Cic edizioni internazionali
Il Giornale di Chirurgia

Nodulo follicolare indeterminato della tiroide: è possibile valutare preoperatoriamente il rischio di malignità?

Articolo, 242 - 243
Tag this article
Abstract
Full text PDF
Aim: Despite fine-needle aspiration biopsy (FNAB) is the cornerstone of assessment of thyroid nodules, when cytology suggests a follicular neoplasm (FN) only histology can differentiate between benign and malignant lesions. Aim of this study was to evaluate factors predictive of malignancy in cytologically indeterminate FN.
Methods: All the patients who underwent FNAB between December 2007 and November 2008 were considered. Among them, those with a cytology of FN (Thy3, British Thyroid Association) and with an histological control were included. Age, sex, ultrasound characteristics, nodulÈs size, thyroid disease, HBME-1 and Galectin-3 immunocytochemical stains and histology were registered.
Results: Among 1585 FNAB, 261 (16.5%) had a cytology of FN and 195 had an histological control: 146 benign and 49 differentiated thyroid carcinoma (DTC) (43 follicular variant of papillary carcinoma and 6 follicular carcinoma). The malignancy rate in case of single nodules was significantly higher than in multinodular goiter (30/63 Vs 19/132) (P<0.001). Positive immunostaining for both HBME-1 and Galectin-3 was observed in 58 cases, negative for both in 137. The malignancy rate was significantly higher in HBME-1 and Galectin-3 positive nodules (42/49 Vs 16/146) (P<0.001). The risk of malignancy was 1:4 for the entire series, but it increased to 1:2.1 (47.6%) for single nodules and 1:1.4 (72.4%) for HBME-1/galectin-3 positive nodules.
Conclusions: One in four patients with FN has a DTC. Thyroidectomy is mandatory in all the patients with single and/or HBME-1/galectin-3 positive nodules, because of the increased risk of malignancy, and suitable in all the other cases.

Vol. XLI (No. 1) 2020 January - February

  1. Laparoscopic Roux-en-Y gastric bypass in the treatment of obesity: evidence based update through randomized clinical trials and meta-analyses
    Morales-Maza J., Rodriguez-Quintero J.H., Sanchez-Morales G.E., Sanchez Garcia-Ramos E., Romero-Velez G., Aguilar-Frasco J.L., Pimienta-Ibarra A.S., Alvarez-Bautista F.E., Leon P., Hernandez-Acevedo J.D., Del Angel-Millan G., Sierra M.
  2. Retroperitoneal sarcomas: from diagnosis to treatment. Case series and review of the literature
    Mantas D., Garmpis N., Polychroni D., Garmpi A., Damaskos C., Liakea A., Sypsa G., Kouskos E.
  3. The discriminative properties of erythrocyte anisocytosis in patients with resectable malignant pancreatic masses compared with an age and gender matched control group
    Akturk O.M., Çakir M.
  4. Diagnostic and therapeutic role of laparoscopy in perforated peptic ulcer in the elderly patients
    Giordano A., Prosperi P., Alemanno G., Bergamini C., Bruscino A., Valeri A.
  5. The role of laparoscopic surgery in isolated adrenal metastasis: our personal experience
    Frattolillo G., Paradiso G., Scarano Catanzaro V., Giordano L., Avantifiori R., D'Ermo G., Letizia C., De Toma G.
  6. Advances in bioengineering of complex tissues: state of the art of mucosae decellularization protocols
    Rizzo M.I., Contardi C., Esposito M., Zama M.
  7. An analysis of missed cases with surgical emergencies admitted in non-surgical departments. Case series and а review of the literature
    Popivanov G., Cirocchi R., Popov G., Stefanovski P., Andonova R., Kjossev K., Tonchev P., Tabakov M., Penkov M., Ivanov P., Mutafchiyski V.
  8. The evolution of robotic arm-assisted arthroplasty in Greece
    Koutserimpas C., Dretakis K.
  9. Current role of open surgery in adrenal tumors
    Chiappini A., Frattolillo G., Paradiso G., De Gori A., Scarano Catanzaro V., Avantifiori R., Fiori E., De Toma G.
  10. Preoperative fasting - “nihil per os” a difficult myth to break down: a randomized controlled study
    Panebianco A., Laforgia R., Volpi A., Punzo C., Vacca G., Minafra M., Di Salvo M., Pezzolla A.
  11. Sentinel lymph node biopsy with intraoperative touch imprint cytology (TIC) in breast cancer: experience of a mild-volume center
    Marano A., Sodano B., Vitiello C., Martini A.M., Baldassarre F., Siciliano A., Iannaci G.
  12. Spontaneous transdiaphragmatic intercostal hernia: clinical considerations and management
    Lonardo M.T., Frezzotti F., Collalti M., Natili A., Metere A.
  13. Systemic immune response after open tension-free inguinal hernia repair under different anesthetic alternatives: a prospective comparative study
    Symeonidis D., Diamantis A., Baloyiannis I., Tzovaras G., Tepetes K.
  14. Minilaparotomic incision for haemorrhagic corpus luteum: a case report
    Leanza V., Mininni C., Di Grazia F.M., Genovese F., Carbonaro A., Leanza G., Palumbo M.
  15. Conservative management of streptococcal necrotizing periorbital fasciitis following primary VZV infection
    Kontou E., Bontzos G., Triantafyllou D., Garnavou-Xirou C., Ragkousis A., Xirou T.
  16. Relief of hemorrhoid symptoms: pilot study of a new topical ally
    Gaj F., Bianchi F.P., Passannanti D., Tedesco D.
  17. Topical use of tranexamic acid in primary total knee arthroplasty: a comparative study
    Besiris G.TH., Koutserimpas C., Karamitros A., Karaiskos I., Tsakalou D., Raptis K., Kourelis K., Paxinos O., Kotsirakis A., Vlasis K.
  18. Insights in clinical examination and diagnosis of Athletic Pubalgia
    Koutserimpas C., Ioannidis A., Konstantinidis M.K., Makris M.C., Antonakopoulos F., Mazarakis A., Papagelopoulos P.J., Vlasis K., Konstantinidis M.K.
Last Viewed articles: la lista degli ultimi x visitati.
  1. Nodulo follicolare indeterminato della tiroide: è possibile valutare preoperatoriamente il rischio di malignità?
    Lombardi C.P., Raffaelli M., De Crea C., Oragano L., D'Amato G., Rossi E.D., Fadda G., Bellantone R.
credits