The association of papillary thyroid cancer with microcalcification in thyroid nodules with indeterminate cytology based on fine-needle aspiration biopsy

The association of papillary thyroid cancer with microcalcification in thyroid nodules with indeterminate cytology based on fine-needle aspiration biopsy

Background/aim: Microcalcifications are generally accepted as highly specific for thyroid malignancy, especially for papillary thyroid carcinoma (PTC). The aim of this study was to determine the significance of microcalcification within nodules that were classified as being of indeterminate cytology (IC) according to fine-needle aspiration biopsy. Materials and methods: Patients who underwent thyroidectomy between January 2010 and 2013 were included in the study. Nodules identified as atypia/follicular lesion of undetermined significance , follicular neoplasm/suspicious for follicular neoplasm , orsuspicious for malignancy were categorized as IC. Patients were subcategorized depending on the presence of microcalcification (Group 1) or its absence (Group 2). The relationship between microcalcification and PTC was evaluated in the IC group retrospectively. Results: Indeterminate cytology was detected in 135 (28.5%) of 473 patients. Microcalcification was detected in 27 (20%) of 135 nodules and classified as Group 1, while the remaining 108 (80%) patients were classified as Group 2. According to the final pathology results, PTC was diagnosed in 13 of 27 (48.1%) patients in Group 1 and 29 of 108 (26.8%) patients in Group 2. A statistically significant relation between microcalcification and malignancy was determined in the IC group (P < 0.05). Conclusion: Surgery might be considered primarily for patients harboring nodule(s) with IC accompanied by microcalcification due to increased risk of PTC.

___

  • 1. Brander AE, Viikinkoski VP, Nickels JI, Kivisaari LM. Importance of thyroid abnormalities detected at US screening: a 5-year follow-up. Radiology 2000; 215: 801-806.
  • 2. Bai Y, Zhou G, Nakamura M, Ozaki T, Mori I, Taniguchi E, Miyauchi A, Ito Y, Kakudo K. Survival impact of psammoma body, stromal calcification, and bone formation in papillary thyroid carcinoma. Mod Pathol 2009; 22: 887-894.
  • 3. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, Cronan JJ, Doubilet PM, Evans DB, Goellner JR et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005; 237: 794-800.
  • 4. Seiberling KA, Dutra JC, Grant T, Bajramovic S. Role of intrathyroidal calcifications detected on ultrasound as a marker of malignancy. Laryngoscope 2004; 114: 1753-1757.
  • 5. Cibas ES, Syed ZA. The Bethesda System for Reporting Thyroid Cytopathology. Am J Clin Pathol 2009; 132: 658-665.
  • 6. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel JS, Mazzaferri LE, McIver B, Pacini F, Schlumberger M et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2009; 19: 1167-1214. 7. Bongiovanni M, Spitale A, Faquin WC, Mazzuchelli L, Baloch ZW. The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis. Acta Cytol 2012; 56: 333-339.
  • 8. Alexander EK, Kennedy GC, Baloch ZW, Cibas ES, Chudova D, Diggans J, Friedman L, Kloos RT, LiVolsi VA, Mandel SJ et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med 2012; 367: 705-715.
  • 9. LiVolsi VA, Mazzaferri EL, Schneider AB. Papillary carcinoma. In: Delellis RA, Lloyd RV, Heitz PU, Eng C, editors. World Health Organization Classification of Tumors, Pathology and Genetics of Tumors of Endocrine Organs. Lyon, France: International Agency for Research on Cancer: Lyon, France; 2004. pp. 57-66.
  • 10. Kakudo K, Tang W, Ito Y, Mori I, Makamura Y, Miyauchi A. Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group. J Clin Pathol 2004; 57: 1041-1046.
  • 11. Bai Y, Kakudo K, Li Y, Liu Z, Ozaki T, Ito Y, Kihara M, Miyauchi A. Subclassification of nonsolid- type papillary thyroid carcinoma identification of high-risk group in common type. Cancer Sci 2008; 99: 1908-1915.
  • 12. Consorti F, Anello A, Benvenuti C, Boncompagni A, Giovannone G, Moles N, Scardella L, Antonaci A. Clinical value of calcifications in thyroid carcinoma and multinodular goiter. Anticancer Res 2003; 23: 3089-3092.
  • 13. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, Panunzi C, Rinaldi R, Toscano V, Pacella CM. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 2002; 8: 1941-1946.
  • 14. Frates MC, Benson C, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, Orcutt J, Moore FD Jr, Larsen PR, Marqusee E et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab 2006; 91: 3411-3417.
  • 15. Fish SA, Langer JE, Mandel SJ. Sonographic imaging of thyroid nodules and cervical lymph nodes. Endocrinol Metab Clin North Am 2008; 37: 401-417.
  • 16. Oh EM, Chung SY, Song WJ, Lee YD. The pattern and significance of the calcifications of papillary thyroid microcarcinoma presented in preoperative neck ultrasonography. Ann Surg Treat Res 2014; 86: 115-121.
  • 17. Triggiani V, Guastamacchia E, Licchelli B, Tafaro E. Microcalcifications and psammoma bodies in thyroid tumors. Thyroid 2008; 18: 1017-1018.
  • 18. Ellison E, Lapuerta P, Martin SE. Psammoma bodies in fineneedle aspirates of the thyroid: predictive value for papillary carcinoma. Cancer 1998; 84: 169-175.
  • 19. Lu Z, Mu Y, Zhu H, Luo Y, Kong Q, Dou J, Lu J. Clinical value of using ultrasound to assess calcification patterns in thyroid nodules. World J Surg 2011; 35: 122-127.
  • 20. Wang Y, Li L, Wang YX, Feng XL, Zhao F, Zou SM, Hao YZ, Ying JM, Zhou CW. Ultrasound findings of papillary thyroid microcarcinoma: a review of 113 consecutive cases with histopathologic correlation. Ultrasound Med Biol 2012; 38: 1681-1688.
  • 21. Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, Yo HS. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002; 178: 687-691.
  • 22. Khoo ML, Asa SL, Witterick IJ, Freeman JL. Thyroid calcification and its association with thyroid carcinoma. Head Neck 2002; 24: 651-655.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Barbara KOT, Jolanta WICHA, Agata GRUZEWSKA, Malgorzata PIECHOTA, Katarzyna WOLSKA, Maria OBREBSKA

