Fine-needle aspiration biopsy of secondary neoplasms of the thyroid gland: A multi-institutional study of 62 cases

Marc Pusztaszeri, He Wang, Edmund S. Cibas, Celeste N. Powers, Massimo Bongiovanni, Syed Z Ali, Kamal K. Khurana, Paul J. Michaels, William C. Faquin

Research output: Contribution to journalArticle

Abstract

BACKGROUND Secondary neoplasms of the thyroid gland (SNTGs) are uncommon, and it is important to recognize them in thyroid fine-needle aspiration biopsy (FNAB). METHODS The authors report a cohort of 62 SNTGs from 7 institutions in the United States and Europe. Patients were identified retrospectively by searching through medical records of the respective institutions. All initial diagnoses were rendered by FNAB. RESULTS SNTGs represented 0.16% of all thyroid FNABs and were more frequent among women (ratio of women to men, 1.2:1.0). The mean patient age was of 59 years (range, 7-84 years), the mean tumor size was 3 cm (range, 0.9-7 cm), and the mean interval from diagnosis of the primary tumor was 45 months (range, 0-156 months). Eighty-seven percent of SNTGs were diagnosed as malignant by FNAB, and there was a specific SNTG diagnosis in 93% of patients. Immunocytochemistry and flow cytometry, which were used in 30% of patients, were useful ancillary studies. Adenocarcinomas (n = 23; 37%) and squamous cell carcinomas (SCCs) (n = 22; 35.5%) represented the majority of SNTGs, followed by lymphoma (n = 5; 8%), melanoma (n = 5; 8%), adenoid cystic carcinoma (n = 3; 5%), and various sarcomas (n = 3; 5%). Adenocarcinomas originated from the kidney (n = 9; 39%), lung (n = 6; 26%), breast (n = 5; 22%), and colon (n = 3; 13%). SCCs originated mostly from the head and neck (n = 13; 59%), followed by lung (n = 3; 13%), esophagus (n = 3; 14%), and unknown primary sites (n = 3; 14%). CONCLUSIONS Adenocarcinomas from the kidney, lung, breast, and colon along with SCCs represent the majority of SNTGs. The current results indicate that FNAB is a sensitive and accurate method for diagnosing SNTG; however, diagnostic difficulties can occur. Knowledge of clinical history and the judicious application of ancillary studies can increase the sensitivity and accuracy of FNAB for detecting SNTGs.

Original languageEnglish (US)
Pages (from-to)19-29
Number of pages11
JournalCancer cytopathology
Volume123
Issue number1
DOIs
StatePublished - Jan 1 2015

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Fine Needle Biopsy
Thyroid Gland
Neoplasms
Squamous Cell Carcinoma
Renal Cell Carcinoma
Colon
Breast
Adenoid Cystic Carcinoma
Lung
Sarcoma
Esophagus
Medical Records
Melanoma
Lymphoma
Flow Cytometry
Adenocarcinoma
Neck
Immunohistochemistry
Head

Keywords

  • adenocarcinoma
  • adenoid cystic carcinoma
  • cytology
  • fine-needle aspiration
  • lymphoma
  • metastasis
  • renal cell carcinoma
  • secondary neoplasm
  • squamous cell carcinoma
  • thyroid

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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Fine-needle aspiration biopsy of secondary neoplasms of the thyroid gland : A multi-institutional study of 62 cases. / Pusztaszeri, Marc; Wang, He; Cibas, Edmund S.; Powers, Celeste N.; Bongiovanni, Massimo; Ali, Syed Z; Khurana, Kamal K.; Michaels, Paul J.; Faquin, William C.

In: Cancer cytopathology, Vol. 123, No. 1, 01.01.2015, p. 19-29.

Research output: Contribution to journalArticle

Pusztaszeri, M, Wang, H, Cibas, ES, Powers, CN, Bongiovanni, M, Ali, SZ, Khurana, KK, Michaels, PJ & Faquin, WC 2015, 'Fine-needle aspiration biopsy of secondary neoplasms of the thyroid gland: A multi-institutional study of 62 cases', Cancer cytopathology, vol. 123, no. 1, pp. 19-29. https://doi.org/10.1002/cncy.21494
Pusztaszeri, Marc ; Wang, He ; Cibas, Edmund S. ; Powers, Celeste N. ; Bongiovanni, Massimo ; Ali, Syed Z ; Khurana, Kamal K. ; Michaels, Paul J. ; Faquin, William C. / Fine-needle aspiration biopsy of secondary neoplasms of the thyroid gland : A multi-institutional study of 62 cases. In: Cancer cytopathology. 2015 ; Vol. 123, No. 1. pp. 19-29.
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abstract = "BACKGROUND Secondary neoplasms of the thyroid gland (SNTGs) are uncommon, and it is important to recognize them in thyroid fine-needle aspiration biopsy (FNAB). METHODS The authors report a cohort of 62 SNTGs from 7 institutions in the United States and Europe. Patients were identified retrospectively by searching through medical records of the respective institutions. All initial diagnoses were rendered by FNAB. RESULTS SNTGs represented 0.16{\%} of all thyroid FNABs and were more frequent among women (ratio of women to men, 1.2:1.0). The mean patient age was of 59 years (range, 7-84 years), the mean tumor size was 3 cm (range, 0.9-7 cm), and the mean interval from diagnosis of the primary tumor was 45 months (range, 0-156 months). Eighty-seven percent of SNTGs were diagnosed as malignant by FNAB, and there was a specific SNTG diagnosis in 93{\%} of patients. Immunocytochemistry and flow cytometry, which were used in 30{\%} of patients, were useful ancillary studies. Adenocarcinomas (n = 23; 37{\%}) and squamous cell carcinomas (SCCs) (n = 22; 35.5{\%}) represented the majority of SNTGs, followed by lymphoma (n = 5; 8{\%}), melanoma (n = 5; 8{\%}), adenoid cystic carcinoma (n = 3; 5{\%}), and various sarcomas (n = 3; 5{\%}). Adenocarcinomas originated from the kidney (n = 9; 39{\%}), lung (n = 6; 26{\%}), breast (n = 5; 22{\%}), and colon (n = 3; 13{\%}). SCCs originated mostly from the head and neck (n = 13; 59{\%}), followed by lung (n = 3; 13{\%}), esophagus (n = 3; 14{\%}), and unknown primary sites (n = 3; 14{\%}). CONCLUSIONS Adenocarcinomas from the kidney, lung, breast, and colon along with SCCs represent the majority of SNTGs. The current results indicate that FNAB is a sensitive and accurate method for diagnosing SNTG; however, diagnostic difficulties can occur. Knowledge of clinical history and the judicious application of ancillary studies can increase the sensitivity and accuracy of FNAB for detecting SNTGs.",
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T1 - Fine-needle aspiration biopsy of secondary neoplasms of the thyroid gland

