naa a22 4500 510773680 CHVBK 20180411083223.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s12022-013-9240-4 doi (NATIONALLICENCE)springer-10.1007/s12022-013-9240-4 Radiologic and Clinical Predictors of Malignancy in the Follicular Lesion of Undetermined Significance of the Thyroid [Elektronische Daten] [Ryan Carr, Berrin Ustun, David Chhieng, Kevin Schofield, Constantine Theoharis, Lynwood Hammers, Adebowale Adeniran] Various ultrasonographic characteristics of thyroid nodules have been associated with a higher likelihood of malignancy, and certain clinical features may also increase the likelihood of malignancy in patients. This study is designed to determine the ultrasonographic and clinical predictors of malignancy in the atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) category. A search through the cytology files at our institution was made for cases with diagnosis of AUS/FLUS. The clinical and radiologic findings were correlated with the final surgical pathology diagnosis. A total of 140 cases of AUS/FLUS with corresponding surgical intervention were identified (112 females and 28 males). There was a 79% malignancy rate in nodules with irregular contours, compared to 51% in nodules with regular outlines. Nodules demonstrating calcifications showed a 57% malignancy rate, compared to 50% in nodules without calcifications. Sixty-one percent of cases with an ultrasonographic diagnosis of indeterminate to suspicious were malignant following surgical resection. The rates of malignancy in patients with radiation exposure, symptomatic nodules, and positive family history of thyroid cancer were 22, 59, and 33%, respectively. BRAF mutation was demonstrated in 57% of malignant cases and in none of benign cases. No single clinical or ultrasonographic feature or combination of features is adequately sensitive or specific to identify all malignant nodules. However, a combination of solid nodules, nodules with irregular contours, symptomatic nodules, and positive BRAF mutation has high predictive value for malignancy in patients with a cytologic diagnosis of AUS/FLUS. Springer Science+Business Media New York, 2013 Thyroid nationallicence Fine needle aspiration nationallicence Predictors of malignancy nationallicence Follicular lesion of undetermined significance nationallicence Indeterminate nationallicence Carr Ryan Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut Ustun Berrin Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut Chhieng David Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut Schofield Kevin Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut Theoharis Constantine Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut Hammers Lynwood Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA aut Adeniran Adebowale Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut Endocrine Pathology Springer US; http://www.springer-ny.com 24/2(2013-06-01), 62-68 1046-3976 24:2<62 2013 24 12022 https://doi.org/10.1007/s12022-013-9240-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12022-013-9240-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Carr Ryan Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut NATIONALLICENCE 700 1- Ustun Berrin Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut NATIONALLICENCE 700 1- Chhieng David Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut NATIONALLICENCE 700 1- Schofield Kevin Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut NATIONALLICENCE 700 1- Theoharis Constantine Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut NATIONALLICENCE 700 1- Hammers Lynwood Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA aut NATIONALLICENCE 700 1- Adeniran Adebowale Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, 06519, New Haven, CT, USA aut NATIONALLICENCE 773 0- Endocrine Pathology Springer US; http://www.springer-ny.com 24/2(2013-06-01), 62-68 1046-3976 24:2<62 2013 24 12022 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer