Journal of Pathology and Translational Medicine

Original Articles

Clinicopathological implications of immunohistochemical expression of TBX21, CXCR3, GATA3, CCR4, and TCF1 in nodal follicular helper T-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified: Bogyeong Han, Sojung Lim, Jeemin Yim, Young Keun Song, Jiwon Koh, Sehui Kim, Cheol Lee, Young A Kim, Yoon Kyung Jeon; J Pathol Transl Med. 2024;58(2):59-71. Published online January 22, 2024; DOI: https://doi.org/10.4132/jptm.2024.01.04

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Abstract PDF Supplementary Material: Background
The classification of nodal peripheral T-cell lymphoma (PTCL) has evolved according to histology, cell-of-origin, and genetic alterations. However, the comprehensive expression pattern of follicular helper T-cell (Tfh) markers, T-cell factor-1 (TCF1), and Th1- and Th2-like molecules in nodal PTCL is unclear.
Methods
Eighty-two cases of nodal PTCL were classified into 53 angioimmunoblastic T-cell lymphomas (AITLs)/nodal T-follicular helper cell lymphoma (nTFHL)-AI, 18 PTCLs-Tfh/nTFHL–not otherwise specified (NOS), and 11 PTCLs-NOS according to the revised 4th/5th World Health Organization classifications. Immunohistochemistry for TCF1, TBX21, CXCR3, GATA3, and CCR4 was performed.
Results
TCF1 was highly expressed in up to 68% of patients with nTFHL but also in 44% of patients with PTCL-NOS (p > .05). CXCR3 expression was higher in AITLs than in non-AITLs (p = .035), whereas GATA3 expression was higher in non-AITL than in AITL (p = .007) and in PTCL-Tfh compared to AITL (p = .010). Of the cases, 70% of AITL, 44% of PTCLTfh/ nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the TBX21 subtype; and 15% of AITL, 38% of PTCL-Tfh/nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the GATA3 subtype. The others were an unclassified subtype. CCR4 expression was associated with poor progression-free survival (PFS) in patients with PTCL-Tfh (p < .001) and nTFHL (p = .023). The GATA3 subtype showed poor overall survival in PTCL-NOS compared to TBX21 (p = .046) and tended to be associated with poor PFS in patients with non-AITL (p = .054).
Conclusions
The TBX21 subtype was more prevalent than the GATA3 subtype in AITL. The GATA3 subtype was associated with poor prognosis in patients with non-AITL and PTCL-NOS.

Identification of invasive subpopulations using spatial transcriptome analysis in thyroid follicular tumors: Ayana Suzuki, Satoshi Nojima, Shinichiro Tahara, Daisuke Motooka, Masaharu Kohara, Daisuke Okuzaki, Mitsuyoshi Hirokawa, Eiichi Morii; J Pathol Transl Med. 2024;58(1):22-28. Published online January 10, 2024; DOI: https://doi.org/10.4132/jptm.2023.11.21

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Abstract PDF: Background
Follicular tumors include follicular thyroid adenomas and carcinomas; however, it is difficult to distinguish between the two when the cytology or biopsy material is obtained from a portion of the tumor. The presence or absence of invasion in the resected material is used to differentiate between adenomas and carcinomas, which often results in the unnecessary removal of the adenomas. If nodules that may be follicular thyroid carcinomas are identified preoperatively, active surveillance of other nodules as adenomas is possible, which reduces the risk of surgical complications and the expenses incurred during medical treatment. Therefore, we aimed to identify biomarkers in the invasive subpopulation of follicular tumor cells.
Methods
We performed a spatial transcriptome analysis of a case of follicular thyroid carcinoma and examined the dynamics of CD74 expression in 36 cases.
Results
We identified a subpopulation in a region close to the invasive area, and this subpopulation expressed high levels of CD74. Immunohistochemically, CD74 was highly expressed in the invasive and peripheral areas of the tumor.
Conclusions
Although high CD74 expression has been reported in papillary and anaplastic thyroid carcinomas, it has not been analyzed in follicular thyroid carcinomas. Furthermore, the heterogeneity of CD74 expression in thyroid tumors has not yet been reported. The CD74-positive subpopulation identified in this study may be useful in predicting invasion of follicular thyroid carcinomas.

Reviews

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: its updated diagnostic criteria, preoperative cytologic diagnoses and impact on the risk of malignancy: Hee Young Na, So Yeon Park; J Pathol Transl Med. 2022;56(6):319-325. Published online November 9, 2022; DOI: https://doi.org/10.4132/jptm.2022.09.29

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Abstract PDF

Due to the extremely indolent behavior, a subset of noninvasive encapsulated follicular variant papillary thyroid carcinomas has been classified as “noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)” since 2016 and is no longer considered carcinoma. Since the introduction of this new terminology, changes and refinements have been made in diagnostic criteria. Initially, the incidence of NIFTP was estimated substantial. However, the reported incidence of NIFTP varies greatly among studies and regions, with higher incidence in North American and European countries than in Asian countries. Thus, the changes in the risk of malignancy (ROM) in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) differ inevitably among regions. Because more conservative surgery is recommended for NIFTPs, distinguishing NIFTPs from papillary thyroid carcinomas in preoperative fine-needle aspiration cytology became one of the major concerns. This review will provide comprehensive overview of updates on diagnostic criteria, actual incidence and preoperative cytologic diagnoses of NIFTP, and its impact on the ROM in TBSRTC.

Citations

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Papillae, psammoma bodies, and/or many nuclear pseudoinclusions are helpful criteria but should not be required for a definitive cytologic diagnosis of papillary thyroid carcinoma: An institutional experience of 207 cases with surgical follow up
Tarik M. Elsheikh, Matthew Thomas, Jennifer Brainard, Jessica Di Marco, Erica Manosky, Bridgette Springer, Dawn Underwood, Deborah J. Chute
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ThyroSeq overview on indeterminate thyroid nodules: An institutional experience
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Reevaluating diagnostic categories and associated malignancy risks in thyroid core needle biopsy
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Strategies for Treatment of Thyroid Cancer
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Identification of NIFTP-Specific mRNA Markers for Reliable Molecular Diagnosis of Thyroid Tumors
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Follicular lymphoma: updates for pathologists: Mahsa Khanlari, Jennifer R. Chapman; J Pathol Transl Med. 2022;56(1):1-15. Published online December 27, 2021; DOI: https://doi.org/10.4132/jptm.2021.09.29

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Abstract PDF

Follicular lymphoma (FL) is the most common indolent B-cell lymphoma and originates from germinal center B-cells (centrocytes and centroblasts) of the lymphoid follicle. Tumorigenesis is believed to initiate early in precursor B-cells in the bone marrow (BM) that acquire the t(14;18)(q32;q21). These cells later migrate to lymph nodes to continue their maturation through the germinal center reaction, at which time they acquire additional genetic and epigeneticabnormalities that promote lymphomagenesis. FLs are heterogeneous in terms of their clinicopathologic features. Most FLs are indolent and clinically characterized by peripheral lymphadenopathy with involvement of the spleen, BM, and peripheral blood in a substantial subset of patients, sometimes accompanied by constitutional symptoms and laboratory abnormalities. Diagnosis is established by the histopathologic identification of a B-cell proliferation usually distributed in an at least partially follicular pattern, typically, but not always, in a lymph node biopsy. The B-cell proliferation is biologically of germinal center cell origin, thus shows an expression of germinal center-associated antigens as detected by immunophenotyping. Although many cases of FLs are typical and histopathologic features are straightforward, the biologic and histopathologic variability of FL is wide, and an accurate diagnosis of FL over this disease spectrum requires knowledge of morphologic variants that can mimic other lymphomas, and rarely non-hematologic malignancies, clinically unique variants, and pitfalls in the interpretation of ancillary studies. The overall survival for most patients is prolonged, but relapses are frequent. The treatment landscape in FL now includes the application of immunotherapy and targeted therapy in addition to chemotherapy.

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Case Study

Composite follicular lymphoma and classic Hodgkin lymphoma: Han-Na Kim, Min Ji Jeon, Eun Sang Yu, Dae Sik Kim, Chul-Won Choi, Young Hyeh Ko; J Pathol Transl Med. 2022;56(1):57-60. Published online November 16, 2021; DOI: https://doi.org/10.4132/jptm.2021.10.09

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Abstract PDF

Composite lymphoma is very rare and a combination of Hodgkin lymphoma and non-Hodgkin lymphoma and even histiocytic tumors can occur. Because of the unfamiliarity, not only can this cause diagnostic problems, but can also affect treatment plan. We report a case of composite lymphoma in a 40-year-old male. Initial biopsy showed a composite lymphoma of follicular lymphoma grade 1 and classic Hodgkin lymphoma. After chemotherapy, another lymph node was taken because of disease progression, which revealed follicular lymphoma, grade 3a without Hodgkin lymphoma component.

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T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy
Guido Ghilardi, Joseph A. Fraietta, James N. Gerson, Vivianna M. Van Deerlin, Jennifer J. D. Morrissette, Gabriel C. Caponetti, Luca Paruzzo, Jaryse C. Harris, Elise A. Chong, Sandra P. Susanibar Adaniya, Jakub Svoboda, Sunita D. Nasta, Ositadimma H. Ugwu
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Composite Lymphoma with Follicular Lymphoma Transformation to Clonally Related Epstein–Barr Virus (EBV) Positive Diffuse Large B-Cell Lymphoma and EBV-PositiveClassic Hodgkin Lymphoma
Christopher B. Ryder, Hayder Saeed, Mohammad Hussaini, Pier Paolo Piccaluga
Case Reports in Hematology.2023; 2023: 1. CrossRef
Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review
Alexis Trecourt, Marie Donzel, Juliette Fontaine, Hervé Ghesquières, Laurent Jallade, Gabriel Antherieu, Camille Laurent, Claire Mauduit, Alexsandra Traverse-Glehen
Cancers.2022; 14(22): 5695. CrossRef

