Utility of thin-layer preparations in thyroid fine-needle aspiration: Diagnostic accuracy, cytomorphology, and optimal sample preparation

Andra R. Frost, Mary K. Sidawy, Mary Ferfelli, Sana O. Tabbara, Nicole A. Bronner, Keith R. Brosky, Mark E. Sherman

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

BACKGROUND. The efficacy of preparing thyroid fine-needle aspirations (FNAs) as thin-layer slides has not been evaluated extensively. METHODS. To evaluate the efficacy of thin-layer cytology, the authors examined thyroid FNAs from 135 unselected palpable lesions that were aspirated using uniform procedures and prepared as air-dried, Diff-Quik(R)-stained direct smears (DS) and Papanicolaou-stained thin-layer slides (TL). Diagnoses rendered independently on masked slides from each thyroid nodule were compared with the reported final cytologic or histologic diagnoses based on all available pathologic material. Slides were analyzed for diagnostically important cytologic features and the optimal number of TL slides per sample was assessed. RESULTS. TL diagnoses agreed with final diagnoses in 85% of cases compared with 96% for DS. All 11 neoplasms were recognized in both preparations. A final diagnosis of chronic lymphocytic thyroiditis (CLT) was missed in 10 of 26 TL (39%) compared with 2 of 26 DS (8%) (P = 0.013, McNemar's test). Cytologic features appreciated less often in TL than DS (McNemar's test) included diffuse colloid, spherules, tissue fragments, and lymphocytes. Multinucleated giant cells were identified more often in TL than DS. Two TL slides were sufficient for diagnosis in 83% of cases. CONCLUSIONS. The diagnostic accuracy of TL was 85% compared with 96% for DS. CLT was diagnosed accurately in 62% of TL compared with 92% of DS. Cytologic features in TL and DS may differ. Preparation of only two TL slides is adequate for definitive diagnosis in most cases.

Original languageEnglish (US)
Pages (from-to)17-25
Number of pages9
JournalCancer
Volume84
Issue number1
DOIs
StatePublished - Feb 25 1998
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Thyroid Gland
Hashimoto Disease
Papanicolaou Test
Thyroid Nodule
Colloids
Giant Cells
Cell Biology
Air
Lymphocytes
Neoplasms

Keywords

  • Cytology
  • Fine-needle aspiration
  • Thin-layer processing
  • Thyroid

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Utility of thin-layer preparations in thyroid fine-needle aspiration : Diagnostic accuracy, cytomorphology, and optimal sample preparation. / Frost, Andra R.; Sidawy, Mary K.; Ferfelli, Mary; Tabbara, Sana O.; Bronner, Nicole A.; Brosky, Keith R.; Sherman, Mark E.

In: Cancer, Vol. 84, No. 1, 25.02.1998, p. 17-25.

Research output: Contribution to journalArticle

Frost, Andra R. ; Sidawy, Mary K. ; Ferfelli, Mary ; Tabbara, Sana O. ; Bronner, Nicole A. ; Brosky, Keith R. ; Sherman, Mark E. / Utility of thin-layer preparations in thyroid fine-needle aspiration : Diagnostic accuracy, cytomorphology, and optimal sample preparation. In: Cancer. 1998 ; Vol. 84, No. 1. pp. 17-25.
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abstract = "BACKGROUND. The efficacy of preparing thyroid fine-needle aspirations (FNAs) as thin-layer slides has not been evaluated extensively. METHODS. To evaluate the efficacy of thin-layer cytology, the authors examined thyroid FNAs from 135 unselected palpable lesions that were aspirated using uniform procedures and prepared as air-dried, Diff-Quik(R)-stained direct smears (DS) and Papanicolaou-stained thin-layer slides (TL). Diagnoses rendered independently on masked slides from each thyroid nodule were compared with the reported final cytologic or histologic diagnoses based on all available pathologic material. Slides were analyzed for diagnostically important cytologic features and the optimal number of TL slides per sample was assessed. RESULTS. TL diagnoses agreed with final diagnoses in 85{\%} of cases compared with 96{\%} for DS. All 11 neoplasms were recognized in both preparations. A final diagnosis of chronic lymphocytic thyroiditis (CLT) was missed in 10 of 26 TL (39{\%}) compared with 2 of 26 DS (8{\%}) (P = 0.013, McNemar's test). Cytologic features appreciated less often in TL than DS (McNemar's test) included diffuse colloid, spherules, tissue fragments, and lymphocytes. Multinucleated giant cells were identified more often in TL than DS. Two TL slides were sufficient for diagnosis in 83{\%} of cases. CONCLUSIONS. The diagnostic accuracy of TL was 85{\%} compared with 96{\%} for DS. CLT was diagnosed accurately in 62{\%} of TL compared with 92{\%} of DS. Cytologic features in TL and DS may differ. Preparation of only two TL slides is adequate for definitive diagnosis in most cases.",
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T1 - Utility of thin-layer preparations in thyroid fine-needle aspiration

