The FCIP studies were performed in accordance with … Blast cell percentages estimated by flow cytometry are affected by specimen processing and gating and, therefore, may differ significantly from AUS with prominent microfollicles in a sparsely cellular specimen or in the background of a mixed pattern where findings are not supportive of a diagnosis of follicular neoplasm (see Fig. ATYPIA OF UNDETERMINED SIGNIFICANCE or FOLLICULAR LESION OF UNDETERMINED SIGNIFICANCE, Atypia of Undetermined Significance (AUS), http://papsociety.org/atlas/displayimage.php?pid=257, Click on an album to see the thumbnail images, Click on the thumbnails to see the intermediate images, Click on the intermediate image to obtain the full sized image. Overall, the risk of malignancy in this category is relatively low, on average 5–25 %, depending on how the data is obtained. (b) Atypia of undetermined significance. How can unfixed specimen be stained? Sparsely definition, in a thinly distributed way; not thickly or densely: Michigan’s Upper Peninsula is very sparsely populated, as more than 90% of it is forested. In our experience, the risk is closer to the lower end of the spectrum. This website is intended for pathologists and laboratory personnel but not for patients. DICTIONARY.COM Cytopspins. We welcome suggestions or questions about using the website. Large pleomorphic cells in a sparsely cellular sample. Photomicrograph showing prominent microfollicles in a moderately cellular specimen (Smear, Giemsa, 400x magnification). Prather et al. Aspirates where malignancy is suspected but cannot be determined due to: Overlapping cytological features with other thyroid lesions, Specimens suspicious for a follicular or Hürthle cell neoplasm (see, Specimens with a minor degree of atypia, primarily cytologic or architectural (see, Frozen section has limited utility for suspicious for malignancy nodules (, 55 year old man with colon cancer metastasis within a NIFTP which was cytologically suspected of PTC (, 58 year old woman with mammary analogue secretory carcinoma of the thyroid which was cytologically suspected of PTC (, 63 year old man with follicular variant of papillary thyroid carcinoma presenting as a toxic nodule which was cytologically suspected of follicular variant of PTC (, 63 year old woman with hyalinizing trabecular tumor which was cytologically suspected of hyalinizing trabecular tumor (, 71 year old man with mixed medullary and follicular cell carcinoma of the thyroid which was cytologically suspected of thyroid carcinoma (, Pattern A (patchy nuclear changes): moderate to high cellularity, nuclei showing enlargement, pallor, grooves, irregularity or molding but absence of nuclear pseudoinclusions, psammoma bodies and papillary architecture, Pattern B (incomplete nuclear changes): nuclei showing enlargement with mild pallor and grooves, absence of nuclear irregularity, nuclear molding, nuclear pseudoinclusions, psammoma bodies and papillary architecture, Pattern C (sparsely cellular specimen): poor cellularity, presence of many findings suggesting papillary thyroid carcinoma, Pattern D (cystic degeneration): cystic degeneration based on foamy histiocytes, scattered clusters of follicular cells with the nuclei showing enlargement, pallor, grooves, absence of nuclear pseudoinclusions, psammoma bodies and papillary architecture, large, atypical, histiocytoid cells with enlarged nuclei and without abundant vacuolated cytoplasm (, Monomorphic population of isolated small or medium sized cells with a high nuclear cytoplasmic ratio, Nuclei are eccentrically located, with smudged chromatin, Numerous monomorphic small to intermediate sized lymphoid cells, Sparsely cellular and contains atypical lymphoid cells, Suspicious for malignancy, not otherwise specified, Other primary thyroid malignancies like anaplastic carcinoma and poorly differentiated carcinoma, Suboptimal cellularity or preservation can lead to uncertainty and result in a suspicious for malignancy interpretation, Usually surgical management similar to that of malignant nodules (, In suspicious for papillary thyroid carcinoma cases with low risk features (≤ 1 cm, without extrathyroidal extension and clinical metastasis), active surveillance is an option (, Molecular testing with high positive predictive value (, For suspicious for medullary thyroid carcinoma, Measuring serum calcitonin level or calcitonin immunostaining are recommended (, Repeat fine needle aspiration to obtain cells for flow cytometry (, A few follicular cells showing nuclear enlargement, pale and powdery chromatin and nuclear grooves are present, Correlation with serum calcitonin level or immunostaining might be helpful for definitive diagnosis if clinically indicated, Re-aspiration for flow cytometry might be helpful to better characterize the lymphocyte population if clinically indicated, Microfollicular architecture with minimal nuclear features of, Trabecular growth pattern of the cells with nuclear grooves and abundant nuclear pseudoinclusions, intratrabecular hyaline material, Nuclear changes of follicular cells with focal enlargement, grooves, prominent nucleoli and chromatin clearing in the lymphocytic background, An abundance of lymphocytes and plasma cells does not exclude the possibility of a coexisting, Numerous lymphocytes, few follicular cells, Elongated cells with pale chromatin, nuclear grooves and relatively large nucleoli, Spindle shaped morphology of the cell and nucleus, reminiscent of reparative epithelium in cervical Pap smears, Follicular variant of papillary thyroid carcinoma. Predominance of