Publications by authors named "Giancarlo Di Coscio"

Background: Papillary thyroid cancer is the most common endocrine malignancy. The most sensitive and specific diagnostic tool for thyroid nodule diagnosis is fine-needle aspiration (FNA) biopsy with cytological evaluation. Nevertheless, FNA biopsy is not always decisive leading to "indeterminate" or "suspicious" diagnoses in 10%-30% of cases.

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Objective: Chromosomal rearrangements of the RET proto-oncogene is one of the most common molecular events in papillary thyroid carcinoma (PTC). However, their pathogenic role and clinical significance are still debated. This study aimed to investigate the prevalence of RET/PTC rearrangement in a cohort of BRAF WT PTCs by fluorescence in situ hybridization (FISH) and to search a reliable cut-off level in order to distinguish clonal or non-clonal RET changes.

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Background: Fine-needle aspiration (FNA) has been widely accepted as the most crucial step in the preoperative assessment of thyroid nodules, but the false-negative rates are generally reported to be between 3.6% and 10.2%.

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Fine-needle aspiration biopsy (FNA) is usually applied to distinguish benign from malignant thyroid nodules. However, cytological analysis cannot always allow a proper diagnosis. We believe that the improvement of the diagnostic capability of pre-surgical FNA could avoid unnecessary thyroidectomy.

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A progressive increase in the incidence of thyroid cancer (TC) has been reported over the last few decades. This either reflects the increased number of newly discovered and accurately selected thyroid nodules with more sensitive technologies and a relative more potent carcinogenic effect of pathogenetic factors in malignant, but not benign nodules. This observational time-trend study addresses this issue by analysing the proportion of TC within 8411 consecutive thyroid nodule (TN) patients evaluated in Pisa by the same pathology Department and individual clinician over a four-decade period.

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Background: Thyroid nodules with indeterminate cytological features on fine needle aspiration (FNA) cytology have a 20% risk of thyroid cancer. The aim of the current study was to determine the diagnostic utility of an 8-gene assay to distinguish benign from malignant thyroid neoplasm.

Methods: The mRNA expression level of 9 genes (KIT, SYNGR2, C21orf4, Hs.

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Objective: MicroRNAs (miRNAs) are small endogenous noncoding RNAs that pair with target messengers regulating gene expression. Changes in miRNA levels occur in thyroid cancer. Fine-needle aspiration (FNA) with cytological evaluation is the most reliable tool for malignancy prediction in thyroid nodules, but cytological diagnosis remains undetermined for 20% of nodules.

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Background: A large amount of information has been collected on the molecular tumorigenesis of thyroid cancer. A low expression of c-KIT gene has been reported during the transformation of normal thyroid epithelium to papillary carcinoma suggesting a possible role of the gene in the differentiation of thyroid tissue rather than in the proliferation. The initial presentation of thyroid carcinoma is through a nodule and the best way nowadays to evaluate it is by fine-needle aspiration (FNA).

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Background: Papillary carcinomas with diameters that are less than or equal to 1 cm (thyroid papillary microcarcinoma [mPTC]) are quite common but can carry more risk than previously thought. The proper treatment and management of these lesions is still being debated. Even though fine needle aspiration cytology (FNAC) is considered the best method for the diagnosis of thyroid nodules, its efficacy is still questioned for mPTC.

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Aims: To assess whether the large needle aspiration biopsy (LNAB) histological distinction between pure microfollicular nodules and mixed micro-macrofollicular nodules can assist preoperative selection of a Hürthle cell nodule (HCN) discovered by fine needle aspiration cytology (FNAC).

Methods And Results: In 24 HCN identified by preoperative FNAC, preoperative LNAB histology was compared with postoperative pathology. FNAC demonstrated seven benign HCN (negative), eight HCN with atypia (positive); seven suspected cancers with HC (positive); and two cancers with Hürthle cells (positive).