T2 - Diagnostic accuracy, cytomorphology, and optimal sample preparation

AU - Frost, Andra R.

AU - Sidawy, Mary K.

AU - Ferfelli, Mary

AU - Tabbara, Sana O.

AU - Bronner, Nicole A.

AU - Brosky, Keith R.

AU - Sherman, Mark E.

PY - 1998/2/25

Y1 - 1998/2/25

N2 - BACKGROUND. The efficacy of preparing thyroid fine-needle aspirations (FNAs) as thin-layer slides has not been evaluated extensively. METHODS. To evaluate the efficacy of thin-layer cytology, the authors examined thyroid FNAs from 135 unselected palpable lesions that were aspirated using uniform procedures and prepared as air-dried, Diff-Quik(R)-stained direct smears (DS) and Papanicolaou-stained thin-layer slides (TL). Diagnoses rendered independently on masked slides from each thyroid nodule were compared with the reported final cytologic or histologic diagnoses based on all available pathologic material. Slides were analyzed for diagnostically important cytologic features and the optimal number of TL slides per sample was assessed. RESULTS. TL diagnoses agreed with final diagnoses in 85% of cases compared with 96% for DS. All 11 neoplasms were recognized in both preparations. A final diagnosis of chronic lymphocytic thyroiditis (CLT) was missed in 10 of 26 TL (39%) compared with 2 of 26 DS (8%) (P = 0.013, McNemar's test). Cytologic features appreciated less often in TL than DS (McNemar's test) included diffuse colloid, spherules, tissue fragments, and lymphocytes. Multinucleated giant cells were identified more often in TL than DS. Two TL slides were sufficient for diagnosis in 83% of cases. CONCLUSIONS. The diagnostic accuracy of TL was 85% compared with 96% for DS. CLT was diagnosed accurately in 62% of TL compared with 92% of DS. Cytologic features in TL and DS may differ. Preparation of only two TL slides is adequate for definitive diagnosis in most cases.

AB - BACKGROUND. The efficacy of preparing thyroid fine-needle aspirations (FNAs) as thin-layer slides has not been evaluated extensively. METHODS. To evaluate the efficacy of thin-layer cytology, the authors examined thyroid FNAs from 135 unselected palpable lesions that were aspirated using uniform procedures and prepared as air-dried, Diff-Quik(R)-stained direct smears (DS) and Papanicolaou-stained thin-layer slides (TL). Diagnoses rendered independently on masked slides from each thyroid nodule were compared with the reported final cytologic or histologic diagnoses based on all available pathologic material. Slides were analyzed for diagnostically important cytologic features and the optimal number of TL slides per sample was assessed. RESULTS. TL diagnoses agreed with final diagnoses in 85% of cases compared with 96% for DS. All 11 neoplasms were recognized in both preparations. A final diagnosis of chronic lymphocytic thyroiditis (CLT) was missed in 10 of 26 TL (39%) compared with 2 of 26 DS (8%) (P = 0.013, McNemar's test). Cytologic features appreciated less often in TL than DS (McNemar's test) included diffuse colloid, spherules, tissue fragments, and lymphocytes. Multinucleated giant cells were identified more often in TL than DS. Two TL slides were sufficient for diagnosis in 83% of cases. CONCLUSIONS. The diagnostic accuracy of TL was 85% compared with 96% for DS. CLT was diagnosed accurately in 62% of TL compared with 92% of DS. Cytologic features in TL and DS may differ. Preparation of only two TL slides is adequate for definitive diagnosis in most cases.

KW - Cytology

KW - Fine-needle aspiration

KW - Thin-layer processing

KW - Thyroid

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