Original Article

Upward trend in follicular lymphoma among the Korean population: 10-year experience at a large tertiary institution: Meejeong Kim, Hee Sang Hwang, Hyungwoo Cho, Dok Hyun Yoon, Cheolwon Suh, Chan Sik Park, Heounjeong Go, Jooryung Huh; J Pathol Transl Med. 2021;55(5):330-337. Published online September 2, 2021; DOI: https://doi.org/10.4132/jptm.2021.07.25

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Abstract PDF Supplementary Material

Background
Follicular lymphoma (FL) is the second most common non-Hodgkin lymphoma (NHL) in Western countries. However, it is relatively rare in Asia. This study examined epidemiologic characteristics of FL in South Korea, with an emphasis on recent trends of increase in cases.
Methods
We retrospectively examined 239 cases of newly diagnosed FL at a large tertiary institution in Korea (Asan Medical Center, Seoul, Republic of Korea) between 2008 and 2017. Age-adjusted incidence rates and clinicopathological variables were analyzed, and joinpoint regression analysis was used to identify the changes.
Results
The age-adjusted incidence of FL significantly increased during the study period (p = .034), and the ratio of (relative incidence) patients with FL to patients with NHL increased from 4.28% to 9.35% in the same period. Over the 10-year study assessment duration, the proportion of patients with stage III/IV FL (p = .035) and expression of BCL2 (p = .022) or BCL6 (p = .039) significantly increased. From 2013–2017, the proportion of patients with highrisk Follicular Lymphoma International Prognostic Index (FLIPI) score increased (21.5% to 28.7%), whereas that of low-risk FLIPI decreased (55.4% to 38.6%), although those results were not statistically significant (p = .066).
Conclusions
We found an increasing incidence of FL, with a disproportionate increase in the incidence of high-stage disease and recent changes in the clinicopathologic features of the Korean patient population.

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Incidence Trend of Follicular Lymphoma in Taiwan Compared to Japan and Korea, 2001–2019
Liang-Chun Chiu, Chih-Wen Lin, Hung-Ju Li, Jian-Han Chen, Fu-Cheng Chuang, Sheng-Fung Lin, Yu Chang, Yu-Chieh Su
Journal of Clinical Medicine.2023; 12(4): 1417. CrossRef
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Kyung-dug Park, Jisoo Kim, Yoona Oh, Beom-Jin Jeong, Yu-jin Jung, Sunhwi Bang
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Case Study

Morphologic variant of follicular lymphoma reminiscent of hyaline-vascular Castleman disease: Jiwon Koh, Yoon Kyung Jeon; J Pathol Transl Med. 2020;54(3):253-257. Published online February 5, 2020; DOI: https://doi.org/10.4132/jptm.2019.12.17

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Abstract PDF

Follicular lymphoma (FL) with hyaline-vascular Castleman disease (FL-HVCD)-like features is a rare morphologic variant, with fewer than 20 cases in the literature. Herein, we report a case of FL-HVCD in a 37-year-old female who presented with isolated neck lymph node enlargement. The excised lymph node showed features reminiscent of HVCD, including regressed germinal centers (GCs) surrounded by onion skin-like mantle zones, lollipop lesions composed of hyalinized blood vessels penetrating into regressed GCs, and hyalinized interfollicular stroma. In addition, focal areas of abnormally conglomerated GCs composed of homogeneous, small centrocytes with strong BCL2, CD10, and BCL6 expression were observed, indicating partial involvement of the FL. Several other lymphoid follicles showed features of in situ follicular neoplasia. Based on the observations, a diagnosis of FL-HVCD was made. Although FLHVCD is very rare, the possibility of this variant should be considered in cases resembling CD. Identification of abnormal, neoplastic follicles and ancillary immunostaining are helpful for proper diagnosis.

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Original Articles

A Multi-institutional Study of Prevalence and Clinicopathologic Features of Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) in Korea: Ja Yeong Seo, Ji Hyun Park, Ju Yeon Pyo, Yoon Jin Cha, Chan Kwon Jung, Dong Eun Song, Jeong Ja Kwak, So Yeon Park, Hee Young Na, Jang-Hee Kim, Jae Yeon Seok, Hee Sung Kim, Soon Won Hong; J Pathol Transl Med. 2019;53(6):378-385. Published online October 21, 2019; DOI: https://doi.org/10.4132/jptm.2019.09.18

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Abstract PDF

Background
In the present multi-institutional study, the prevalence and clinicopathologic characteristics of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) were evaluated among Korean patients who underwent thyroidectomy for papillary thyroid carcinoma (PTC).
Methods
Data from 18,819 patients with PTC from eight university hospitals between January 2012 and February 2018 were retrospectively evaluated. Pathology reports of all PTCs and slides of potential NIFTP cases were reviewed. The strict criterion of no papillae was applied for the diagnosis of NIFTP. Due to assumptions regarding misclassification of NIFTP as non-PTC tumors, the lower boundary of NIFTP prevalence among PTCs was estimated. Mutational analysis for BRAF and three RAS isoforms was performed in 27 randomly selected NIFTP cases.
Results
The prevalence of NIFTP was 1.3% (238/18,819) of all PTCs when the same histologic criteria were applied for NIFTP regardless of the tumor size but decreased to 0.8% (152/18,819) when tumors ≥1 cm in size were included. The mean follow-up was 37.7 months and no patient with NIFTP had evidence of lymph node metastasis, distant metastasis, or disease recurrence during the follow-up period. A difference in prevalence of NIFTP before and after NIFTP introduction was not observed. BRAF^V600E mutation was not found in NIFTP. The mutation rate for the three RAS genes was 55.6% (15/27).
Conclusions
The low prevalence and indolent clinical outcome of NIFTP in Korea was confirmed using the largest number of cases to date. The introduction of NIFTP may have a small overall impact in Korean practice.

