Clonal hematopoiesis of indeterminate significance (CHIP) refers to somatic mutations that occur within hematopoietic stem cells and is associated with increased cardiovascular risk, including myocardial infarction, and decreased overall survival. 83 , 84 Interestingly, an increased prevalence of CHIP has been noted in patients who have received pr
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“indeterminate significance”
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In the literature
In addition, in a series of 270 nodules with atypia of indeterminate significance evaluated by means of semi-quantitative USE, Cakir et al.
The use of fine needle aspiration of a thyroid mass can be considered; however presence of cytology of indeterminate significance including follicular proliferation and atypia of undetermined significance in between 5 and 20% of cases limits the use of this method [ 2 ].
A total of 50% of the patients had no indication of colposcopy, that is, normal cytologies, benign changes, ectopia, cervicitis, atypical squamous cells of indeterminate significance (ASC-US) and low-grade intraepithelial lesion (LSIL) without persistence and normal clinical appearance.
Furthermore, some authors have indicated that chemotherapy is of indeterminate significance in patients with PCNSL [ 7 ].
In terms of laterality, 3.2% of patients demonstrated bilateral nodule of indeterminate significance, while 3.9% demonstrated a unilateral pulmonary nodule.
D2‐40 (podoplanin) highlighted a subset of the spindled cells, with absent staining within the rounded nodules of indeterminate significance.
In certain cases, HE does not lead to organic impairments, being termed indeterminate significance HE or simply HE, which requires no treatment; only clinical follow-up is needed.
About 20% of the cytology results from thyroid FNA come back as an indeterminate result, which includes atypia or follicular lesion of indeterminate significance (Bethesda III) (AUS/FLUS) and follicular neoplasm/suspicious for follicular or oncocytic (formerly Hurthle) neoplasm (Bethesda IV) [ 2 ].
Surgery was indicated based on cytopathological results (5 malignant, 4 suspect, 8 follicular neoplasm, and 3 atypia of indeterminate significance cases) or when the nodule was benign but larger than 3 cm and causing compressive symptoms (25 cases).
6 Not surprisingly, in light of the pre‐existing diagnosis of RARS, a missense somatic mutation of SF3B1 was identified in our patient, which is among the 15 most commonly mutated genes seen in myeloid disorders and clonal hematopoiesis of indeterminate significance and is particularly prevalent (>80%) in patients MDS with ringed sideroblasts. 7 Our patient presented with an acute coronary syndrome on the background of no cardiovascular risk factors except a history of low‐grade MDS requiring regular darbepoetin infusions.
The chest CT demonstrated two 1-mm nodules of indeterminate significance and the bone scan showed uptake only in the left femur.
There were also sub-centimeter enhancing foci in the liver, of indeterminate significance.