A Large Series of Hyalinizing Trabecular Tumors: Cytomorphology and Ancillary Techniques on Fine Needle Aspiration

Luca Revelli, Maurizio Martini, Luigi Maria Larocca, Marco Dell'Aquila, Alessandra Cocomazzi, Sara Capodimonti, Stefania Sfregola, Liron Pantanowitz

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Hyalinizing trabecular tumors (HTTs) are rare, essentially benign, follicular cell-derived thyroid neoplasms characterized by a trabecular growth pattern and nuclear pseudoinclusions. Their cytological findings are misleading, because these tumors are often misinterpreted on fine needle aspirate cytology as malignant lesions, such as papillary thyroid cancer and/or medullary thyroid cancer, leading to unnecessary total thyroidectomy. The aim of this study was to analyze the cytomorphological features and application of ancillary techniques in a series of HTTs. METHODS: Of 26 histological cases of HTT collected from September 2001 to December 2018, 18 cases had concomitant cytopathology. Cytological cases were processed with liquid-based cytology (LBC). Immunocytochemistry for HBME-1 and galectine-3 as well as molecular testing for BRAF(V600E) mutation were performed on both LBC and histological specimens. RESULTS: The 18 lesions with fine needle aspirate cytology ranged in size from 5 to 45 mm. Cytological diagnoses included: 1 benign lesion favoring goiter (5.5%), 4 atypia of undetermined significance (22.2%), 6 follicular neoplasms (33.3%), 5 suspicious for malignancy favoring papillary thyroid cancer (28%), and 2 malignant (11%). Hence, 89% HTT had a negative concordant immunopanel, and they were 100% wild-type BRAF(V600E). CONCLUSION: The majority of our HTTs (83.3%) were diagnosed in the indeterminate Bethesda categories, suggesting that their cytomorphological features pose issues for reaching a conclusive cytological diagnosis. The ancillary test results in our series support the fact that HTT is a benign neoplasm. (c) 2019 American Cancer Society.
Original languageEnglish
Pages (from-to)390-398
Number of pages9
JournalCancer cytopathology
Volume127
DOIs
Publication statusPublished - 2019

Keywords

  • Adult
  • Aged
  • BRAF mutation
  • Biomarkers, Tumor
  • Biopsy, Fine-Needle
  • Carcinoma, Neuroendocrine
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • Galectin 3
  • Humans
  • Hyalin
  • Immunohistochemistry
  • Liquid Biopsy
  • Male
  • Middle Aged
  • Proto-Oncogene Proteins B-raf
  • Retrospective Studies
  • Thyroid Cancer, Papillary
  • Thyroid Gland
  • Thyroid Neoplasms
  • Thyroid Nodule
  • Thyroidectomy
  • Unnecessary Procedures
  • hyalinizing trabecular tumor
  • immunocytochemistry
  • molecular testing
  • personalized medicine
  • thyroid malignancy
  • thyroid nodule

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