A review of follicular neoplasm of the thyroid

Diagnosing follicular neoplasms in thyroid fine-needle aspiration specimens can be difficult, and for good reason: it is a diagnostic category intended for a family of lesions for whom it is generally not possible to determine whether they are benign or not.

This unfortunately means that most patients end up getting surgery to remove at least the half of their thyroid where the nodule is present despite the absence of a firm diagnosis. Most people I know aren't particularly enthusiastic about living with this sort of uncertainty.

At McGill, where I am currently wrapping up my Area of Focused Competency in Cytopathology, cases like these are over-represented in the consultation cases we receive. This is a testament to the challenge they represent to many pathologists in Québec, where it is difficult to access molecular testing that can make the decision to proceed or not with surgery more straightforward.

Rendering this diagnosis means that someone who often has no symptoms and is in otherwise good health will have to get surgery that they may never have needed, so it is reasonable to be extra careful and think twice before committing.

With the guidance of my fellowship supervisor Dr. Manon Auger and the help of other colleagues, I put together a review article [1] to help pathologists consider and rule out other diagnoses that should be considered.

I took photos with a no-name industrial camera that seems to be sold by different online vendors every month. It is usually available for a price about 10 times lower than competing big-name brands, and I am quite satisfied with the results.

The paper is published under an open-access license—check it out!

References