Diagnostic role of FNA cytology in the evaluation of cervical lymph nodes in thyroid cancers: Combined evaluation of thyroglobulin in eluate from FNA cytology

Author:

Tralongo Pietro1,Bruno Carmine2,Policardo Federica1,Vegni Federica1,Feraco Angela1,Carlino Angela1,Ferraro Giulia1,Milardi Domenico2,Navarra Elena1,Pontecorvi Alfredo2,Lombardi Celestino Pio3,Raffaelli Marco3,Larocca Luigi Maria1,Pantanowitz Liron4ORCID,Rossi Esther Diana1ORCID

Affiliation:

1. Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario “Agostino Gemelli”–IRCCS Rome Italy

2. Division of Endocrinology Fondazione Policlinico Universitario “Agostino Gemelli”–IRCCS Rome Italy

3. Division of Endocrine‐Surgery Fondazione Policlinico Universitario “Agostino Gemelli”–IRCCS Rome Italy

4. Department of Pathology University of Pittsburgh Pittsburgh Pennsylvania USA

Abstract

AbstractBackgroundThe presurgical evaluation of cervical lymph nodes (CLNs) in the management of thyroid malignant lesions is crucial for the extent of surgery or detection of metastases. In these last decades, fine‐needle aspiration cytology (FNAC) has been shown to have a central role in the detection of nodal thyroid metastases. It is adopted for the possibility of confirming suspected metastases either in the presurgical phase or in the follow‐up of patients after thyroidectomy. However, FNAC from CLNs can be challenging, especially in cystic lesions. In this regard, the combination of FNAC with thyroglobulin measurement in the eluate from FNAC (Tg‐FNAC) seems to increase the sensitivity of FNAC in the detection of CLN metastases. The role of FNAC and Tg‐FNAC was investigated in this series.MethodsOne hundred fifty‐three prospective cytological samples of CLNs were studied along with surgical follow‐up in the period between 2020 and 2022. Immunocytochemistry (ICC) was performed on liquid‐based cytology–stored material.ResultsOne hundred fifty‐nine enlarged CLNs included 19 central lymph nodes and 140 CLNs. Forty‐two thyroidal CLN metastases and 117 reactive lymph nodes were found. Thirty‐one CLN dissections were performed in patients with a previous diagnosis of thyroid carcinoma (mostly papillary thyroid carcinoma [PTC]), whereas 128 CLNs with a concomitant suspicious and/or malignant thyroid nodule were found. There was one false‐positive case among all the malignant histologically confirmed cases, and two of 117 reactive CLNs (1.7%) had a diagnosis of metastatic PTC. Markedly high Tg‐FNAC was found in all metastatic CLNs, including 11 cystic metastatic CLNs detected by Tg‐FNAC with a negative FNAC. ICC (including Tg, CK‐19, and LCA) recognized nine cases with low Tg‐FNAC and scant suspicious thyrocytes. Tg‐FNAC plus FNAC diagnosed 94.2% of malignancies.ConclusionsFNAC represents a valid method for the evaluation of CLNs, especially combined with ICC. Tg‐FNAC is an additional method with a useful role in FNAC.

Publisher

Wiley

Subject

Cancer Research,Oncology

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Thyroid Nodules and Biopsy;Hypothyroidism - Causes, Screening and Therapeutic Approaches [Working Title];2024-06-14

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