Squamous Cells in Thyroid Cytology and Their Clinical Significance: A Multi-Institutional Study.

IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Diagnostic Cytopathology Pub Date : 2024-11-14 DOI:10.1002/dc.25421
Brian A Pedro, Iiris Harjunpää, Eric Young, Leili Mirsadraei, Ivana Kholová, Zahra Maleki
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Abstract

Background: Squamous cells are uncommon in thyroid fine needle aspirations (FNAs) presenting diagnostic challenges. We report our multi-institutional experience.

Materials and method: The electronic data were searched for thyroid FNAs containing squamous cells at the Johns Hopkins Medicine, New York University Langone Hospital, United States, and Fimlab Laboratories, Finland (2001-2023). The patients' demographics, clinical history, and pathologic diagnosis were recorded.

Results: One hundred and seven cases (103 patients) were identified 35 males and 68 females (median age 58 years). Forty-eight cases (44.9%) were malignant, primary carcinomas with squamous features, such as anaplastic thyroid carcinoma (ATC), and metastatic or directly invasive squamous cell carcinomas (SqCC) including oral, oropharyngeal (HPV-related), esophageal, and laryngeal SqCC. Twenty-seven cases (25.2%) contained benign squamous cells with cystic background, suggestive of developmental cysts. Nineteen cases (17.8%) contained metaplastic benign squamous cells within an adenomatoid nodule. Seven cases (6.5%) contained atypical squamous cells. Four cases (3.7%) showed squamous cells with bacterial or fungal organisms, suggestive of esophageal fistula/diverticulum, and two cases (1.9%) contained benign squamous cells with unknown source. Thirty-six cases had surgical follow-up, 33 (91.7%) were concordant (23 metastatic or directly invasive SqCC, 8 undifferentiated/ATC, and 10 papillary thyroid carcinoma). Ancillary studies were used confirming HPV-related SqCC, or therapeutic targets (BRAF V600E), with highly variable staining in ATC.

Conclusion: Squamous cells in thyroid FNAs carry a broad differential diagnosis with variable prognoses. It is crucial to interpret squamous cells in the context of clinical and radiographic findings for optimal patient care.

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甲状腺细胞学中的鳞状细胞及其临床意义:一项多机构研究
背景:鳞状细胞在甲状腺细针穿刺术(FNA)中并不常见,给诊断带来了挑战。我们报告了我们的多机构经验:搜索了美国约翰霍普金斯医学院、纽约大学朗贡医院和芬兰 Fimlab 实验室(2001-2023 年)含有鳞状细胞的甲状腺 FNA 的电子数据。记录了患者的人口统计学特征、临床病史和病理诊断:共发现 107 个病例(103 名患者),其中男性 35 人,女性 68 人(中位年龄 58 岁)。48例(44.9%)为恶性、具有鳞状特征的原发癌,如甲状腺无节细胞癌(ATC)、转移性或直接浸润性鳞状细胞癌(SqCC),包括口腔、口咽(HPV相关)、食管和喉SqCC。27例(25.2%)良性鳞状细胞伴囊性背景,提示为发育囊肿。19个病例(17.8%)在腺瘤样结节内含有变性良性鳞状细胞。7 个病例(6.5%)含有非典型鳞状细胞。四例(3.7%)的鳞状细胞带有细菌或真菌,提示食管瘘/憩室,两例(1.9%)的良性鳞状细胞来源不明。36例病例接受了手术随访,33例(91.7%)结果一致(23例转移性或直接浸润性SqCC,8例未分化/ATC,10例甲状腺乳头状癌)。辅助研究证实了与HPV相关的SqCC或治疗靶点(BRAF V600E),ATC的染色差异很大:结论:甲状腺FNA中的鳞状细胞具有广泛的鉴别诊断价值,其预后各不相同。结论:甲状腺 FNA 中的鳞状细胞具有广泛的鉴别诊断价值,其预后各不相同。结合临床和影像学检查结果解释鳞状细胞对患者的最佳治疗至关重要。
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来源期刊
Diagnostic Cytopathology
Diagnostic Cytopathology 医学-病理学
CiteScore
2.60
自引率
7.70%
发文量
163
审稿时长
3-6 weeks
期刊介绍: Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.
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Squamous Cells in Thyroid Cytology and Their Clinical Significance: A Multi-Institutional Study.
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