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The Role of Cell Blocks and Immunohistochemistry in Thyroid Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Bethesda Category

Authors
  • Abram, Mikk
  • Huhtamella, Roope
  • Kalfert, David
  • Hakso-Mäkinen, Heli
  • Ludvíková, Marie
  • Kholová, Ivana
Type
Published Article
Journal
Acta Cytologica
Publisher
S. Karger AG
Publication Date
Mar 31, 2021
Volume
65
Issue
3
Pages
257–263
Identifiers
DOI: 10.1159/000514906
PMID: 33789274
Source
Karger
Keywords
Disciplines
  • Techniques
License
Green
External links

Abstract

Introduction: Thyroid cytology is a widely accepted tool in the clinical triaging of nodular lesions. Cell blocks (CBs) can help in the diagnosis of atypical lesions, namely, thyroid Bethesda category of Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS). Methods: In a series of 224 AUS/FLUS thyroid samples with CB, we studied CB cellularity and feasibility of 3 immunohistochemical markers (cytokeratin 19 [CK19], HBME-1, and galectin-3) apart and in combination. Results: The CBs were non-diagnostic in 34 cases. Twenty-four CBs contained <10 cells, 45 CBs 10–50 cells, and 121 CBs >50 cells. Notably, more cellularity was found in CBs performed by plasma-thrombin and in-house techniques (p < 0.001). The diagnostic accuracy to detect malignancy was 65.1% for CK19, 72.1% for HBME-1, and 70.3% for galectin-3. Conclusion: In conclusion, CB cellularity is essential for successful immunohistochemistry application and further diagnostic workup of AUS/FLUS cases.

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