Clinical and Cytopathological Features of Suspected Thyroglossal Duct Cysts and Neoplasms Arising From Them: A Large Series From a Referral Cancer Center

摘要

BACKGROUND: Thyroglossal duct cysts (TGDCs) are the most common congenital midline cystic lesions in the neck, and they are often evaluated by fine-needle aspiration. Recognizing the cytomorphologic features of TGDCs and their mimics is important for clinical management. METHODS: This study examined the clinical, radiological, and cytopathological features of 86 ultrasonography-guided fine-needle aspiration (US-FNA) specimens from clinically suspected TGDCs or malignancies arising from TGDCs and correlated the findings with surgical follow-up and/or imaging studies. RESULTS: According to ultrasound examinations of 66 lesions, 17 (25.8) were cystic, 8 (12.1) were cystic with septations, 21 (31.8) were cystic with solid nodules, and 20 (30.3) were solid or cystic with internal debris. Cytopathologically, 81 lesions (94) were categorized as benign, 2 (2) were categorized as atypical, and 3 (3) were categorized as malignant. In benign lesions, proteinaceous material (63), histiocytes (63), colloid (37), squamous cells (35), columnar cells (32), follicular cells (15), inflammatory cells (9), and multinucleated giant cells (9) were noted. Diagnoses in the benign category included TGDC in 64 patients (75), TGDC or mimics (colloid nodule/epidermoid cyst) in 14 patients (17), a colloid nodule in 1 patient, and thy-roiditis in 1 patient. Surgical resection, performed in 23 patients, confirmed TGDCs in 12, benign mimics in 7, and carcinoma in 4. CONCLUSIONS: Cytopathological features, in conjunction with imaging, allowed a definite diagnosis of TGDC in most patients (75). The presence of mature squamous cells, thyroid follicular cells, with or without colloid and/or lymphocytes alone allowed a differential diagnosis of TGDC and its mimics in 17. US-FNA findings could not distinguish primary carcinomas arising from TGDCs from metastatic tumors.