Implications of the proposed thyroid fine-needle aspiration category of "follicular lesion of undetermined significance": A five-year multi-institutional analysis

Lester J. Layfield, M. J. Morton, Harvey Cramer, Sharon Hirschowitz

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124 Citations (Scopus)

Abstract

National Cancer Institute State of the Science Conference on thyroid fine-needle aspiration (FNA) summarized diagnostic terminology. Six diagnostic categories were proposed including "follicular lesion of undetermined significance" (FLUS). FLUS was defined as findings neither convincingly benign nor sufficiently atypical for a diagnosis of "follicular neoplasm" or "suspicious for malignancy." It was proposed that this category represent less than 7% of thyroid FNAs. A search of the cytology records at three University Hospitals was performed for the term FLUS or older equivalent terms. Usage of FLUS was compared between institutions and among pathologists. Surgical pathology outcome for FLUS cases was determined. Twenty-eight pathologists evaluated 6,872 cases at the three institutions. Use of FLUS varied among pathologists (2.5 to 28.6%). Frequency of use of FLUS among institutions varied from 3.3 to 14.9%. FLUS cases [127 of 673 (18.9%)] underwent surgical exploration with malignancy identified in 36 cases (28.3%) undergoing resection. Use of FLUS varied substantially among pathologists and institutions. FLUS category requires more rigorously defined morphologic criteria for it to become a useful guide in clinical management.

Original languageEnglish
Pages (from-to)710-714
Number of pages5
JournalDiagnostic Cytopathology
Volume37
Issue number10
DOIs
StatePublished - Oct 2009

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Fine Needle Biopsy
Thyroid Gland
Neoplasms
Surgical Pathology
National Cancer Institute (U.S.)
Terminology
Cell Biology
Pathologists

Keywords

  • FNA
  • Follicular proliferation
  • Thyroid
  • Undetermined significance

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Implications of the proposed thyroid fine-needle aspiration category of "follicular lesion of undetermined significance" : A five-year multi-institutional analysis. / Layfield, Lester J.; Morton, M. J.; Cramer, Harvey; Hirschowitz, Sharon.

In: Diagnostic Cytopathology, Vol. 37, No. 10, 10.2009, p. 710-714.

Research output: Contribution to journalArticle

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