Journal List > Korean J Cytopathol > v.19(2) > 1006519

Korean J Cytopathol. 2008 Sep;19(2):152-159. Korean.
Published online September 30, 2008.
Copyright © 2008 The Korean Society for Cytopathology
Cytologic Features of Follicular sAdenoma and Follicular Carcinoma of the Thyroid: A Study on the Likelihood of Cytologic Diagnosis by Fine Needle Aspiration Cytology
Hee Dae Park, C.T.(IAC), Woon Sun Park, C.T.(IAC), Sun Hee Kim, C.T.(IAC), Seock Hyun Choi, M.T., Young Hye Cho, M.D., Sung Hee Kang, M.D., Kyung Bun Lee, M.D., Dong Hoon Kim, M.D., Seoung Wan Chae, M.D. and Jin Hee Shon, M.D.
Department of Pathology, Kangbuk Samsung Hospital, SungKyunkwan University School of Medicine, Seoul, Korea.
Received July 17, 2008; Accepted August 29, 2008.


Fine-needle aspiration cytology (FNAC) cannot differentiate follicular adenoma from follicular carcinoma since this distinction can only be based on the presence of capsular or vascular invasion, and this cannot be detected on a cytologic smear. The goal of this study was to define the diagnostic cytologic findings of follicular neoplasm and the possibility of diagnosing follicular neoplasm by performing FNAC. The cases of histologically diagnosed follicular adenoma and follicular carcinoma on the thyroidectomy specimens were retrieved. Among them, the cases with preoperative FNAC that was done within 3 months of the operation were finally selected. Then we reviewed the FNAC and histologic slides of 19 cases: 9 follicular adenomas and 10 follicular carcinomas. Our results suggest that for cases of follicular neoplasm, the aspirates show high or abundant cellularity, frequent follicle formation and occasional cellular atypism of the follicular cells. However, the atypism is more pronounced and more frequently noticed in the cases of follicular carcinoma, which reveals more higher anisocytosis (7/10, 70%), nuclear pleomorphism (9/10, 90%), coarse clumping of chromatin (8/10, 80%) and cellular overlapping (8/10, 80%).

Keywords: Fine needle aspiration cytololgy; Follicular adenoma; Follicular carcinoma; Thyroid


Fig. 1
Fine needle aspiration cytology of the follicular adenoma. (A) Follicular adenoma confirmed by histologic diagnosis shows many small follicles composed of bland - looking follicular cells. (B) Follicular cells exhibit mild anisocytosis and anisonucleosis with preserved cytoplasm. (H&E).
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Fig. 2
Fine needle aspiration cytology of the follicular carcinoma. (A) Follicular carcinoma confirmed by histologic diagnosis shows abundant syncytial clusters and small follicles. (B) Follicular cells exhibit moderate anisocytosis and anisonucleosis with hyperchromasia, coarse nuclear chromatin and small nucleoli. Irregularity of the nuclear membrane is also noted. (H&E).
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Table 1
Cytologic - Histologic Correlation of the Follicular Adenoma
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Table 2
Cytologic - Histologic Correlation of the Follicular Carcinoma
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Table 3
Cellular Features of the Follicular Adenoma in FNAC
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Table 4
Cellular Features of the Follicular Carcinoma in FNAC
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Table 5
Comparison of the Cytologic Features in Thyroid Neoplasm
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