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Analysis of a pre-2017 follicular variant papillary thyroid carcinoma cohort reclassified as noninvasive follicular thyroid neoplasm with papillary-like features (NIFTP): an 11-year retrospective single institution experience
Shaham Beg, Sana Irfan Khan, Isabella Cui, Theresa Scognamiglio, Rema Rao
Journal of the American Society of Cytopathology.2023; 12(2): 112. CrossRef
Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features: What a Surgeon Should Know
Jabir Alharbi, Thamer Alraddadi, Haneen Sebeih, Mohammad A Alessa, Haddad H Alkaf, Ahmed Bahaj, Sherif K Abdelmonim
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A Comprehensive Study on the Diagnosis and Management of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features
Bayan A. Alzumaili, Lauren N. Krumeich, Reagan Collins, Timothy Kravchenko, Emad I. Ababneh, Adam S. Fisch, William C. Faquin, Vania Nosé, Maria Martinez-Lage, Gregory W. Randolph, Rajshri M. Gartland, Carrie C. Lubitz, Peter M. Sadow
Thyroid.2023; 33(5): 566. CrossRef
Clinical-Pathological and Molecular Evaluation of 451 NIFTP Patients from a Single Referral Center
Paola Vignali, Agnese Proietti, Elisabetta Macerola, Anello Marcello Poma, Liborio Torregrossa, Clara Ugolini, Alessio Basolo, Antonio Matrone, Teresa Rago, Ferruccio Santini, Rossella Elisei, Gabriele Materazzi, Fulvio Basolo
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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: its updated diagnostic criteria, preoperative cytologic diagnoses and impact on the risk of malignancy
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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is rare, benign lesion using modified stringent diagnostic criteria: Reclassification and outcome study
David Cubero Rego, Hwajeong Lee, Anne Boguniewicz, Timothy A. Jennings
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Cytologic Diagnosis of Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features and Its Impact on the Risk of Malignancy in the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience: Milim Kim, Joung Eun Kim, Hyun Jeong Kim, Yul Ri Chung, Yoonjin Kwak, So Yeon Park; J Pathol Transl Med. 2018;52(3):171-178. Published online April 3, 2018; DOI: https://doi.org/10.4132/jptm.2018.04.03

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Abstract PDF

Background
This study was performed to analyze cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and its impact on the risk of malignancy (ROM) in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).
Methods
Five thousand five hundred and forty-nine cases of thyroid fine-needle aspiration cytology (FNAC) diagnosed between 2012 and 2014 were included in this study. Diagnostic categories based on TBSRTC were compared with final surgical diagnoses, and the ROM in each category was calculated both when NIFTP was included in malignant lesions and when excluded from malignant lesions.
Results
Of the 5,549 thyroid FNAC cases, 1,891 cases underwent surgical resection. In final diagnosis, 1,700 cases were revealed as papillary thyroid carcinoma (PTC), and 25 cases were reclassified as NIFTP. The cytologic diagnoses of NIFTP were non-diagnostic in one, benign in five, atypia of undetermined significance (AUS) in 14, follicular neoplasm in two, and suspicious for malignancy in three cases. Collectively, NIFTP/encapsulated follicular variant of PTC (EFVPTC) were more frequently classified as benign, AUS, or follicular neoplasm and less frequently categorized as malignant compared to conventional PTCs. Exclusion of NIFTP from malignant diagnoses resulted in a slight decrease in malignancy rates in non-diagnostic, benign, AUS, follicular neoplasm, and suspicious for malignancy categories without any statistical significance.
Conclusions
The decrease in the ROM was not significant when NIFTP was excluded from malignant lesions. In thyroid FNACs, NIFTP/EFVPTCs were mostly classified into indeterminate categories. Therefore, it might be feasible to separate NIFTP/EFVPTC from conventional PTC on FNAC to guide clinicians to conservative management for patients with NIFTP/EFVPTC.

