Department of Radiology, Seoul St. Marys Hospital, The Catholic University of Korea, Seoul 137-701, Korea.
Korean J Radiol. 2010 Mar-Apr;11(2):141-8. doi: 10.3348/kjr.2010.11.2.141. Epub 2010 Feb 22.
To determine histopathologic findings related to the indeterminate or inadequate result of fine-needle aspiration biopsy (FNAB) in papillary thyroid carcinomas (PTCs) and to correlate histopathological findings with ultrasonographic features of tumors.
We retrospectively reviewed the medical records of FNAB, histopathologic characteristics, and sonographic findings of the solid portion of 95 PTCs in 95 patients. All cases were pathologically confirmed by surgery. Histopathologic characteristics were analyzed for tumor distribution, microcystic changes, fibrosis, and tumor component. We assumed several histopathologic conditions to be the cause of indeterminate or inadequate results of FNAB, including: 1) an uneven tumor distribution, 2) > 30% microcystic changes, 3) > 30% fibrosis, and 4) < 30% tumor component. Ultrasonographic findings of each PTC were evaluated for echotexture (homogeneous or heterogeneous), echogenicity (markedly hypoechoic, hypoechoic, isoechoic, or hyperechoic), and volume of the nodule. We correlated histopathologic characteristics of the PTC with results of the FNAB and ultrasonographic findings.
From 95 FNABs, 71 cases (74%) were confirmed with malignancy or suspicious malignancy (PTCs), 21 (22%) had indeterminate results (atypical cells), and three (4%) were negative for malignancy. None of the assumed variables influenced the diagnostic accuracy of FNAB. Tumor distribution and fibrosis were statistically correlated with ultrasonographic findings of the PTCs (p < 0.05). Uneven tumor distribution was related with small tumor volume, and fibrosis over 30% was correlated with homogeneous echotexture, markedly hypoechoic and hypoechoic echogenicity, and small tumor volume (p < 0.05).
No histopathologic component was found to correlate with improper results of FNAB in PTCs. In contrast, two histopathologic characteristics, uneven distribution and fibrosis, were correlated with ultrasonographic findings.
确定与甲状腺乳头状癌（PTC）细针穿刺活检（FNAB）结果不确定或不充分相关的组织病理学发现，并将组织病理学发现与肿瘤的超声特征相关联。
我们回顾性分析了 95 例 PTC 患者 95 例 FNAB、组织病理学特征和实性部分超声检查结果的病历。所有病例均经手术病理证实。分析了肿瘤分布、微囊性改变、纤维化和肿瘤成分的组织病理学特征。我们假设几种组织病理学情况是 FNAB 结果不确定或不充分的原因，包括：1）肿瘤分布不均匀，2）>30%微囊性改变，3）>30%纤维化，和 4）<30%肿瘤成分。对每个 PTC 的超声表现进行了评估，包括回声纹理（均匀或不均匀）、回声强度（明显低回声、低回声、等回声或高回声）和结节体积。我们将 PTC 的组织病理学特征与 FNAB 结果和超声表现相关联。
95 例 FNAB 中，71 例（74%）证实为恶性或可疑恶性（PTC），21 例（22%）结果不确定（非典型细胞），3 例（4%）为恶性阴性。没有一个假设的变量影响 FNAB 的诊断准确性。肿瘤分布和纤维化与 PTC 的超声表现有统计学相关性（p<0.05）。不均匀的肿瘤分布与肿瘤体积小有关，纤维化超过 30%与回声均匀、明显低回声和低回声回声强度以及肿瘤体积小有关（p<0.05）。
在 PTC 中，没有组织病理学成分与 FNAB 结果不当相关。相比之下，两种组织病理学特征，即不均匀分布和纤维化，与超声表现相关。
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