Thyroid Oncocytic Cell in Cytological and Histologic Reports: Institutional Experience

José Marçalo, M. Cardoso, D. Presa, Maria João M Bugalho
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Abstract

Purpose: Oncocytic cell tumors, due to historical and clinical reasons, tend to be put in a higher risk category compared with other cell type tumors. We tried to define the malignancy risk for this entity. Methods: At our institution, we studied the risk of malignancy associated with a cohort of 107 thyroid nodules aspirates containing oncocytic cells in the cytology report and we have further analyzed other clinical factors. Results: A tendency for higher risk of malignancy in male sex was found (31.3% vs. 15.4% in women), the difference, however, was not statistically significant (P = 0.291). Total thyroidectomy was the preferred surgical approach and only 10.3% of patients were submitted to lobectomy. Histopathology reports documented 46.7% hyperplastic/adenomatoid nodules, 31.8% adenomas, 12.1% papillary carcinoma, 3.7% oncocytic cell carcinoma, 2.8% lymphocytic thyroiditis and 1.9% poorly differentiated carcinoma. Benign nodules (Bethesda Class II) exhibited a 9.7% malignancy risk; Class III exhibited a 20% malignancy risk; Class IV exhibited a 18.4% malignancy; Class V exhibited a 16% malignancy risk and Class VI exhibited a 100% malignancy risk. Overall histologic data from the aspirated nodules showed a risk of malignancy of 17.8%. Conclusion: Our study seems to suggest that in the presence of oncocytic cells there may be a tendency for a higher than expected malignancy rate. Clinical factors appear to be insufficient to base our management decisions with confidence and molecular markers are still under development. Therefore, surgery may stand as the favored option in this setting.
细胞学和组织学报告中的甲状腺嗜瘤细胞:机构经验
目的:由于历史和临床原因,嗜瘤细胞肿瘤比其他细胞类型的肿瘤具有更高的危险性。我们试图定义这个实体的恶性风险。方法:在我们的机构,我们研究了107例细胞学报告中含有嗜瘤细胞的甲状腺结节的恶性肿瘤风险,并进一步分析了其他临床因素。结果:男性患恶性肿瘤的风险较高(31.3% vs. 15.4%),但差异无统计学意义(P = 0.291)。甲状腺全切除术是首选的手术方式,只有10.3%的患者接受了肺叶切除术。组织病理学报告显示:增生性/腺瘤样结节46.7%,腺瘤31.8%,乳头状癌12.1%,癌性细胞癌3.7%,淋巴细胞性甲状腺炎2.8%,低分化癌1.9%。良性结节(Bethesda II类)的恶性风险为9.7%;第三类患者患恶性肿瘤的风险为20%;IV类恶性肿瘤18.4%;V类显示出16%的恶性风险,而VI类显示出100%的恶性风险。抽吸结节的总体组织学数据显示恶性肿瘤的风险为17.8%。结论:我们的研究似乎表明,在嗜瘤细胞存在的情况下,可能有高于预期的恶性肿瘤发生率的趋势。临床因素似乎不足以使我们的管理决策有信心,分子标记仍在开发中。因此,在这种情况下,手术可能是最好的选择。
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