Hürthle cells in a sparsely cellular aspirate Interpretation obscured by preparation artifact (e.g., air drying or clotting artifact) Moderate to markedly cellular specimen composed exclusively of Hürthle cells in a clinical setting of benign Hürthle cell nodule (e.g., lymphocytic (Hashimoto) thyroiditis or multinodular goiter) The thyroid web atlas contains 300 images of key thyroid lesions in an easy-to-search format. Whenever a specific diagnosis (eg, lymphocytic thyroiditis) can be rendered and whenever there is any atypia, the … Suspicious for medullary thyroid carcinoma, Suspicious for papillary thyroid carcinoma, 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA). • Pattern C ( “ sparsely cellular specimen “) • Cellular features of PTC present but very sparsely cellular • Pattern D (“ cystic degeneration “) • Haemosiderin laden macrophages + • Scattered groups and sheets of follicular cells , enlarged , pale nuclei, some have nuclear grooves . Materials and Methods. IMAGE ATLAS. Comment: Given the suboptimal nature of the analyzed specimen, this finding is of uncertain significance. Thin, watery colloid often forms a “thin membrane/cellophane” coating or film … In fact, a specimen that is sparsely cellular may indicate an inadequate sample. • an acellular or sparsely cellular sample may be representative if it is from a scar • a lipoma or fatty lesion yields plentiful fat but no epithelial cells. (Histologic follow-up revealed a carcinoma with thymus-like differentiation [CASTLE]). It may be thin or thick in texture. [ 2 ] determined that a cutoff of 20 well-visualized, well-preserved urothelial cells per ten high-power fields increased the positive predictive value of bladder wash (TP). Colloid is viscous, shiny, and light yellow or gold in color (resembling honey or varnish) on gross examination. Remedy: The supernatant may not have been completely poured off resulting in The clot formed with the combination of plasma and thrombin was often sparsely cellular and as a result there were very few cells present on the H & E sections. groups of follicular cells are not identified: A sparsely cellular specimen with abundant colloid is, by implication, a predomi-nantly macrofollicular nodule and, therefore, almost certainly benign. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears. Pattern C (sparsely cellular specimen): poor cellularity, presence of many findings suggesting papillary thyroid carcinoma 5.11). The objective of this study was to analyze the thyroid cytology smears by TBSRTC, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features, and to correlate the cytopathology with histopathology, wherever surgery was done. All images have been independently reviewed and approved by the committee members. Collection of gynecologic cytology specimens. This was a prospective study of 22… Issue: Non-Gyn specimen slide is sparsely cellular when ample specimen collected and centrifuged cell pellet is visibly adequate. © Copyright PathologyOutlines.com, Inc. Click, Bethesda guidelines suspicious for malignancy, Ali: The Bethesda System for Reporting Thyroid Cytopathology - Definitions, Criteria and Explanatory Notes, 2nd Edition, 2018, Head Neck Pathol 2019 Oct 17 [Epub ahead of print], Noninvasive follicular thyroid neoplasm with papillary-like nuclear features, invasive follicular variant of papillary thyroid carcinoma, Bethesda category V suspicious for malignancy (SM) is used when some cytologic features are strongly suspected of malignancy but are not sufficient for a conclusive diagnosis (, Higher suspicion of malignancy than atypia of undetermined significance / follicular lesion of undetermined significance (AUS / FLUS) but lower suspicion than malignant, Molecular testing with mutation panels may be useful, particularly for potential noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) cases, Purpose of separating suspicious for malignancy from malignant is to preserve the very high positive predictive value of the malignant category without compromising the overall sensitivity of fine needle cytology aspiration, Used when cytology is strongly suspected of malignancy but is not sufficient for a conclusive diagnosis, Frequency < 5%, resection rate 70%, risk of malignancy 80% (NIFTP = malignant), 45 - 60% (NIFTP ≠ malignant), Most common histological diagnosis is papillary thyroid carcinoma (PTC) (, Risk of malignancy: 80% (NIFTP = malignant), 45 - 60% (NIFTP ≠ malignant) (, Suspicious for malignancy interpretation allows for more conservative management options (e.g. In 31 patients, the CSF examination was part of a diagnostic evaluation of neurologic conditions; in one patient, the CSF examination was for lymphoma staging. About the Site: The thyroid web atlas contains 300 images of key thyroid lesions in an easy-to-search format. A normal voided urine specimen is sparsely cellular, but urothelial (synonym: transitional) cells are usually present (Fig. FNA specimens range from sparsely to highly cellular. Such changes may represent atypical but benign cyst lining cells, but a papillary carcinoma cannot be entirely excluded. sparsely cellular, but urothelial (or transitional) cells are usually present, and Sparsely cellular sample with epithelioid and fusiform cells. 