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Difference between revisions of "Thyroid cytopathology"
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Thyroid cytopathology (view source)
Revision as of 14:56, 28 February 2011
, 14:56, 28 February 2011+FLUS
(+FLUS) |
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| Line 34: | Line 34: | ||
| Follow/nothing | | Follow/nothing | ||
|- | |- | ||
| Follicular lesion of undetermined significance | | Follicular lesion of undetermined significance (FLUS) | ||
| 1. Atypia of undetermined significance<br>2. Rule-out neoplasm<br>3. Atypical follicular lesion<br>4. Cellular follicular lesion | | 1. Atypia of undetermined significance<br>2. Rule-out neoplasm<br>3. Atypical follicular lesion<br>4. Cellular follicular lesion | ||
| Uncertain, favour benign | | Uncertain, favour benign | ||
| Line 107: | Line 107: | ||
*This is a clinical diagnosis. | *This is a clinical diagnosis. | ||
**It should be reported by the pathologist as "lymphocytic thyroiditis". | **It should be reported by the pathologist as "lymphocytic thyroiditis". | ||
==Follicular lesion of undetermined significance== | |||
Abbreviated ''FLUS''. | |||
===General=== | |||
*This is [[waffle diagnosis]], i.e. something the pathologist diagnoses when they cannot decide whether it is benign or suspicious for malignant (''follicular neoplasm'' or ''suspicious for malignancy'').<ref name=pmid19373907>{{cite journal |author=Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S |title=Implications of the proposed thyroid fine-needle aspiration category of "follicular lesion of undetermined significance": A five-year multi-institutional analysis |journal=Diagn. Cytopathol. |volume=37 |issue=10 |pages=710–4 |year=2009 |month=October |pmid=19373907 |doi=10.1002/dc.21093 |url=}}</ref> | |||
**Like all waffle diagnoses... | |||
***Use should be minimized; < 7% is suggested, though it varies considerably between pathologists and institutions.<ref name=pmid19373907/> | |||
===Cytology=== | |||
Features: | |||
*Mild nuclear atypia - that by definition is insufficient for ''follicular neoplasm'' or ''suspicious for malignancy''. | |||
**Mild irregularities in the nuclear contour. | |||
**Mild size variation or nuclear enlargement. | |||
**Mild accentuation of nuclear staining. | |||
==Papillary carcinoma== | ==Papillary carcinoma== | ||