T2 - A multi-institutional study of 62 cases

AU - Pusztaszeri, Marc

AU - Wang, He

AU - Cibas, Edmund S.

AU - Powers, Celeste N.

AU - Bongiovanni, Massimo

AU - Ali, Syed Z

AU - Khurana, Kamal K.

AU - Michaels, Paul J.

AU - Faquin, William C.

PY - 2015/1/1

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N2 - BACKGROUND Secondary neoplasms of the thyroid gland (SNTGs) are uncommon, and it is important to recognize them in thyroid fine-needle aspiration biopsy (FNAB). METHODS The authors report a cohort of 62 SNTGs from 7 institutions in the United States and Europe. Patients were identified retrospectively by searching through medical records of the respective institutions. All initial diagnoses were rendered by FNAB. RESULTS SNTGs represented 0.16% of all thyroid FNABs and were more frequent among women (ratio of women to men, 1.2:1.0). The mean patient age was of 59 years (range, 7-84 years), the mean tumor size was 3 cm (range, 0.9-7 cm), and the mean interval from diagnosis of the primary tumor was 45 months (range, 0-156 months). Eighty-seven percent of SNTGs were diagnosed as malignant by FNAB, and there was a specific SNTG diagnosis in 93% of patients. Immunocytochemistry and flow cytometry, which were used in 30% of patients, were useful ancillary studies. Adenocarcinomas (n = 23; 37%) and squamous cell carcinomas (SCCs) (n = 22; 35.5%) represented the majority of SNTGs, followed by lymphoma (n = 5; 8%), melanoma (n = 5; 8%), adenoid cystic carcinoma (n = 3; 5%), and various sarcomas (n = 3; 5%). Adenocarcinomas originated from the kidney (n = 9; 39%), lung (n = 6; 26%), breast (n = 5; 22%), and colon (n = 3; 13%). SCCs originated mostly from the head and neck (n = 13; 59%), followed by lung (n = 3; 13%), esophagus (n = 3; 14%), and unknown primary sites (n = 3; 14%). CONCLUSIONS Adenocarcinomas from the kidney, lung, breast, and colon along with SCCs represent the majority of SNTGs. The current results indicate that FNAB is a sensitive and accurate method for diagnosing SNTG; however, diagnostic difficulties can occur. Knowledge of clinical history and the judicious application of ancillary studies can increase the sensitivity and accuracy of FNAB for detecting SNTGs.

AB - BACKGROUND Secondary neoplasms of the thyroid gland (SNTGs) are uncommon, and it is important to recognize them in thyroid fine-needle aspiration biopsy (FNAB). METHODS The authors report a cohort of 62 SNTGs from 7 institutions in the United States and Europe. Patients were identified retrospectively by searching through medical records of the respective institutions. All initial diagnoses were rendered by FNAB. RESULTS SNTGs represented 0.16% of all thyroid FNABs and were more frequent among women (ratio of women to men, 1.2:1.0). The mean patient age was of 59 years (range, 7-84 years), the mean tumor size was 3 cm (range, 0.9-7 cm), and the mean interval from diagnosis of the primary tumor was 45 months (range, 0-156 months). Eighty-seven percent of SNTGs were diagnosed as malignant by FNAB, and there was a specific SNTG diagnosis in 93% of patients. Immunocytochemistry and flow cytometry, which were used in 30% of patients, were useful ancillary studies. Adenocarcinomas (n = 23; 37%) and squamous cell carcinomas (SCCs) (n = 22; 35.5%) represented the majority of SNTGs, followed by lymphoma (n = 5; 8%), melanoma (n = 5; 8%), adenoid cystic carcinoma (n = 3; 5%), and various sarcomas (n = 3; 5%). Adenocarcinomas originated from the kidney (n = 9; 39%), lung (n = 6; 26%), breast (n = 5; 22%), and colon (n = 3; 13%). SCCs originated mostly from the head and neck (n = 13; 59%), followed by lung (n = 3; 13%), esophagus (n = 3; 14%), and unknown primary sites (n = 3; 14%). CONCLUSIONS Adenocarcinomas from the kidney, lung, breast, and colon along with SCCs represent the majority of SNTGs. The current results indicate that FNAB is a sensitive and accurate method for diagnosing SNTG; however, diagnostic difficulties can occur. Knowledge of clinical history and the judicious application of ancillary studies can increase the sensitivity and accuracy of FNAB for detecting SNTGs.

KW - adenocarcinoma

KW - adenoid cystic carcinoma

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KW - fine-needle aspiration

KW - lymphoma

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KW - renal cell carcinoma

KW - secondary neoplasm

KW - squamous cell carcinoma

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