{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:43:54Z","timestamp":1785404634540,"version":"3.56.0"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,6,2]],"date-time":"2014-06-02T00:00:00Z","timestamp":1401667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Benign thyroid nodules with papillary hyperplasia (BTN\u2010PH) are sometimes misinterpreted cytologically as papillary thyroid carcinoma (PTC). We evaluated a fine\u2010needle aspiration biopsy (FNAB) series of BTN\u2010PH to identify the causes of diagnostic error and to better define its cytologic criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A total of 48 FNAB cases of histologically confirmed BTN\u2010PHs from 44 patients were identified from our archives. The available cytological and histological slides were reviewed and scored for 10 cytomorphological features. Fifteen FNAB cases of classical PTC were also reviewed for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The FNAB diagnoses for the 48 BTN\u2010PHs were: benign, 18; suspicious for malignancy (S\u2010PTC), 12); atypia of undetermined significance\/follicular lesion of undetermined significance (AUS\/FLUS), 10; follicular neoplasm, 5; malignant (PTC), 2; and nondiagnostic, 1. The extent of PH in the corresponding histology was highest in FNAB cases diagnosed as S\u2010PTC\/PTC versus all other categories (54% vs 27%; <jats:italic>P<\/jats:italic>\u2009=\u2009.0084). Papillary cytoarchitectural features were present in 53% of FNAB cases overall and in 89% of cases diagnosed as S\u2010PTC\/PTC (<jats:italic>P<\/jats:italic>\u2009=\u2009.0093). Nuclei were smaller in FNABs of BTN\u2010PH compared with PTC (mean diameter\/range, 8.2\/6\u201012 vs 14.2\/7\u201026 \u03bcm, respectively; <jats:italic>P<\/jats:italic>\u2009=\u2009.0001). Twenty\u2010six percent of BTN\u2010PHs contained cytoplasmic pigment. All FNAB cases diagnosed as S\u2010PTC\/PTC had focal nuclear atypia including grooves (87.5%), enlargement and crowding (75%), and chromatin pallor and pseudoinclusions (25%); however, the extent of nuclear atypia was significantly less than in the control group of PTCs (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>BTN\u2010PH represents a significant pitfall in thyroid FNABs in which it can be misinterpreted as S\u2010PTC\/PTC. Cytologic clues to this pitfall include limited and variable nuclear atypia, small nuclear size, and cytoplasmic pigment. <jats:bold><jats:italic>Cancer (Cancer Cytopathol)<\/jats:italic> 2014;122:666\u2013677.<\/jats:bold> \u00a9 <jats:italic>2014 American Cancer Society.<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21441","type":"journal-article","created":{"date-parts":[[2014,6,2]],"date-time":"2014-06-02T18:31:00Z","timestamp":1401733860000},"page":"666-677","source":"Crossref","is-referenced-by-count":28,"title":["FNAB of benign thyroid nodules with papillary hyperplasia: A cytological and histological evaluation"],"prefix":"10.1002","volume":"122","author":[{"given":"Marc P.","family":"Pusztaszeri","sequence":"first","affiliation":[{"name":"Department of Pathology Geneva University Hospital Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey F.","family":"Krane","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Department of Pathology Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund S.","family":"Cibas","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Department of Pathology Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Daniels","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Thyroid Unit and Department of Medicine Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Faquin","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Department of Pathology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,6,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.16.3.468"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-87666-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20830"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0155"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP5N4MTHPAFXFB"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21754"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2559.2001.01148.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1385\/EP:14:1:55"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.2007.00379.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199705)16:5<454::AID-DC14>3.0.CO;2-I"},{"key":"e_1_2_7_12_1","first-page":"510","article-title":"Thyroid papillary hyperplasia mistaken for papillary carcinoma in fine needle aspiration cytology and frozen section examination","volume":"147","author":"Flikweert ER","year":"2003","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.14.7.863"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.5858\/2001-125-1575-ACOPSP","article-title":"Aspiration cytology of pediatric solitary papillary hyperplastic thyroid nodule","volume":"125","author":"Khurana KK","year":"2001","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_7_15_1","first-page":"S135","article-title":"Cytologic and architectural mimics of papillary thyroid carcinoma. 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