Thyroid Lesions and Recent Advances in the Diagnosis of Thyroid Lesions (Other (Not Listed) Sample)


Modern Diagnosis of Thyroid Lesions

Thyroid Lesions and Recent Advances in the Diagnosis of Thyroid Lesions
Collected by Fine Needle Aspiration
A Critical Literature Review
Conduct a Critical Review of the Literature on the use of Fine Needle Aspiration in the diagnosis and treatment of of Thyroid Lesions
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Project Due By  DATE \@ "d MMMM yyyy" 24 October 2015
Abstract
This paper presents a detailed, comprehensive and strategically developed literature review, critically focusing on contemporary practices when testing for and diagnosing thyroid lesions. Accumulating an immense volume of academic arguments, empirical research studies and clinical tests of the Fine-Needle Aspiration (FNA) practice, the paper presents a critical review of the most recent peer-reviewed literature. Although slightly basing the evaluative argument on research studies conducted in the last three decades, the core of the review evaluates recent academic arguments and research findings on the application of FNA.
Towards this end, the literature review traces its argument to thyroid lesions in cytopathology, the condition of benign nodules (such as colloid, Hyperplastic and cyst), contemporary thyroiditis practice (both Hashimoto and de Quervain’s thyroiditis), and the accruing neo-plastic tissue changes. This creates a background to review the dynamics of fine-needle aspirate, specifically discussing the role and importance of cytology, the limitations of fine-needle aspirates, potential in the diagnostic testing of thyroid lesions and the use of imaging and molecular options. The critical review then contextualizes the Bethesda reporting system, in contemporary cytopathology. In agreement with previous research studies and clinical tests, the review concludes that the FNA emerges as a relevant, reliable, effective, precise, cost-effective and accurate diagnostic tool for thyroid lesions, when applied with relatively few limitations, towards a purposive goal in cytopathology, such as when complemented with imaging and molecular pathogenesis.
Keywords: Thyroid Lesions, Benign Nodules, Fine Needle Aspiration, Bethesda Reporting System, Thyroid Lesion Diagnosis, and Thyroid Nodules Test

