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Hyperthyroidism-Related Epithelial Hyperplasia as a Potential Pitfall of Thyroid Cytology: Institutional Cytomorphological Analysis of Histologically Verified Cases

Year: 2025

Type: article

Abstract: INTRODUCTION: Hyperthyroidism-related epithelial hyperplasia is seldomly listed as a pitfall in thyroid cytology. Therefore, we focused on the cytomorphological characteristics of epithelial hyperplasia and compared these features with papillary thyroid carcinoma (PTC). METHODS: Study group consisted of 76 patients (133 FNA specimens) histologically diagnosed with hyperthyroidism-related epithelial hyperplasia without a concomitant malignancy. The control group contained 21 histologically verified FNAs of PTCs. A total of 48 cytomorphological features were quantitatively evaluated. RESULTS: Statistically significant differences between the study groups were discovered on the architectural, cellular, and nuclear levels. Nuclear features varied most: nuclear elongation, grooves, irregular nuclear membrane, pseudoinclusions, the presence of nucleoli or small eccentric nucleoli were clearly more common in PTC group. CONCLUSION: Fine-needle aspiration referrals with clinical data and thyroid function test results can facilitate the interpretation of cytomorphological features and reduce the use of undetermined categories in cases of hyperthyroidism-related epithelial hyperplasia.

Source: Acta Cytologica

DOI: 10.1159/000548613

Authors: Eliisa Eveliina Viljanen, Lotta Virtanen, David Kalfert, Marie Ludvíková, Ivana Kholová