Experiential avoidance, empathy, and anger-related attitudes in antisocial personality disorder

Kaasım Fatih YAVUZ, Erhan KURT, Sevinç ULUSOY, Okan Ufuk İPEK, Oktay ŞAHİN

Hoda RANJBAR, Maryam RADAHMADI, Hojjatallah ALAEI, Parham REISI, Sara KARIMI

The effect of basolateral amygdala nucleus lesion on memory under acute, mid and chronic stress in male rats

Hoda RANJBAR, Maryam RADAHMADI, Hojjatallah ALAEI, Parham REISI, Sara KARIMI

Tuğrul ÖRMECİ, Mukaddes ÇOLAKOĞULLARI, İsrafil ORHAN, Bayram Ufuk ŞAKUL

Exploring CYP2B6 activity by measuring the presence of nevirapine hydroxy metabolites in plasma

Soo Choon TAN, Suzana MUSTAFA, Norul Badriah HASSAN, Mahiran MUSTAFA, Ahmad Kashfi AB RAHMAN, Lee Lee LOW, Wan Nazirah WAN YUSUF

Cryptogenic organizing pneumonia: clinical and radiological features, treatment outcomes of 17 patients, and review of the literature

Sibel YURT, Lütfiye KILIÇ, Güngör ÇAMSARI, Gülcihan Zehra ÖZKAN, Elif Yelda NİKSARLIOĞLU, Nur Dilek BAKAN

Derya Akdağ CİRİK, Berna DİLBAZ, Sezin Ertürk AKSAKAL, Zeynep KOTAN, Runa ÖZELÇİ, Funda AKPINAR, Leyla MOLLAMAHMUTOĞLU

Senem ŞAŞ, Şeyda Toprak ÇELENAY, Derya Özer KAYA

Surgical management of large-cell neuroendocrine lung carcinoma: an analysis of 25 cases

Koray AYDOĞDU, Göktürk FINDIK, Funda DEMİRAĞ, Sadi KAYA, Selim Şakir Erkmen GÜLHAN, Funda İNCEKARA, Ebru SAYILIR