Thyroid Aspiration Overview in the Diagnosis of Suspicious Malignancy (Thyroid Papillary Carcinoma)

Abstract

Background
Thyroid carcinoma is the most common malignancy in the endocrine system. Fine Needle Aspiration Biopsy (FNAB) is a preliminary
examination to detect thyroid neoplasms. One of FNAB diagnostic category according to Bethesda is Suspicious for Malignancy
(SFM). This study was conducted to assess the cytology feature of SFM category and its concordance with histopathologic result.
Methods
This retrospective study is a descriptive categoric study with cross sectional design of 40 samples. Secondary datas were arsip in
laboratory of Anatomical Pathology of FKUI/RSCM collected on 2015 diagnosa as suspect for malignancy of tiroid based on
histopathologic result.
Results
The histopathological results of SFM were: PTC 20 cases (50%), Hurthle cell carcinoma 2 cases (5%), adenomatous goitre with
PTC focus 11 cases (27%), adenomatous goitre with atypical cell 1 case (2%), adenomatous goitre 4 cases (10%), follicular
adenoma 1 case (3%), Hashimoto's thyroiditis with atypical cell 1 case (3%). Positive predictive value was 82.5% with 94% of
malignancies were papillary type. Cytology feature of SFM specimen: cellularity moderate (57.5%), macrofollicular (67.5%), nuclear
change powdery chromatin (85%). Giant cell were 18 cases (45%, cytoplasmic were 20 cases (50%), bubble gum colloid were, 9
cases (22.5%).
Conclusion
Most of SFM specimen have malignant histopathologic result, especially papillary type. The positive predictive value of the SFM
category is quite high, but there is still disconcordance on histopathologic results.