Background: The objective of this study was to the assess the risk of malignancy in thyroid lesions that were diagnosed as AUS/FLUS when using a novel cytology subclassification system that is based on the presence or absence of papillary features.
Methods: AUS/FLUS case cytology was re-reviewed and subclassified into minor or major concern groups based upon the absence or presence of papillary features, respectively. The risk of malignancy (ROM) was calculated and compared between the two groups. Inter-pathologist agreement in case subclassification was also measured.
Results: The minor concern group had a 12.6% associated ROM, while the major concern group had a significantly higher ROM (58.4%), (P < 0.001). Based on 108 cases, the inter-pathologist agreement in case subclassification was 79%, and the κ value was 0.47.
Conclusions: The identification of papillary features significantly increases the ROM in thyroid lesions with an AUS/FLUS diagnosis.
Keywords: Atypia of undetermined significance; Fine needle aspiration biopsy; Follicular lesion of undetermined significance; Malignancy risk; Thyroid cytology.
Copyright © 2023 Elsevier Inc. All rights reserved.