTC) (43 follicular variant of papillary carcinoma and 6 follicular carcinoma). The malignancy rate in case of single nodules was significantly higher than in multinodular goiter (30/63 Vs 19/132) (P<0.001). Positive immunostaining for both HBME-1 and Galectin-3 was observed in 58 cases, negative for both in 137. The malignancy rate was significantly higher in HBME-1 and Galectin-3 positive nodules (42/49 Vs 16/146) (P<0.001). The risk of malignancy was 1:4 for the entire series, but it increased to 1:2.1 (47.6%) for single nodules and 1:1.4 (72.4%) for HBME-1/galectin-3 positive nodules. Conclusions: One in four patients with FN has a DTC. Thyroidectomy is mandatory in all the patients with single and/or HBME-1/galectin-3 positive nodules, because of the increased risk of malignancy, and suitable in all the other cases.

Item Type: Article
Uncontrolled Keywords: thyroid nodule, cytology, biopsy fine-needle
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 22 Feb 2016 12:25
Last Modified: 22 Feb 2016 12:25

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