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Article Synopsis
  • The study investigates the BRAF mutation status in thyroid tumors, specifically focusing on follicular variant of papillary thyroid carcinoma (FVPTC) to help differentiate between benign and malignant lesions.
  • A total of 187 patients’ tumors were analyzed, correlating BRAF status with cytomorphological features assessed through fine-needle aspiration diagnoses categorized by the British Thyroid Association Guidelines.
  • Results indicated significant differences in BRAF mutation prevalence between the cytological classes, with only a small percentage of FVPTC cases showing BRAF mutations, suggesting that BRAF might play a limited role in the diagnosis of FVPTC.
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Article Synopsis
  • More cases of differentiated thyroid cancer (DTC) have been found around the world, especially after 1990.
  • Patients diagnosed after 1990 had smaller tumors and a better chance of living longer compared to those diagnosed before.
  • Older age and advanced disease are still the biggest reasons for lower survival rates in DTC patients.
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Background: New techniques of improving diagnostic reliability of thyroid nodules are needed.

Aim And Methods: This prospective cohort study includes patients with one (201) or multiple (22) palpable nodule(s). Preoperative fine-needle aspiration biopsy (FNAB), large-needle aspiration biopsy (LNAB), and galectin-3 detection on LNAB (GAL-3-LNAB) (total of 245 nodules) were compared when the FNAB finding was 'inadequate' or 'indeterminate'.

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Background: Although most thyroid nodule fine-needle aspiration (FNA) diagnoses are definitive or nearly definitive, about 30% of them are not read as definitively benign or malignant, the so-called indeterminate or suspicious FNA diagnosis. The prevalence of malignancy in FNA samples with these diagnoses varies from 10% to 52%. The first aim of this study was to determine if BRAF V600E analysis of thyroid FNA cytological smears could be performed with a relatively simple protocol.

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Objective: To assess by ultrasonography the safety of the association fine-needle aspiration (FNA) plus a new percutaneous large-needle aspiration biopsy technique (LNAB), and to compare the results obtained with the two techniques in the same testicle and with FNA in the two testicles of the same patient.

Design: Retrospective analysis of clinical, ultrasonographic, and pathologic data.

Setting: Clinical and academic research environment.

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Among 1875 patients with palpable thyroid nodules examined with FNA cytology and LNAB histology, 132 with a preoperative FNA diagnosis of microfollicular nodule with atypical cells (n = 50) or suspected cancer (n = 82) were operated on. The 50 nodules showed the following preoperative LNAB finding: inadequate (8), benign (15), microfollicular (20), microfollicular with atypical cells (5), suspected cancer (2). The postoperative cancer incidence in the nodules with the benign LNAB diagnosis was 0% while it was 10%, 60% (P = 0.

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The survival rate of patients with medullary thyroid carcinoma (MTC) is significantly better in patients diagnosed and treated when the tumor is limited to the thyroid. In a pioneer study carried out in 1991, we demonstrated that routine measurement of serum calcitonin (CT) in nodular thyroid disease allowed the preoperative diagnosis of unsuspected sporadic MTC with better accuracy than routine fine needle aspiration cytology (FNAC). This finding has been confirmed in subsequent studies.

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Objective: To assess the use of testicular needle aspiration techniques to evaluate fertility potential in azoospermic, formerly cryptorchid men.

Study Design: Fifteen consecutive adult azoospermic, formerly cryptorchid patients (eight unilateral and seven bilateral) were examined by needle aspiration techniques, fine (FNA) and large needle (LNAB) testicular aspiration biopsy, for cytologic and histologic analysis. Five of the 15 subsequently underwent surgical biopsy for attempted assisted fertilization.

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The preoperative fine-needle aspiration (FNA) cytologic diagnoses of microfollicular nodule and suspected cancer include nodules that yield histologic results of typically benign lesions, nodular hyperplasia and follicular adenomas, and differentiated thyroid cancer postoperatively. We reviewed the clinical and pathologic data for patients with palpable thyroid nodules with these two cytologic diagnoses; nodules were also examined by large-needle aspiration biopsy (LNAB) to assess whether the distinction achieved by LNAB in pure microfollicular or mixed microfollicular-macrofollicular nodules could be used preoperatively to better predict the diagnosis of follicular adenoma. One hundred fourteen nodules of this type were excised.

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