Should atypia of undetermined significance be subclassified to better estimate risk of thyroid cancer?

Joy C. Chen, S. Carter Pace, Amer Khiyami, Christopher R. McHenry

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background Atypia or follicular lesion of undetermined significance (AUS) is a cytologic category of thyroid aspirates with a wide range of reported malignancy. We aimed to determine whether specific cytologic features are associated with different rates of thyroid malignancy. Methods All thyroid fine needle aspiration biopsies with AUS from 2010 to 2012 were reanalyzed. Cytologic features were correlated with final pathology. Cytopathologists were blinded to the original cytologic interpretation and final diagnosis. Results Seventy-six patients had AUS; 39 (54%) underwent surgery with a malignancy rate of 18%. Specimens with moderate or large amount of thin colloid and absent or few nuclear inclusions had a >88% rate of benign disease. More than rare nuclear inclusions or grooves were associated with a higher rate of cancer (75% vs 9%, P =.005; 45% vs 7%, P =.003). Conclusions Patients with AUS and more than rare nuclear inclusions or grooves are at higher risk for cancer and should forego repeat fine needle aspiration biopsy and undergo thyroidectomy.

Original languageEnglish (US)
Pages (from-to)331-336
Number of pages6
JournalAmerican journal of surgery
Volume207
Issue number3
DOIs
StatePublished - Mar 2014

Keywords

  • Atypia
  • Cytology
  • Thyroid cancer
  • Thyroid nodule

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