The ultrasonography features of hyalinizing trabecular tumor of the thyroid gland and the role of fine needle aspiration cytology and core needle biopsy in its diagnosis

Woo Jung Choi, Jung Hwan Baek, Eun Ju Ha, Young Jun Choi, Min Ji Hong, Dong Eun Song, Jin Yong Sung, Hyunju Yoo, So Lyung Jung, Ha Young Lee, Jeong Hyun Lee

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background: Hyalinizing trabecular tumor (HTT) of the thyroid gland is a rare, benign neoplasm of follicular cell origin. Misdiagnosis of HTT as either papillary or medullary thyroid carcinoma after fine-needle aspiration (FNA) may lead to unnecessary surgery. Purpose: To evaluate the ultrasonography (US) findings of HTT of the thyroid gland and the role of FNA cytology and core needle biopsy (CNB) in its diagnosis. Material and Methods: Data from 24 patients with a histopathological diagnosis of HTT between January 2000 and May 2013 were retrospectively analyzed. US findings were categorized according to shape, margin, orientation, echogenicity, composition, calcification, and vascularity. Cytologic and histologic results of FNA, CNB, and surgery were reviewed. Results: US revealed the following tumor features: oval-to-round (24/24), solid (22/24), smooth margin (21/24), hypoechoic or marked hypoechogenicity (18/24), and peri- and/or intranodular vascularity (17/17). Malignant US features such as marked hypoechogenicity (n=7) and a spiculated margin (n=3) were also observed. Final confirmation was by surgery in 22 patients and by CNB in two patients. All 19 patients who underwent FNA were initially misdiagnosed, including 12 with malignancies and five with atypia of undetermined significance. All four patients who underwent CNB were correctly diagnosed with HTT. The histology of CNB specimens suggested HTT, which was confirmed by immunostaining of MIB-1. Conclusion: HTT should be suspected when the cytological diagnosis of papillary thyroid carcinoma is made after FNA without malignant US findings. CNB could prevent unnecessary surgery for HTT.

Original languageEnglish
Pages (from-to)1113-1118
Number of pages6
JournalActa Radiologica
Volume56
Issue number9
DOIs
StatePublished - 1 Jan 2015

Bibliographical note

Publisher Copyright:
© The Foundation Acta Radiologica 2014.

Keywords

  • Core-needle biopsy
  • Fine-needle aspiration
  • Hyalinizing trabecular tumor
  • Thyroid
  • Ultrasonography

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