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The importance of risk of neoplasm as an outcome in cytologic‐histologic correlation studies on thyroid fine needle aspiration
Yu‐Hsin Chen, Kristen L. Partyka, Rae Dougherty, Harvey M. Cramer, Howard H. Wu
Diagnostic Cytopathology.2020; 48(12): 1237. CrossRef
Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
PLOS ONE.2020; 15(11): e0241597. CrossRef
How is noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) shaping the way we interpret thyroid cytology?
Michiya Nishino
Journal of the American Society of Cytopathology.2019; 8(1): 1. CrossRef
Cytological Diagnoses Associated with Noninvasive Follicular Thyroid Neoplasms with Papillary-Like Nuclear Features According to the Bethesda System for Reporting Thyroid Cytopathology: A Systematic Review and Meta-Analysis
Massimo Bongiovanni, Luca Giovanella, Francesco Romanelli, Pierpaolo Trimboli
Thyroid.2019; 29(2): 222. CrossRef
Preoperative Diagnostic Categories of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Thyroid Core Needle Biopsy and Its Impact on Risk of Malignancy
Hee Young Na, Ji Won Woo, Jae Hoon Moon, June Young Choi, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park
Endocrine Pathology.2019; 30(4): 329. CrossRef
Papillary Thyroid Microcarcinoma: Reclassification to Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP): a Retrospective Clinicopathologic Study
Khurram Shafique, Virginia A. LiVolsi, Kathleen Montone, Zubair W. Baloch
Endocrine Pathology.2018; 29(4): 339. CrossRef

Cytological Features That Differentiate Follicular Neoplasm from Mimicking Lesions: Kanghee Han, Hwa-Jeong Ha, Joon Seog Kong, Jung-Soon Kim, Jae Kyung Myung, Jae Soo Koh, Sunhoo Park, Myung-Soon Shin, Woo-Tack Song, Hye Sil Seol, Seung-Sook Lee; J Pathol Transl Med. 2018;52(2):110-120. Published online January 29, 2018; DOI: https://doi.org/10.4132/jptm.2018.01.17

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Abstract PDF

Background
It is difficult to correctly diagnose follicular neoplasms (FNs) on fine-needle aspiration cytology (FNAC) because it shares many cytological features with other mimicking lesions. The aim of this study was to identify the cytological features that differentiate FNs from mimicking lesions.
Methods
We included the cytological slides from 116 cases of thyroid FN diagnosed on FNAC, and included their subsequent histological diagnoses. We evaluated the cytological architectural pattern and nuclear features of the lesions according to their histological groups.
Results
The final histological diagnoses of the 116 cases varied, and included 51 FNs (44%), 47 papillary thyroid carcinomas (40%) including follicular variant, and seventeen cellular nodular hyperplasias (15%). Regardless of the final histological diagnosis, microfollicular pattern was observed in most cases. On the other hand, trabecular pattern was identified in 34% of FNs, but not in any other lesions. Additionally, elongated nuclei and ground glass chromatin were found in only some papillary thyroid carcinomas.
Conclusions
This study shows that the trabecular pattern is a representative cytological feature of FNs that can be used to distinguish FNs from mimicking lesions. In addition, nuclear shape and chromatin pattern can be used to further confirm the diagnosis of FNs from mimicking lesions through FNAC.

Citations

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Diagnostic implication of thyroid spherules for cytological diagnosis of thyroid nodules
Heeseung Sohn, Kennichi Kakudo, Chan Kwon Jung
Cytopathology.2024; 35(3): 383. CrossRef
Using Deep Convolutional Neural Networks for Enhanced Ultrasonographic Image Diagnosis of Differentiated Thyroid Cancer
Wai-Kin Chan, Jui-Hung Sun, Miaw-Jene Liou, Yan-Rong Li, Wei-Yu Chou, Feng-Hsuan Liu, Szu-Tah Chen, Syu-Jyun Peng
Biomedicines.2021; 9(12): 1771. CrossRef
The Role of Fine Needle Aspiration Biopsy with Bethesda System in the Evaluation of Thyroid Nodules
Gizem AKKAŞ AKGÜN, Figen ASLAN
Anadolu Kliniği Tıp Bilimleri Dergisi.2021; 26(1): 23. CrossRef
Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
Thyroid.2020; 30(2): 192. CrossRef
Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
PLOS ONE.2020; 15(11): e0241597. CrossRef

The Intraoperative Immunohistochemical Staining of CD56 and CK19 Improves Surgical Decision for Thyroid Follicular Lesions: Ju Yeon Pyo, Sung-eun Choi, Eunah Shin, JaSeung Koo, SoonWon Hong; J Pathol Transl Med. 2017;51(5):463-470. Published online August 2, 2017; DOI: https://doi.org/10.4132/jptm.2017.05.25

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Abstract PDF

Background
When differential diagnosis is difficult in thyroid follicular lesions with overlapping histological features, the immunohistochemical staining can help confirm the diagnosis. We aimed to evaluate the effectiveness of rapid immunohistochemical stains of CD56 and cytokeratin 19 on frozen sections of thyroid follicular lesion and explore the possible gains and limitations of the practice. Methods: Eighty-six nodules of 79 patients whose intraoperative frozen sections were selected as the control group, and 53 nodules of 48 patients whose intraoperative frozen sections were subject to rapid immunohistochemistry were selected as the study group. Results: Five nodules (6%) in the control group were diagnosed as follicular neoplasm and six nodules (7%) were deferred. In the study group, six nodules (11%) were follicular neoplasm and none were deferred. Three nodules (4%) in the control group showed diagnostic discrepancy between the frozen and permanent diagnoses, but none in the study group. The average turnaround time for the frozen diagnosis of the control group was 24 minutes, whereas it was 54 minutes for the study group. Conclusions: Intraoperative rapid immunohistochemical stains significantly decreased the diagnostic discrepancy in this study. Considering the adverse effects of indefinite frozen diagnosis or discrepancy with permanent diagnoses, the intraoperative rapid immunohistochemical stain can help to accurately diagnose and hence provide guidance to surgical treatment.

