Interpretive Errors in Fine-Needle Aspiration of Thyroid: A 13-Year Institutional Experience in Lebanon.

Introduction: Fine-needle aspiration (FNA) is a worldwide established diagnostic tool for the assessment of patients with thyroid nodules. All thyroid FNA interpretive errors (IEs) were reviewed at the American University of Beirut Medical Center over a 13-year period, in order to identify and analy...

Descripción completa

Detalles Bibliográficos
Publicado en:Acta Cytologica Vol. 66; no. 1; pp. 23 - 36
Autores principales: Khaled, Chirine S., Khalifeh, Ibrahim M., Shabb, Nina S.
Formato: pictorial research tables/charts Journal Article
Publicado: Karger AG Jan2022
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154541654&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 154541654
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00015547
        10OE
      jtl: Acta Cytologica
      issn: 00015547
      maglogo: N
    pubinfo:
      dt: Jan2022
      vid: 66
      iid: 1
      pid: 2485
      pub: Karger AG
    artinfo:
      ui:
        154541654
        152704162
        154541654
        154541654
        10.1159/000519075
        154541654
      ppf: 23
      ppct: 13
      formats:
      tig:
        atl: Interpretive Errors in Fine-Needle Aspiration of Thyroid: A 13-Year Institutional Experience in Lebanon.
      aug:
        au:
          Khaled, Chirine S.
          Khalifeh, Ibrahim M.
          Shabb, Nina S.
        affil: Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
      sug:
        subj:
          Thyroiditis, Autoimmune Diagnosis
          Biopsy, Needle
          Diagnostic Errors
          Human
          Lebanon
          Quality Assurance
          Sampling Error
      ab: Introduction: Fine-needle aspiration (FNA) is a worldwide established diagnostic tool for the assessment of patients with thyroid nodules. All thyroid FNA interpretive errors (IEs) were reviewed at the American University of Beirut Medical Center over a 13-year period, in order to identify and analyze them. Materials and Methods: All FNAs and their corresponding pathology results are correlated yearly for quality assurance. Discrepant cases are segregated into sampling errors and IEs. All thyroid FNAs with IEs were collected from 2005 to 2017. FNA and pathology slides were reviewed by trained, board-certified cytopathologists, adhering to the latest Bethesda criteria. Reasons for erroneous diagnoses were studied. Results: There was a total of 11 IEs out of 340 thyroid FNAs followed by surgical resection. Five benign follicular nodules (BFNs) were misinterpreted as suspicious for carcinoma. Focal nuclear atypia in cyst-lining or follicular cells and a monotonous population of macrophages misinterpreted as Hurthle cells (HCs) were the causes of IEs in this category. Four Hashimoto's thyroiditis (HT) cases were misinterpreted as suspicious for malignancy. Innate atypia of HCs and sampling misinterpretation were the causes of IEs in HT. One medullary and 1 follicular carcinoma were misinterpreted as suspicious for follicular neoplasm and BFN, respectively. Nine cases were better classified after review. Conclusion: Thyroid FNA IEs can be mitigated by meticulous screening and identification of all elements on FNA smears. Awareness of focal nuclear atypia in reactive cyst-lining and follicular cells in BFN, as well as HCs in HT, is highlighted. Adherence to The Bethesda System for Reporting Thyroid Cytopathology and consulting experienced cytopathologists significantly decrease IEs.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N