Reassessing Combining Real-time Elastography with Fine-needle Aspiration Biopsy to Identify Malignant Thyroid Nodules

Demet Sengul^1, and Ilker Sengul^{2, 3}

¹Department of Pathology, Giresun University Faculty of Medicine, 28100 Giresun, Turkey

²Division of Endocrine Surgery, Giresun University Faculty of Medicine, 28100 Giresun, Turkey

³Department of General Surgery, Giresun University Faculty of Medicine, 28100 Giresun, Turkey

Cite this paper

Demet Sengul and Ilker Sengul. Reassessing Combining Real-time Elastography with Fine-needle Aspiration Biopsy to Identify Malignant Thyroid Nodules. American Journal of Medical Case Reports. 2021; 9(11):552-553. doi: 10.12691/AJMCR-9-11-9

Abstract

Debate is still ongoing in the thyroid gland with indeterminate cytology w/wo suspicious clinics and sonographic features, besides their size selection criteria, in Endocrine Pathology, Endocrine Surgery, and Thyroidology, till today. Real-time elastography (RTE) still have been utilized for this purpose though it remains a controversial determinant. We postulate that the so-called RTE diagnostic tool selectively is enriched by considering nondiagnostic, Category I, and indeterminate cytology, Category III, IV, and V, of The Bethesda System for Reporting Thyroid Cytopathology, TBSRTC, 2nd ed., individually and separately, regarding noninvasive follicular thyroid neoplasm with papillary-like nuclear features, NIFTP, all of which a wide range of implied risk of malignancies.

Keywords

thyroid gland, nondiagnostic cytology, indeterminate cytology, elastography, real-time elastography, Endocrine Surgery, Endocrine Pathology, Thyroidology

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Sengul, I., Sengul, D. “Hermeneutics for Evaluation of the Diagnostic Value of Ultrasound Elastography in TIRADS 4 Categories of Thyroid Nodules.” Am J Med Case Rep, 9(11): 538-539. Jul 2021.
[2]	Zhu, L., Chen, Y., Ali, H., et al. “Combining real-time elastography with fine-needle aspiration biopsy to identify malignant thyroid nodules.” J Int Med Res, 48(12). 300060520976027. Dec 2020.
[3]	Sengul, D., Sengul, I. “Association between Tsukuba elasticity scores 4 and 5 on elastography and Bethesda undetermined cytology on US-guided FNA with 27-G needle, verified by histopathology: a cut-off point of 20 mm of diameter designated for thyroid nodules.” J BUON, 24(1): 382-390. Jan-Feb 2019.
[4]	Sengul, D., Sengul, I., Van Slycke, S. “Risk stratification of the thyroid nodule with Bethesda indeterminate cytology, category III, IV, V on the one surgeon-performed US-guided fine-needle aspiration with 27-gauge needle, verified by histopathology of thyroidectomy: the additional value of one surgeon-performed elastography.” Acta Chir Belg, 119(1): 38-46. Feb 2019.
[5]	Sengul, D., Sengul, I., Pelikán, A. “Paraphrase for the impact of repeat fine-needle aspiration in thyroid nodules categorized as atypia of undetermined significance or follicular lesion of undetermined significance: A single-center experience”. Diagn Cytopathol, 49(3). 452-453. Mar 2021.
[6]	Nardi, F., Basolo, F., Crescenzi, A., et al. “Italian consensus for the classifcation and reporting of thyroid cytology.” J Endocrinol Invest, 37(6):593-599. Jun 2014.
[7]	En, N.M., Kumarasinghe, M.P., Tie, B., et al. “Experience with standardized thyroid fine-needle aspiration reporting categories.” Cancer Cytopathol, 118(6):423-433. Dec 2010.
[8]	Kakudo, K., Kameyama, K., Miyauchi, A. “History of thyroid cytology in Japan and reporting system recommended by the Japan Thyroid Association.” J Basic & Clin Med, 2(2):10-15. Dec 2013.
[9]	Baloch, Z.W., Cooper, D.S., Gharib, H., et al. “Overview of diagnostic terminology and reporting.” In: Ali, S.Z., Cibas, E.S., editors. The Bethesda System for Reporting Thyroid Cytopathology. 2nd ed. Springer International Publishing AG Cham, Switzerland, 2018, pp.1-6.