Research Papers: Gerotarget (Focus on Aging):
The role of fine-needle aspiration in the thyroid nodules of elderly patients
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Esther Diana Rossi1,*, Tommaso Bizzarro1,*, Maurizio Martini1, Patrizia Straccia1, Celestino Pio Lombardi2, Alfredo Pontecorvi3, Luigi Maria Larocca1,** and Guido Fadda1,**
1 Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
2 Division of Endocrine Surgery, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
3 Division of Endocrinology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
* These authors have contributed equally to this work
** These authors share the seniorship
Esther Diana Rossi, email:
Keywords: elderly patients, thyroid lesions, malignancies, liquid based cytology, immunocytochemistry, Gerotarget
Received: December 16, 2015 Accepted: January 30, 2016 Published: February 23, 2016
We assess the role of thyroid fine needle aspiration cytology(FNAC) in our series of elderly patients. The growing subset of people aged older than 70 years has shown an increased incidence of thyroid diseases which need to be studied in order to reduce the percentage of surgical treatments in patients with higher likelihood of co-morbidities and associated life risk. We compared Follicular/Indeterminate Neoplasms(FN) and suspicious of malignancy(SM) with pediatric and adult cohorts. We discussed the role of immunocytochemistry-ICC to refine diagnoses. Four hundred and eighty out of 3539FNACs(13.5%) in elderly patients, were surgical followed-up. They included: 35Inadequate, 188benign(BL), 164FN/AUS, 49SM and 44positive for malignancy (PM). All PM and 95.7%BL were histological confirmed. The malignant rate was 24.3% mostly diagnosed as papillary thyroid carcinomas. An ICC panel (HBME-1 and Galectin-3) was carried out on liquid based cytology (LBC) and performed on FN/AUS, SM and PM.We found concordant positive ICC in 69.3%malignancies and concordant negative ICC in 97.6%benign follicular adenomas. Among FNs, 42.9%malignant histologic cases had concordant positivity whilst 97.4%benign histology had negative panel.Thyroid FNAC shows high feasibility in elderly patients. ICC helps in reducing the number of useless thyroidectomies and providing a more adequate clinical and/or surgical selection in elderly patients.
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