Bethesda System for Reporting Thyroid Cytopathology (eBook)

Preface 5
Contents 6
Contributors 8
Chapter 1 14
Overview of Diagnostic Terminology and Reporting 14
Format of the Report 14
Chapter 2 17
Nondiagnostic/Unsatisfactory 17
Background 17
Definition 18
Criteria for Adequacy 18
Nondiagnostic/Unsatisfactory (Figs. .2.1.–.2.7.) 18
Explanatory Notes 22
Management 24
Sample Reports 25
Example 1 (solid nodule): 25
Example 2 (cystic lesion): 25
Example 3 25
References 25
Chapter 3 27
Benign 27
Benign Follicular Nodule 27
Background 27
Definition 28
Criteria (Figs. .3.1.–.3.13.) 28
Explanatory Notes 33
Graves’ Disease (Figs. .3.15.–.3.18.) 36
Lymphocytic (Hashimoto´s) Thyroiditis (Figs. .3.19.–.3.22.) 39
Background 39
Definition 39
Criteria 39
Granulomatous (subacute, de Quervain´s) Thyroiditis (Fig. .3.23.) 42
Criteria 42
Acute Thyroiditis (Fig. .3.24.) 43
Criteria 43
Riedel´s Thyroiditis/Disease (Fig. .3.25.) 43
Criteria 44
Explanatory Notes 44
Management 45
Sample Reports 46
References 47
Chapter 4 49
Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance 49
Background 49
Definition 49
Criteria (Figs 4.1–4.8) 50
Explanatory Notes 51
Management 58
Sample Reports 58
References 60
Chapter 5 62
Follicular Neoplasm/Suspicious for a Follicular Neoplasm 62
Background 62
Definition 63
Criteria 63
Explanatory Notes 65
Management 68
Sample Reports 68
References 68
Chapter 6 70
Follicular Neoplasm, Hürthle Cell Type/Suspicious for a Follicular Neoplasm, Hürthle Cell Type 70
Background 70
Definition 71
Criteria 71
Explanatory Notes 75
Sample Reports 82
Example 1: 82
Example 2: 82
Example 3: 82
Example 4: 82
Example 5: 82
Example 6: 82
References 83
Chapter 7 85
Suspicious for Malignancy 85
Background 85
Definition 86
Criteria 86
Suspicious for Papillary Carcinoma 86
Pattern A (“Patchy Nuclear Changes Pattern,” Figs. .7.1. and .7.2.) 86
Pattern B (“Incomplete Nuclear Changes Pattern,” Fig. .7.3.) 86
Pattern C (“Sparsely Cellular Specimen Pattern”) 88
Pattern D (“Cystic Degeneration Pattern,” Fig. .7.4.) 88
Suspicious for Medullary Carcinoma (Figs. .7.5. and .7.6.) 88
Suspicious for Lymphoma (Fig. .7.7.) 90
Suspicious for Malignancy, Not Otherwise Specified 90
Explanatory Notes 90
Suspicious for Papillary Carcinoma 90
Suspicious for Medullary Carcinoma 95
Suspicious for Lymphoma 95
Suspicious for Malignancy, Not Otherwise Specified 96
Management 96
Sample Reports 97
Example 1: 97
Example 2: 97
References 97
Chapter 8 100
Papillary Thyroid Carcinoma and Variants 100
Background 100
Papillary Thyroid Carcinoma (Figs. 8.1–8.13) 101
Definition 101
Criteria (for All Types of PTC, Conventional and Variants) 101
Explanatory Notes 103
Variants of Papillary Thyroid Carcinoma 109
Follicular Variant (Figs. 8.14–8.16) 110
Definition 110
Background 111
Criteria 111
Explanatory Notes 112
Macrofollicular Variant (Figs. 8.17, 8.18) 112
Definition 112
Criteria 112
Explanatory Notes 113
Cystic Variant (Figs. 8.19, 8.20) 113
Definition 113
Criteria 114
Explanatory Notes 115
Oncocytic Variant (Figs. 8.21, 8.22) 115
Definition 115
Criteria 116
Explanatory Notes 117
Warthin-like Variant 117
Definition 117
Criteria 117
Explanatory Notes 117
Tall Cell Variant (Figs. 8.23, 8.24) 118
Definition 118
Criteria 118
Explanatory Notes 119
Columnar Cell Variant (Figs. 8.25, 8.26) 120
Definition 120
Criteria 120
Explanatory Notes 120
Hyalinizing Trabecular Tumor (Fig. 8.27) 121
Definition 121
Criteria 121
Explanatory Notes 122
Other Rare Variants 122
Management 122
Sample Reports 123
Example 1 123
Example 2 123
References 123
Chapter 9 126
Medullary Thyroid Carcinoma 126
Background 126
Definition 127
Criteria (Figs. 9.1–9.16) 127
Explanatory Notes 134
Management 135
Sample Reports 135
References 136
Chapter 10 138
Poorly Differentiated Thyroid Carcinoma 138
Background 138
Definition 138
Criteria (Figs. .10.1–10.12) 139
Explanatory Notes 139
Management 146
Sample Reports 146
References 147
Chapter 11 148
Undifferentiated (Anaplastic) Carcinoma and Squamous Cell Carcinoma of the Thyroid 148
Undifferentiated (Anaplastic) Thyroid Carcinoma 148
Background 148
Definition 149
Criteria (Figs. .11.1.–.11.15.) 149
Explanatory Notes 151
Management 158
Squamous Cell Carcinoma of the Thyroid 158
Definition 158
Criteria (Fig. .11.16.) 158
Explanatory Notes and Management 158
Sample Reports 159
References 160
Chapter 12 161
Metastatic Tumors and Lymphomas 161
Background 161
Metastatic Renal Cell Carcinoma 162
Definition 162
Criteria (Figs. .12.1. and .12.2.) 162
Explanatory Notes 162
Metastatic Malignant Melanoma 163
Definition 163
Criteria (Figs. .12.3. and .12.4.) 164
Explanatory Notes 164
Metastatic Adenocarcinoma from the Breast 165
Definition 165
Criteria (Fig. .12.5.) 165
Explanatory Notes 166
Metastatic Pulmonary Carcinoma 167
Other Metastatic Malignancies 168
Lymphoma Involving the Thyroid Gland 169
Definition 169
Criteria 170
Explanatory Notes 170
Extranodal Marginal Zone B-Cell Lymphoma (MALT Lymphoma) 171
Diffuse Large B-Cell Lymphoma 171
Sample Reports 172
Example 1: 173
Example 2: 173
References 173
Index 175