False-positive FNA due to highly sensitive BRAF assay.
Publication/Presentation Date
1-1-2014
Abstract
OBJECTIVE: False-positive BRAF analysis on fine-needle aspiration (FNA) has rarely been reported in the literature but may become more common with the advent of assays that can detect the BRAF V600E mutation in only 2% of otherwise wild-type thyroid cells. We present the case of an indeterminate BRAF-positive FNA that showed no evidence of cancer on final surgical pathology.
METHODS: Case report and literature review.
RESULTS: An 87-year-old female with an indeterminate 1.7-cm nodule but BRAF-positive cytology underwent thyroid lobectomy. Final pathology revealed a benign adenomatoid nodule. An area rich in tumor cells from the nodule was identified, labeled, and microdissected for molecular testing, which demonstrated only wild-type BRAF, at the analytical limit of the assay.
CONCLUSION: Increasingly sensitive BRAF assays using dual-priming oligonucleotide-based multiplex polymerase chain reaction analysis can detect the BRAF V600E mutation when present in only 2% of a population of wild-type cells. This increases the risk of false-positive results, particularly in cases of indeterminate FNA. Clinicians must caution patients in these circumstances that BRAF molecular testing may not have a 100% positive predictive value.
Volume
20
Issue
1
First Page
8
Last Page
10
ISSN
1934-2403
Published In/Presented At
DiLorenzo, M. M., Miller, J. L., Tuluc, M., Wang, Z. X., Savarese, V. W., & Pribitkin, E. A. (2014). False-positive FNA due to highly sensitive BRAF assay. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 20(1), e8–e10. https://doi.org/10.4158/EP13294.CR
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
24014015
Department(s)
Administration and Leadership
Document Type
Article