UNASSIGNED: We reviewed 69,848 thyroid nodules that underwent aspiration cytology at Kuma Hospital between January 2007 and August 2021. Among them, 355 (0.5%) nodules with aspirated materials described as clay-like materials were retrospectively examined.
UNASSIGNED: Among 355 nodules, 322 (90.7%) were categorized as cystic fluid or benign. The aspirated materials were mainly composed of non-epithelial components, including colloid or proteinaceous materials, foamy histiocytes, and degenerative red blood cells. In original ultrasound reports, the incidence of intermediate and high suspicion was 11.0%. Malignant cells were observed in 21 nodules (5.9%), one-third of which were papillary thyroid carcinomas. The materials aspirated from papillary and follicular thyroid carcinomas exhibited necrotic carcinoma cells derived from infarcted areas. The overall risk of malignancy was 3.9%. The risk of malignancy in nodules interpreted as highly suspicious on ultrasound examination was 37.5%.
UNASSIGNED: As clay-like materials aspirated from thyroid nodules were considered sufficient specimens, the recognition contributes to avoiding unnecessary second punctures. The presence of clay-like materials was indicative of the colloid and/or blood components of benign cystic lesions, or, more rarely, of infarcted carcinoma. The ultrasound examination results tended to overestimate nodules. We should reaffirm that on-site gross visual assessment of aspirated materials is a fast and reasonably accurate predictor of the on-site adequacy of the samples.
■我们回顾了2007年1月至2021年8月期间在库马医院接受抽吸细胞学检查的69,848个甲状腺结节。其中,回顾性检查了355个(0.5%)结节,其中抽吸的材料被描述为粘土样材料。
■在355个结节中,322例(90.7%)被归类为囊性积液或良性。抽吸材料主要由非上皮成分组成,包括胶体或蛋白质材料,泡沫组织细胞,和退化的红细胞。在原始超声报告中,中度和高度怀疑的发生率为11.0%。在21个结节中观察到恶性细胞(5.9%),其中三分之一是甲状腺乳头状癌。从乳头状和滤泡性甲状腺癌中抽出的材料显示出来自梗塞区域的坏死癌细胞。恶性肿瘤的总体风险为3.9%。在超声检查中被解释为高度可疑的结节中恶性肿瘤的风险为37.5%。
■由于从甲状腺结节中抽出的粘土样物质被认为是足够的标本,识别有助于避免不必要的第二次穿刺。粘土样物质的存在表明良性囊性病变的胶体和/或血液成分,或者,很少,梗塞癌。超声检查结果倾向于高估结节。我们应该重申,对吸入材料的现场总体视觉评估是样本现场充足性的快速和合理准确的预测指标。