From Smear to Sequence: Using Thyroid Cytology Smear Slides for ThyroSeq Molecular Analysis and Clinicopathologic Insights From 61 Tested Nodules.

Context.--In the absence of conventional testing media, thyroid cytology smear slides may be used for molecular analysis of nodules with indeterminate cytology results. Objective.--To present solutions for overcoming challenges of ThyroSeq testing using smear slides and report findings from tested n...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 150; no. 3; pp. 202 - 210
Autores principales: Trabzonlu, Levent, Elliott, Caroline, Fisch, Adam S., Chebib, Ivan A., Madrigal, Emilio
Formato: pictorial research tables/charts Journal Article
Publicado: College of American Pathologists Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
      vid: 150
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      pub: College of American Pathologists
      place: Northfield, Illinois
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        10.5858/arpa.2025-0115-OA
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        atl: From Smear to Sequence: Using Thyroid Cytology Smear Slides for ThyroSeq Molecular Analysis and Clinicopathologic Insights From 61 Tested Nodules.
      aug:
        au:
          Trabzonlu, Levent
          Elliott, Caroline
          Fisch, Adam S.
          Chebib, Ivan A.
          Madrigal, Emilio
        affil: Department of Pathology, Massachusetts General Hospital, Boston
      sug:
        subj:
          Thyroid Nodule Pathology
          Thyroid Neoplasms Diagnosis
          Cancer Screening Methods
          Biopsy, Needle
          Molecular Diagnostic Techniques
          Sequence Analysis
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Massachusetts
          Hospitals, Public
          Retrospective Design
          Record Review
          Medical Records
          Prospective Studies
          Mutation
          Gene Expression
          Comparative Studies
          Descriptive Statistics
          Data Analysis Software
          DNA
          RNA
          Thyroid Neoplasms Familial and Genetic
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Context.--In the absence of conventional testing media, thyroid cytology smear slides may be used for molecular analysis of nodules with indeterminate cytology results. Objective.--To present solutions for overcoming challenges of ThyroSeq testing using smear slides and report findings from tested nodules. Design.--We developed software to parse unstructured ThyroSeq reports for actionable data extraction. To ensure compliance with sample retention requirements, substitute specimen records were created by digitizing smear slides before they were exhausted for molecular analysis.We stream-lined the test send-out process and recorded the clinical, molecular, and pathologic findings of the cases in our cohort. Results.--We submitted 61 thyroid fine-needle aspiration specimens from 59 cases for ThyroSeq testing. All 61 specimens were adequate for DNA analysis, and only 1 was insufficient for RNA analysis. In 8 cases, the smear slide was the only viable sample for molecular testing. A total of 21 specimens (34.4%) had a positive ThyroSeq result. Gene mutations were the most common findings, with 16 mutations detected in 13 "positive" specimens. Additionally, copy number alterations, gene expression alterations, and gene fusions were identified. Conclusions.--This study presents our approach to extending the utility of thyroid cytology smear slides by enabling molecular analysis, particularly when routine sample types are unavailable. High adequacy rates and successful detection of molecular alterations highlight the potential of smear slides in molecular testing, reducing the need for repeated procedures and streamlining care. Effective communication between clinical and cytology teams remains essential to manage the additional workload.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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