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Incidence, malignancy rates of diagnoses and cyto-histological correlations in the new Italian Reporting System for Thyroid Cytology: An institutional experience.

Incidence, malignancy rates of diagnoses and cyto-histological correlations in the new Italian Reporting System for Thyroid Cytology: An institutional experience.
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Straccia P, Santoro A, Rossi ED, Brunelli C, Mosseri C, Musarra T, Pontecorvi A, Lombardi CP, Fadda G,


Straccia P, Santoro A, Rossi ED, Brunelli C, Mosseri C, Musarra T, Pontecorvi A, Lombardi CP, Fadda G, (click to view)

Straccia P, Santoro A, Rossi ED, Brunelli C, Mosseri C, Musarra T, Pontecorvi A, Lombardi CP, Fadda G,

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Cytopathology : official journal of the British Society for Clinical Cytology 2017 09 1528(6) 503-508 doi 10.1111/cyt.12455

Abstract
OBJECTIVE
FNA biopsy is considered as the most accurate method for the selection of patients with thyroid nodules that need for surgery or for the wait and see management. The aim of the present study is to clarify the risk of malignancy for the cytological data classified according to the 2014 Italian reporting system.

METHODS
We report a retrospective analysis of 4043 patients in our institution’s experience during the period April 2014 through December 2016 with the Italian reporting system for thyroid cytology.

RESULTS
The diagnostic incidences of the 4043 cases were as follows: 9.8% TIR1; 1.3% TIR1C; 70% TIR2; 6.6% TIR3A; 4.5% TIR3B; 2.4% TIR4; 5.2% TIR5. A repeated aspiration was carried out in 68 out of 269 cases (25%) classified as TIR3A. A total of 407 cases with cytology underwent surgical resection. A malignant neoplasm was detected in 261 out of 407 (64%) cases. Regarding TIR3B, surgical excision was undertaken in 109 cases, which included 42 high-risk lesions and 67 Hürthle cell neoplasms. The risk of malignancy was significantly higher in the former compared to the latter (50% vs 9%; P<.05). CONCLUSIONS
This investigation emphasises the reliability of the 2014 Italian Reporting System concerning the mutual frequency of the diagnostic categories. The risk of malignancy is perfectly within the range of the estimated values.

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