ABSTRACT
BACKGROUND: The clinical evaluation of enlarged local lymph nodes (LNs) is difficult at the beginning and throughout the follow-up of differentiated thyroid carcinoma (DTC). Although the examination of samples collected from LNs by fine-needle aspiration biopsy cytology (FNAB-C) is extremely specific for the diagnosis of metastases, its sensitivity is low, especially in paucicellular samples. SUMMARY: The measurement of thyroglobulin (Tg) in the fine-needle aspiration biopsy (FNAB) washout fluid (FNAB-Tg) increases the diagnostic performance of cytology to up to 100% sensitivity and specificity. However, the application of FNAB-Tg is currently hindered by the absence of methodological standardization, a lack of definite cutoff points, and the ongoing debate regarding its accuracy in nonthyroidectomized patients, those with elevated serum Tg, and those with circulating anti-Tg antibodies. CONCLUSION: FNAB-Tg improves the diagnostic performance of FNAB-C in LN metastases, even when the latter is unable to diagnose the metastases. For that reason, FNAB-Tg should be included in the monitoring of DTC.
Subject(s)
Biopsy, Fine-Needle/standards , Thyroglobulin/blood , Thyroid Neoplasms/pathology , Autoantibodies/analysis , Biopsy, Fine-Needle/methods , Carcinoma, Papillary/pathology , Follow-Up Studies , Humans , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Neck/diagnostic imaging , Sensitivity and Specificity , Thyroglobulin/immunology , Thyroid Neoplasms/diagnostic imaging , UltrasonographyABSTRACT
Os autores relatam o caso de uma paciente com hiperparatireoidismo primário causado por adenoma de paratireóide diagnosticado através de punção aspirativa por agulha fina (PAAF) no pré-operatório. A paratireóide aumentada foi visualizada pela ultra-sonografia (US) e submetida à PAAF, que foi compatível com adenoma de paratireóide. Realizou-se a remoção cirúrgica do adenoma e o histopatológico resultou concordante com a citologia. Este relato destaca a importância da localização e do diagnóstico citológico pré-operatório das lesões de paratireóide para proporcionar uma abordagem cirúrgica menos agressiva.
The authors report a patients case with primary hyperparathyroidism caused by parathyroid adenoma that was diagnosed by fine needle aspiration cytology (FNAC) in the preoperative. The increased parathyroid was visualized by the ultrasonography and submitted to FNAC that was compatible with parathyroid adenoma. The surgical removal of adenoma was accomplished and the histopathologic was concordant with the cytology. This report detaches the importance of the location and preoperative cytological diagnosis of the parathyroid lesions in providing a less aggressive surgical approach.
Subject(s)
Humans , Female , Middle Aged , Adenoma/complications , Adenoma/pathology , Parathyroid Glands/pathology , Hyperparathyroidism/complications , Hyperparathyroidism/pathology , Biopsy, Fine-NeedleABSTRACT
Os nódulos tireoidianos têm elevada prevalência na populaçäo geral. O objetivo desse estudo foi avaliar o grau de associaçäo das técnicas de punçäo aspirativa e näo-aspirativa e comparar a citologia obtida pelas duas técnicas. Foram selecionados 61 pacientes portadores de nódulo tireoidiano, que foram submetidos à punçäo pelas duas técnicas, guiadas por ultra-sonografia. Os esfregaços foram analisados por dois citopatologistas independentes, conforme 5 critérios que avaliam a qualidade do material. Näo houve diferença significativa entre as técnicas quanto à soma dos pontos dos critérios, quando estes foram analisados juntos ou isoladamente (p>0,05). A concordância entre as técnicas foi muito baixa (k=0,13). Näo houve diferença entre as técnicas quando foram comparadas as somas dos critérios conforme os dois patologistas (p>0,05). A técnica näo-aspirativa foi superior à técnica aspirativa nos nódulos hiperecogênicos (p<0,05). As técnicas fornecem material de qualidade semelhante e a associaçäo das duas técnicas diminui falhas diagnósticas.
