Different qualifiers of AUS/FLUS thyroid FNA have distinct BRAF, RAS, RET/PTC, and PAX8/PPARg alterations

Cancer Cytopathology
Claudio BellevicineGiancarlo Troncone

Abstract

The Bethesda System for Reporting Thyroid Cytopathology category of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) includes fine-needle aspiration (FNA) specimens that cannot straightforwardly be classified as benign or malignant. To determine whether morphological subcategorization based on atypia qualifiers and molecular testing could improve malignancy risk stratification of AUS/FLUS patients, this study assessed the correlation between these qualifiers and the molecular alterations commonly harbored by thyroid neoplasms. A total of 162 AUS/FLUS cases were subcategorized by atypia qualifiers (Hürthle cell changes, architectural atypia, and cytologic atypia [CyA]) and were tested for BRAF, N-H-KRAS, RET/PTC, and paired box 8 (PAX8)/peroxisome proliferator activated receptor γ (PPARg) mutations. CyA was observed more frequently in mutation-positive AUS/FLUS (14 of 37 [37.84%]) than mutation-negative AUS/FLUS (20 of 125 [16.00%]; P < .0084), and it specifically harbored the BRAFV600E point mutation. Malignancy was confirmed in the available follow-up. Conversely, although RAS was the most frequent mutation identified in AUS/FLUS FNA specimens (26 of 37 cases [70.27%]; P < .0001), i...Continue Reading

References

Oct 23, 2009·American Journal of Clinical Pathology·Edmund S CibasUNKNOWN NCI Thyroid FNA State of the Science Conference
Sep 16, 2011·American Journal of Clinical Pathology·Paul A VanderLaanJeffrey F Krane
Aug 1, 2012·Acta Cytologica·Massimo BongiovanniZubair W Baloch
Jul 11, 2013·Thyroid : Official Journal of the American Thyroid Association·Markus EszlingerRalf Paschke
Mar 19, 2014·Cancer Cytopathology·Michiya Nishino, Helen H Wang
Mar 27, 2015·Cytopathology : Official Journal of the British Society for Clinical Cytology·C BellevicineG Troncone
Aug 9, 2015·BMC Medicine·Marco MediciErik K Alexander
Oct 1, 2015·Thyroid : Official Journal of the American Thyroid Association·Christopher CoyneMarina N Nikiforova
Jan 25, 2017·Thyroid : Official Journal of the American Thyroid Association·Vera A PaulsonJustine A Barletta
May 5, 2017·Cytopathology : Official Journal of the British Society for Clinical Cytology·C BellevicineG Troncone

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Citations

Aug 31, 2019·Thyroid : Official Journal of the American Thyroid Association·Whitney S GoldnerRichard T Kloos
Jan 7, 2020·Diagnostic Cytopathology·Caterina De LucaGiancarlo Troncone
Jun 6, 2020·Diagnostic Cytopathology·Neeta KumarSanjay Gupta
May 18, 2019·Archives of Pathology & Laboratory Medicine·Daniel D MaisJoseph A Tworek
Sep 10, 2020·Cancers·Philippe VielhMartin Schlumberger
Aug 26, 2021·Diagnostic Cytopathology·Teresa H Kim, Jeffrey F Krane
Jan 13, 2022·Cancer Cytopathology·Catarina EloyPhilippe Vielh

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