Contents

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Abstract  PAGEREF _Toc396052471 \h
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Contents  PAGEREF _Toc396052472 \h
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Introduction  PAGEREF _Toc396052473 \h
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Thematic Review  PAGEREF _Toc396052474 \h
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Structure of the Paper  PAGEREF _Toc396052475 \h
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Thyroid Lesions in Cytopathology  PAGEREF _Toc396052476 \h
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Contextual Definitions  PAGEREF _Toc396052477 \h
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Benign Nodules  PAGEREF _Toc396052478 \h
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Thyroiditis (Hashimoto and De Quervain’s)  PAGEREF _Toc396052479 \h
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Neo-Plastic Tissue Changes  PAGEREF _Toc396052480 \h
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Fine-Needle Aspirate (FNA)  PAGEREF _Toc396052481 \h
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Role and Importance of Cytology  PAGEREF _Toc396052482 \h
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Limitations of Fine-Needle Aspirates  PAGEREF _Toc396052483 \h
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Imaging and the Molecular Diagnostic/Surveillance Approach  PAGEREF _Toc396052484 \h
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Imaging  PAGEREF _Toc396052485 \h
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Molecular Pathogenesis and Diagnosis  PAGEREF _Toc396052486 \h
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The Bethesda Reporting System  PAGEREF _Toc396052487 \h
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Conclusion to the Review  PAGEREF _Toc396052488 \h
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Reference List  PAGEREF _Toc396052489 \h
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Thyroid Lesions and Recent Advances in the Diagnosis of Thyroid Lesions Collected by Fine Needle Aspiration: A Critical Literature Review
Introduction
Thematic Review
From the perspective of cytopathology, modern pathological practices have enabled the study, testing and diagnosis of thyroid lesions from the cellular level. Of focus in the preset review is the use of thyroid Fine-Needle Aspiration (FNA), where according to Cibas and Ali (2009), “FNA) has an essential role in the evaluation of euthyroid patients with a thyroid nodule”. After ages of what have been termed as unnecessary surgeries, cytopathologists can now use FNA to attend to the needs of thyroid patients with reliable effectiveness. The question however emerges on the sensitivity, effectiveness, precision and diagnostic accuracy of FNA, in comparison with alternative diagnostic tests available for thyroid lesions.
This area of interest has a wide and highly detailed presence on the literature, both in research findings and academic arguments. Numerous scholars have in the last few decades, conducted several retrospective studies on FNA. As early as 1982, researchers such as Hamberger and others had started to evaluate the cost and practice implications of FNA diagnosis. A few years later, Suen (1998) reviewed the application of FNA to separate cellular follicular lesions. Nearly a decade later, Schlinkert et al. (1997) investigated the factors that can determine FNA’s accuracy to predict malignant thyroid lesions. At the beginning of the century, Kelman et al (2001) reviewed the malignancy risk in thyroid cytology and contextualized the role of FNA. Towards the close of that decade, Layfield et al. (2008) had investigated the post-testing implications of FNA diagnosis, particularly in the treatment of thyroid lesions. Recently, Sinna and Ezzat (2012) investigated the diagnostic accuracy of FNA in thyroid lesions for contemporary practice after decades of its use.
As exemplified above therefore, FNA testing and diagnosis of thyroid lesions has been widely covered in the last few decades, both in empirical research, clinical tests and academic discourse. What is critically essential therefore is a thematic analysis of this literature to reach a reliable, accurate, relevant and evidence-based conclusion. Consequently, this paper seeks to provide a critical review and assessment of such studies currently published in peer-reviewed literature on the dynamics of FNA when diagnosing thyroid lesions, leading to an evidence-based evaluation of the Bethesda reporting system as defined by contemporary pathological practice.
Structure of the Paper
Following this brief introduction, the paper will present a critical literature review of contemporary practices when testing for and diagnosing thyroid lesions. Immediately hereafter, the paper will review thyroid lesions in cytopathology, starting by critically discussing benign nodules including colloid, Hyperplastic and cyst, highlighting thyroiditis practice (briefly focusing on Hashimoto and de Quervain’s thyroiditis), and finally reviewing neo-plastic changes in conventional medical practice.
Thereafter, the paper will focus on the dynamics of fine-needle aspirate, discussing the role and importance of cytology, the limitations of fine-needle aspirates and briefly, on the use of imaging and molecular options for the diagnosis of thyroid lesions. Ultimately, the paper will briefly discuss the Bethesda reporting system, before developing a precise conclusion to the literature review.
Thyroid Lesions in Cytopathology
Contextual Definitions
Thyroid lesions, alternatively termed as thyroid nodules are abnormal cells that develop in a tissue, within and even around the human thyroid gland. Upon progressive development, the thyroid lesions emerge as small bumpy lumps such as around the neck region (where they can be examined physically) just above the breastbone, or developing internally and thus impossible to examine physically. The present paper seeks to review the assessment, examination and diagnosis of internal thyroid lesions that cannot be validated physically. The bumpy lumps are referred to as cysts, which may or may not incorporate fluid (fluid-filled/cystic or solid lumps) and the fluid can be either independent or integrated with thyroid cells.
The size and nature of thyroid nodules often influence their impact on the human neck and its function, such as in swallowing. The rate of a thyroid lesion to infect and negatively aggrieve normal functioning of the thyroid gland is termed as malignancy. Some of the nodules are cancerous, but the majority of nodules are non-cancerous. According to the American Thyroid Association, “the vast majority of thyroid nodules are benign (noncancerous) but a small proportion of thyroid nodules do contain thyroid cancer”.
As shall emerge hereafter, ultrasound imaging is a potential way of detecting ad diagnosing thyroid lesions, and according to Wong and Ahuja (2005), such imaging “helps to differentiate a malignant nodule from a more common benign thyroid nodule and identify a malignant nodule against a background nodular goiter (with an) incidence of between 1% and 3%”. Importantly however, it is important to differentiate a malignant thyroid lesion from a benign/noncancerous thyroid lesion. Malignant lesions are cancerous and they often grow infinitely, such that they can and doe invade adjacent tissues and thereafter spread, unlike the benign lesion that are noncancerous and often static and independent.
Benign Nodules
The condition of thyroid lesions has become common occurrence, most notably based on their common impact such as develop...