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High-Contrast Facile Imaging with Target-Directing Fluorescent Molecular Rotors, the N3-Modified Thioflavin T Derivatives
Yuka Kataoka, Hiroto Fujita, Arina Afanaseva, Chioko Nagao, Kenji Mizuguchi, Yuuya Kasahara, Satoshi Obika, Masayasu Kuwahara
Biochemistry.2019; 58(6): 493. CrossRef
The diagnostic value of TROP-2, SLP-2 and CD56 expression in papillary thyroid carcinoma
Xueyang Yang, Yifang Hu, He Shi, Chengzhou Zhang, Zhixiao Wang, Xiaoyun Liu, Huanhuan Chen, Lijuan Zhang, Dai Cui
European Archives of Oto-Rhino-Laryngology.2018; 275(8): 2127. CrossRef

Case Study

Thymoma and Synchronous Primary Mediastinal Seminomas with Florid Follicular Lymphoid Hyperplasia in the Anterior Mediastinum: A Case Report and Review of the Literature: Hyang-im Lee, In-seok Jang, Kyung Nyeo Jeon, Gyung Hyuck Ko, Jong Sil Lee, Dong Chul Kim, Dae Hyun Song, Jeong-Hee Lee; J Pathol Transl Med. 2017;51(2):165-170. Published online February 2, 2017; DOI: https://doi.org/10.4132/jptm.2016.08.24

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Abstract PDF

Thymoma is the most common neoplasm of the anterior mediastinum and has malignant potential. Germ cell tumors (GCTs) found in the anterior mediastinum are usually benign, and malignant GCTs, such as seminomas, are rare. Histologically, mediastinal seminoma is indistinguishable from testicular seminoma except for site-associated morphological features such as lymphoid follicular hyperplasia. Therefore, excluding metastasis is very important. Recently, we treated a young adult patient with multiple thymic masses that occurred simultaneously. The patient underwent a thymectomy for the removal of the mediastinal masses, one of which was diagnosed as type B2 invasive thymoma, and two of which were diagnosed as primary mediastinal seminomas with massive follicular hyperplasia. The patient received adjuvant chemotherapy after surgical resection. To our knowledge, this is the first description of a thymoma and a mediastinal seminoma occurring simultaneously in the thymus. We present this case along with a literature review.

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Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges
Alexander Fichtner, Alexander Marx, Philipp Ströbel, Felix Bremmer
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Combined Thymic Epithelial Neoplasms – a Review
Annikka Weissferdt
International Journal of Surgical Pathology.2023; 31(6): 917. CrossRef
Primary mediastinal seminoma presenting with paraneoplastic anti-Hu encephalitis: a case report and literature review
Chelsey M. Williams, Derek B. Allison, Adam B. Coleman, Roshmita Bardhan, Jordan D. Miller, Zin W. Myint
Frontiers in Oncology.2023;[Epub] CrossRef
Primary mediastinal seminoma with florid follicular lymphoid hyperplasia: a case report and review of the literature
Charlotte Holmes, Peh Sun Loo, Sion Barnard
Diagnostic Pathology.2021;[Epub] CrossRef

Original Articles

Core Needle Biopsy Is a More Conclusive Follow-up Method Than Repeat Fine Needle Aspiration for Thyroid Nodules with Initially Inconclusive Results: A Systematic Review and Meta-Analysis: Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang; J Pathol Transl Med. 2016;50(3):217-224. Published online April 14, 2016; DOI: https://doi.org/10.4132/jptm.2016.02.15

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Abstract PDF

Background
This study investigated the appropriate management of thyroid nodules with prior non-diagnostic or atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) through a systematic review and meta-analysis.
Methods
This study included 4,235 thyroid nodules from 26 eligible studies. We investigated the conclusive rate of follow-up core needle biopsy (CNB) or repeat fine needle aspiration (rFNA) after initial fine needle aspiration (FNA) with non-diagnostic or AUS/FLUS results. A diagnostic test accuracy (DTA) review was performed to determine the diagnostic role of the follow-up CNB and to calculate the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve.
Results
The conclusive rates of follow-up CNB and rFNA after initial FNA were 0.879 (95% confidence interval [CI], 0.801 to 0.929) and 0.684 (95% CI, 0.627 to 0.736), respectively. In comparison of the odds ratios of CNB and rFNA, CNB had more frequent conclusive results than rFNA (odds ratio, 5.707; 95% CI, 2.530 to 12.875). Upon subgroup analysis, follow-up CNB showed a higher conclusive rate than rFNA in both initial non-diagnostic and AUS/FLUS subgroups. In DTA review of followup CNB, the pooled sensitivity and specificity were 0.94 (95% CI, 0.88 to 0.97) and 0.88 (95% CI, 0.84 to 0.91), respectively. The AUC for the SROC curve was 0.981, nearing 1.
Conclusions
Our results show that CNB has a higher conclusive rate than rFNA when the initial FNA produced inconclusive results. Further prospective studies with more detailed criteria are necessary before follow-up CNB can be applied in daily practice.

