Atypical adenoma of the thyroid. A clinicopathologic and flow cytometric DNA study in comparison with other follicular neoplasms.

A clinicopathologic and DNA flow cytometric study was performed on seven patients (three males, four females) with atypical adenoma of the thyroid gland, using formalin-fixed paraffin-embedded tissues. The results were compared with those of 30 follicular adenomas and 13 follicular carcinomas. The patients ranged in age from 32 to 74 years (mean; 55.8 years), and the mean follow-up period was 11.0 years. All patients except two who died of other diseases were free of thyroid disease after initial surgery. It showed that there was no evidence of clinical cancer in this follow-up study of patients operated on for atypical adenomas. Four of the atypical adenomas were diploid, two were aneuploid, and one was tetraploid. Twenty-seven of the 30 follicular adenomas were diploid. Three patients with aneuploid follicular adenoma were free of disease. Of the 13 follicular carcinomas with a mean follow-up period of 6.9 years, five were diploid, seven were aneuploid, and one was tetraploid. Two patients with aneuploid follicular carcinoma and one with diploid carcinoma developed lung metastases, and one patient each with diploid and aneuploid follicular carcinoma died of disease. There was no significant correlation between histologic features, ploidy status and prognosis among follicular carcinomas. The results of this study suggest that DNA flow cytometric analysis is not a useful tool for predicting the clinical behavior of follicular neoplasms.