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Atypical de Quervain's thyroiditis diagnosed as atypia of undetermined significance by cytology and suspicious for cancer by Afirma Genomic Sequencing Classifier.
- Source :
-
Diagnostic cytopathology [Diagn Cytopathol] 2021 Aug; Vol. 49 (8), pp. E312-E315. Date of Electronic Publication: 2021 Mar 03. - Publication Year :
- 2021
-
Abstract
- We report a case of atypical de Quervain's thyroiditis diagnosed as atypia of undetermined significance by cytology and suspicious for cancer by Afirma Genomic Sequencing Classifier. A 71-year-old male underwent thyroid ultrasound for goiter and was found to have two American Thyroid Association (ATA) 2015 high-suspicion nodules. The larger, 2.2-cm nodule was biopsied and the cytology showed atypical follicular cells and histiocytes. The Afirma Genomic Sequencing Classifier (detecting mRNA expression profile) result was ''suspicious'' (risk of malignancy ~50%) but Afirma Xpression Atlas (detecting specific mutations) did not find mutations in BRAF V600E, RET/PTC1, or RET/PTC3. The patient saw two endocrine surgeons and two endocrinologists who each recommended hemithyroidectomy. The patient chose to monitor the nodules. A new diagnostic ultrasound performed 3 months after the first one showed that the thyroid was significantly smaller and the previously seen nodules were no longer found. Re-examination of the cellular smears confirmed that the cytological findings were also compatible with de Quervain's thyroiditis. This case illustrates that atypical de Quervain's thyroiditis should be in the differential diagnosis of thyroid nodules for cytologists, radiologists, and clinicians. Furthermore, this case demonstrates that atypical de Quervain's thyroiditis can generate false positive results of molecular tests for indeterminate thyroid nodules.<br /> (© 2021 Wiley Periodicals LLC.)
- Subjects :
- Aged
Cytodiagnosis methods
Gene Expression Profiling
Humans
Male
Mutation
Oncogenes
Thyroid Gland pathology
Thyroid Nodule pathology
Diagnosis, Differential
Thyroid Neoplasms diagnosis
Thyroid Neoplasms genetics
Thyroid Neoplasms pathology
Thyroiditis diagnosis
Thyroiditis genetics
Thyroiditis pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0339
- Volume :
- 49
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Diagnostic cytopathology
- Publication Type :
- Academic Journal
- Accession number :
- 33656790
- Full Text :
- https://doi.org/10.1002/dc.24733