3.1). Large atypical cells with macronucleoli. Dr. Monika Nema (b) benign appearing follicular cells with few pale chromatin nucleus Any specimen that contains abundant colloid is adequate (and benign), even if 6 groups of follicular cells are not identified; a sparsely cellular specimen with abundant colloid is, by implication, a predominantly macrofollicular nodule and therefore almost certainly benign. All images have been independently reviewed and approved by the committee members. Whenever a specific diagnosis (eg, lymphocytic thyroiditis) can be rendered, and whenever there is any significant atypia, the specimen … It may be thin or thick in texture. Flow cytometric immunophenotyping (FCIP) analysis was performed on CSF specimens from 32 patients at the Mayo Clinic (Rochester, MN) over a 5‐year period (1998 through 2003). Aims. These images are intended for educational purposes and may be freely used for such as long as the Papanicolaou Society and the Bethesda System for Reporting Thyroid Cytopathology is credited. 20,33 The granulosa cells can be isolated, but they have a tendency to cluster haphazardly in loose spherical aggregates . Benign Criteria Specimens are sparsely to moderately cellular. Posted by ubder at 3:51 AM No comments: Email This BlogThis! It is dark blue-violet-magenta with Romanowsky-type stains and green to orange-pink with the Papanicolaou stain . Background. Microscopic findings of the sparsely cellular areas demonstrated a proliferation of atypical spindle-shaped stromal cells having hyperchromatic and cigar-shaped pleomorphic nuclei, as well as abundant eosinophilic cytoplasm with few pockets of greater … Whenever a specific diagnosis (eg, lymphocytic thyroiditis) can be rendered and whenever there is any atypia, the specimen is, by definition, adequate for evaluation. lobectomy). If a specimen is considered to be non-representative and does not correlate with the clinical or imaging findings, repeat FNA or core biopsy is recommended. See more. Usually sparsely cellular; Ductal cells; Foamy cells; Inflammatory cells; Red blood cells; Benign ductal cells are molded around one another and arranged in tight clusters, which can be small and spherical or large and branching; isolated cells are very uncommon. It is dark blue-violet- magenta with Romanowsky-type stains and green to orange-pink with the Papanicolaou stain. Photomicrograph showing sparsely cellular specimen with a predominance of microfollicles (Smear, Giemsa, 400x magnification). sparsely cellular specimens. Rate this file (Current rating : 0.7 / 5 with 48 votes) / Powered by Coppermine Photo Gallery. Aspirates were sparsely cellular against a clean or granular, proteinaceous background. Sparsely cellular specimen comprised predominantly of microfollicles (ThinPrep®)(scenario 1). mostly microfollicles or Hurthle cells but specimen too sparse to definitively call; atypia but lots of obscuring blood or artifact; Lots of Hurthle cells, but may be due to Hashimotos; focal marked atypia in an otherwise benign sample ; atypical cyst lining cells; atypical lymphoid cells. Benign Follicular Nodule Criteria Specimens are sparsely to moderately cellular. Learn more One nucleus has an apparent intranuclear pseudoinclusion (arrow). Specimen preparation artifacts also account for some instances of AUS from MEDICAL MED130 at Stratford University Sparsely cellular specimen for evaluation with increased myeloid lineage blasts, 11%. • INCIs rare / absent • Occ atypical histiocytoid cells + , calcification + 35. using the diff quick stain? Any specimen that contains abundant colloid is considered adequate (and benign), even if 6 groups of follicular cells are not identified: A sparsely cellular specimen with abundant colloid is, by implication, a predominantly macrofollicular nodule and, therefore, almost certainly benign. A blinded retrospective review of 6 morphologic features in the thyroid FNA specimens was conducted. Cytocentrifugation. METHODS: Thyroid FNA cases with a report of cyst fluid only and a follow‐up thyroidectomy specimen were identified during a 3‐year period. See more. Although the SPT pellet was eventually placed in formalin before being submitted to histology, cell lysis and low cellularity remained a factor for all SPT samples. Any specimen that contains abundant colloid is adequate (and benign), even if six groups of follicular cells are not identified: a sparsely cellular specimen with abundant colloid is, by implication, a predominantly macrofollicular nodule and therefore almost certainly benign. Which method is most commonly used for sparsely cellular specimen? Which method involves the specimen being placed in a funnel type appartatus, which is attached to a filter card and a slide spin on the cytocentrifuge . The highly cellular cases are termed cellular follicle cysts and account for between 23% and 76% of all follicle cysts. Signout. The purpose of the current study was to identify any cytomorphologic characteristics in this type of specimen that are predictive of an underlying malignancy. … Colloid is viscous, shiny, and light yellow or gold in color (resembling honey or varnish) on gross examination. Nuclei were small, round, with fine chromatin and indistinct nucleoli and devoid of mitotic activity. However, we cannot answer medical or research questions or give advice. They are dispersed as isolated individual cells; tight clusters of urothelial cells are distinctly uncommon in a normal voided urine sample. This website uses cookies to ensure you get the best experience on our website. Tumor cells formed loose clusters or monolayered sheets composed of cuboidal cells with indistinct cell borders and granular or clear cytoplasm that was often stripped from the nucleus. a) sparsely cellular specimen, some of the cells had abundant cytoplasm and enlarged nuclei, some with prominent nucleoli.

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