Abstract

FERREIRA, Rita de Cássia; MORARI, Elaine Cristina  and  WARD, Laura Sterian. Role of nuclear architecture in the management of thyroid carcinoma. Salud(i)Ciencia [online]. 2022, vol.25, n.1, pp.15-22.  Epub Sep 01, 2022. ISSN 1667-8682.  http://dx.doi.org/10.21840/siic/166283.

One of the biggest dilemmas facing a cytopathology slide is the differential diagnosis of follicular thyroid lesions, grouped as follicular pattern lesions, which include goiter, follicular adenoma (FA) and follicular carcinoma (FC), follicular variant of papillary thyroid carcinoma (FVPTC) and non-invasive follicular thyroid neoplasm with papillary like nuclear features (NIFTP). Such lesions share many characteristics, which makes the proper identification of malignant follicular lesions a challenge. The cytology obtained through fine needle aspiration puncture (FNAB) is the most effective standard method for diagnosis in thyroid nodules, but its diagnostic efficacy clearly decreases in lesions of thyroid follicular pattern. Thus, a series of auxiliary tools for diagnosis, such as morphometry and nuclear texture analysis, have been increasingly used in the pathologist's practice, as an objective and reproducible tool. These are techniques, which depend on the incorporation of software to digital image analysis and can add accuracy to classical morphological analysis and immunohistochemistry in the evaluation of follicular pattern lesions. In addition to immunocytochemistry and molecular techniques, morphometry allows the estimation of parameters identified in individual cells and represents a tool that, based on quantitative parameters, translates reliable parameters for objective classification of malignancy. The aim of this study is to review the nuclear characteristics and their role in the diagnosis of follicular thyroid lesions.

Keywords : cytopathology; follicular thyroid lesions; immunocytochemistry; fine needle aspiration puncture.

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