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Molecular Cytology Application on Thyroid

  • Esther Diana Rossi
  • Massimo Bongiovanni
Chapter

Abstract

The detection of thyroid nodules (TN) represents a common finding in population. Their evaluation and diagnosis are mostly achieved with fine-needle aspiration cytology (FNAC) which is increasing due to the reliance upon sonographic and detection of millimeter lesions. The cytological evaluation of both palpable and not-palpable thyroid lesions represents a challenge for pathologists and cytopathologists. The correct cytological discrimination between benign and malignant lesions is the first invaluable point for the adequate clinical and/or surgical management of thyroid lesions. Even though the majority of TNs are correctly diagnosed, a total 25–30% of them are classified as follicular neoplasms (FN) comprising lesions with varying risk of malignancy and different management.

Due to the issue in the morphological interpretations and inter-observer reproducibility especially among the FNs, the best results have been obtained with the support of ancillary techniques (e.g., immunocytochemistry-ICC and molecular analysis) which are reshaping the practice of FNAC and the diagnosis of thyroid lesions. Their application, due to the high specificity, contributes to obtain the best results as a complement analysis allowing more specific and tailored therapeutic strategies. Even though many markers are in development and have been studied, two principal tests are currently used to improve the malignant risk assessment of thyroid lesions. These “rule in “and “rule out” tests are able to confirm or exclude, respectively, the presence of cancer within a thyroid nodule.

We overviewed the role of molecular testing in different cytological methods (i.e., conventional cytology, liquid based cytology, cell-blocks).

Keywords

Thyroid gland Thyroid lesions Thyroid carcinoma Papillary thyroid carcinoma Medullary carcinoma Poorly differentiated thyroid carcinoma Immunocytochemistry Molecular analysis miRNA Gene expression classifier 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Anatomic Pathology and HistologyFondazione Universtaria Policlinico Agostino Gemelli-IRCCSRomeItaly
  2. 2.Service of Clinical PathologyLausanne University Hospital, Institute of PathologyLausanneSwitzerland

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