Citations

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Fine Needle Aspiration Cytology vs. Core Needle Biopsy for Thyroid Nodules: A Prospective, Experimental Study Using Surgical Specimen
Hyuk Kwon, Jandee Lee, Soon Won Hong, Hyeong Ju Kwon, Jin Young Kwak, Jung Hyun Yoon
Journal of the Korean Society of Radiology.2022; 83(3): 645. CrossRef
Comparison of Core Needle Biopsy and Repeat Fine-Needle Aspiration in Avoiding Diagnostic Surgery for Thyroid Nodules Initially Diagnosed as Atypia/Follicular Lesion of Undetermined Significance
Leehi Joo, Dong Gyu Na, Ji-hoon Kim, Hyobin Seo
Korean Journal of Radiology.2022; 23(2): 280. CrossRef
Diagnostic performance of core needle biopsy as a first‐line diagnostic tool for thyroid nodules according to ultrasound patterns: Comparison with fine needle aspiration using propensity score matching analysis
Hye Shin Ahn, Inyoung Youn, Dong Gyu Na, Soo Jin Kim, Mi Yeon Lee
Clinical Endocrinology.2021; 94(3): 494. CrossRef
Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors
Soon-Hyun Ahn
Clinical and Experimental Otorhinolaryngology.2021; 14(1): 116. CrossRef
2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations
Eun Ju Ha, Sae Rom Chung, Dong Gyu Na, Hye Shin Ahn, Jin Chung, Ji Ye Lee, Jeong Seon Park, Roh-Eul Yoo, Jung Hwan Baek, Sun Mi Baek, Seong Whi Cho, Yoon Jung Choi, Soo Yeon Hahn, So Lyung Jung, Ji-hoon Kim, Seul Kee Kim, Soo Jin Kim, Chang Yoon Lee, Ho K
Korean Journal of Radiology.2021; 22(12): 2094. CrossRef
Malignancy rate of Bethesda category III thyroid nodules according to ultrasound risk stratification system and cytological subtype
Won Sang Yoo, Hwa Young Ahn, Hye Shin Ahn, Yun Jae Chung, Hee Sung Kim, Bo Youn Cho, Mirinae Seo, Jae Hoon Moon, Young Joo Park
Medicine.2020; 99(2): e18780. CrossRef
2019 Practice guidelines for thyroid core needle biopsy: a report of the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association
Chan Kwon Jung, Jung Hwan Baek, Dong Gyu Na, Young Lyun Oh, Ka Hee Yi, Ho-Cheol Kang
Journal of Pathology and Translational Medicine.2020; 54(1): 64. CrossRef
Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial)
Roberto Cesareo, Claudio Maurizio Pacella, Valerio Pasqualini, Giuseppe Campagna, Mario Iozzino, Andrea Gallo, Angelo Lauria Pantano, Roberto Cianni, Claudio Pedone, Paolo Pozzilli, Chiara Taffon, Anna Crescenzi, Silvia Manfrini, Andrea Palermo
Thyroid.2020; 30(6): 847. CrossRef
Diagnostic Efficacy and Safety of Core Needle Biopsy as a First-Line Diagnostic Method for Thyroid Nodules: A Prospective Cohort Study
Min Ji Hong, Dong Gyu Na, Hunkyung Lee
Thyroid.2020; 30(8): 1141. CrossRef
Is thyroid core needle biopsy a valid compliment to fine-needle aspiration?
Liron Pantanowitz, Lester D.R. Thompson, Xin Jing, Esther Diana Rossi
Journal of the American Society of Cytopathology.2020; 9(5): 383. CrossRef
A Monocentric Retrospective Study about the Correlation between Histology and Cytology of Thyroid Indeterminate Nodules Classified as TIR 3A and TIR 3B, according to 2014 Italian Consensus for Classification and Reporting of Thyroid Cytology
Francesco Quaglino, Giulia Arnulfo, Sergio Sandrucci, Claudio Rossi, Valentina Marchese, Roberto Saracco, Stefano Guzzetti, Stefano Taraglio, Enrico Mazza
Advances in Medicine.2019; 2019: 1. CrossRef
Nuclear features of papillary thyroid carcinoma: Comparison of Core needle biopsy and thyroidectomy specimens
Jae Yeon Seok, Jungsuk An, Hyun Yee Cho, Younghye Kim, Seung Yeon Ha
Annals of Diagnostic Pathology.2018; 32: 35. CrossRef
Statement and Recommendations on Interventional Ultrasound as a Thyroid Diagnostic and Treatment Procedure
Christoph F. Dietrich, Thomas Müller, Jörg Bojunga, Yi Dong, Giovanni Mauri, Maija Radzina, Manjiri Dighe, Xin-Wu Cui, Frank Grünwald, Andreas Schuler, Andre Ignee, Huedayi Korkusuz
Ultrasound in Medicine & Biology.2018; 44(1): 14. CrossRef
Role of core needle biopsy as a first-line diagnostic tool for thyroid nodules: a retrospective cohort study
Min Ji Hong, Dong Gyu Na, Soo Jin Kim, Dae Sik Kim
Ultrasonography.2018; 37(3): 244. CrossRef
Core Needle Biopsy of the Thyroid: 2016 Consensus Statement and Recommendations from Korean Society of Thyroid Radiology
Dong Gyu Na, Jung Hwan Baek, So Lyung Jung, Ji-hoon Kim, Jin Yong Sung, Kyu Sun Kim, Jeong Hyun Lee, Jung Hee Shin, Yoon Jung Choi, Eun Ju Ha, Hyun Kyung Lim, Soo Jin Kim, Soo Yeon Hahn, Kwang Hwi Lee, Young Jun Choi, Inyoung Youn, Young Joong Kim, Hye Sh
Korean Journal of Radiology.2017; 18(1): 217. CrossRef
Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors
In Hye Chae, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Y. Park, Jin Young Kwak
Endocrine.2017; 57(1): 108. CrossRef
The Role of Core Needle Biopsy for Thyroid Nodules with Initially Indeterminate Results on Previous Fine-Needle Aspiration: A Systematic Review and Meta-Analysis
C.H. Suh, J.H. Baek, C. Park, Y.J. Choi, J.H. Lee
American Journal of Neuroradiology.2017; 38(7): 1421. CrossRef

