Reappraisal of “cyst fluid only” on thyroid fine-needle aspiration cytology

Endocrine journal

Mitsuyoshi Hirokawa¹  Seiji Kuma¹  Nami Takada²  Ayana Suzuki²  Miyoko Higuchi²  Akira Miyauchi³ 

[1] Department of Diagnostic Pathology, Kuma Hospital, Kobe, Japan;Department of Laboratory, Kuma Hospital, Kobe, Japan;Department of Surgery, Kuma Hospital, Kobe, Japan

关键词: Bethesda System;    Non-diagnostic;    Unsatisfactory;    Cyst fluid only;    Thyroid;   

DOI  :  10.1507/endocrj.EJ17-0082

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

According to the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), cyst fluid only (CFO) cases are classified in the non-diagnostic category.To date, no large study focusing on CFO has been conducted.To reassess the diagnostic significance of CFO, we compared CFO nodules with non-diagnostic nodules excluding CFO (ND-other). We reviewed the conventional thyroid smears of 715 CFO and 766 ND-other nodules.We compared the timing of and findings at re-aspiration, the histology of resected specimens, and the proportion of malignant nodules between the two groups.Re-aspiration was performed in 9.0% of CFO and 23.8% of ND-other cases.In 12.5% of CFO and 49.4% of ND-other cases, the interval between the first and second aspirations was <3 months.Despite this, there were no cases in which cytological interpretation was complicated by the first aspiration.Overall, 77 CFO nodules (10.8%) were surgically resected; 14 were malignant.In all cases in which re-aspiration cytology revealed malignancy, the initial ultrasound interpretation was a high or intermediate suspicion pattern.The proportion of malignancies subsequently diagnosed in nodules initially classified as CFO and ND-other was 2.0% and 5.6%, respectively (p<0.01).As CFO and ND-other thyroid nodules have different clinical management and malignancy rates, we would like to assert that CFO and ND-other nodules should be separated, and that the former should be considered diagnostic.In terms of clinical management, we recommend that only CFO cases with concerning features on ultrasound undergo re-aspiration.

【 授权许可】

Unknown