Smad1 Expression in Follicular Lymphoma: Jai Hyang Go; J Pathol Transl Med. 2015;49(3):243-248. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.30

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Abstract PDF: Background
Follicular lymphomas present with various immunohistologic patterns. The immunohistochemical markers used in the diagnosis of follicular lymphoma show variable degrees of sensitivity and specificity, and thus, additional germinal center markers are required. Smad1 has been reported to be overexpressed in follicular lymphoma, but little is known regarding the expression patterns of Smad proteins in human lymphoid tissue. Methods: In the present study, we performed immunohistochemistry for traditional germinal center markers and for Smad1 in human reactive lymphoid and follicular lymphoma tissues to investigate Smad1’s usefulness in the diagnosis of follicular lymphoma. Results: In the reactive germinal centers, most cells were positive for Smad1. Among the 27 follicular lymphoma cases, 17 of 21 (80%) were Smad1 positive, 17 of 27 (63%) were positive for CD10, and 23 of 27 (85%) were positive for Bcl6. Notably, three cases expressed CD10 only, and one only expressed Bcl6. All these cases were grade 3 tumors and showed follicular and diffuse growth patterns. Conclusions: These results indicate that Smad1 is a candidate as a germinal center marker. Furthermore, they suggest that the Smad signaling pathway might be involved in follicular lymphoma.

Case Study

Follicular Proliferative Lesion Arising in Struma Ovarii: Min Jee Park, Min A Kim, Mi Kyung Shin, Hye Sook Min; J Pathol Transl Med. 2015;49(3):262-266. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.26

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Abstract PDF

Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibit-ed solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as “proliferative stromal ovarii” or “follicular proliferative lesion arising in the stromal ovarii” would be appropriate.

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Role of gene sequencing in classifying struma ovarii: BRAF p.G469A mutation and TERT promoter alterations favour malignant struma ovarii
Sophie Neyrand, Alexis Trecourt, Jonathan Lopez, Pierre Alexandre Just, Françoise Descotes, Françoise Borson‐Chazot, Isabelle Ray‐Coquard, Myriam Decaussin‐Petrucci, Mojgan Devouassoux‐Shisheboran
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Malignant struma ovarii: next-generation sequencing of six cases revealed Nras, Braf, and Jak3 mutations
Roberta Poli, Maria Scatolini, Enrico Grosso, Francesca Maletta, Marco Gallo, Daniele Liscia, Anna Nelva, Flora Cesario, Giuseppe Forte, Jasna Metovic, Marco Volante, Emanuela Arvat, Mauro Papotti
Endocrine.2021; 71(1): 216. CrossRef
Proliferative struma ovarii: A rare case report
Shankhanila Mazumdar, GaganKumar Rangari, Neeraj Dhameja, NishaRani Agrawal
International Journal of Clinicopathological Correlation.2021; 5(2): 85. CrossRef
Malignant struma ovarii presenting with follicular carcinoma: A case report with molecular analysis
Takafumi Tsukada, Hiroshi Yoshida, Mitsuya Ishikawa, Yuka Asami, Kouya Shiraishi, Tomoyasu Kato
Gynecologic Oncology Reports.2019; 30: 100498. CrossRef
A Rare Case: Struma Ovarii in a 14-Year-Old Girl
Elif Iltar, Isin Ureyen, Tayfun Toptas, Melike Savas, Sema Çekiç, Aysel Uysal
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Natalie M. Liu, Neda Moatamed, Racquel S. Bueno, Wendy L. Sacks
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