Advertisement

Thyroid Fine Needle Aspiration Cytology

  • Xin Jing
Chapter
Part of the Atlas of Anatomic Pathology book series (AAP)

Abstract

Fine needle aspiration (FNA) is the procedure of choice in the management of thyroid nodules in an appropriate clinical setting. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been widely used while evaluating thyroid FNA specimens and communicating the findings with the clinicians who treat patients. This chapter includes 90 images demonstrating key cytologic features of common and uncommon thyroid entities outlined in TBSRTC. The role of ancillary studies as an adjunct to FNA cytology is discussed.

Keywords

Thyroid Fine needle aspiration FNA Bethesda system Benign thyroid nodule Malignant thyroid nodule Atypia of undetermined significance Follicular lesion of undetermined significance AUS/FLUS 

Notes

Acknowledgment

The author thanks Brian Smola, senior cytotechnologist at the University of Michigan, for proofreading and editing the chapter.

References

  1. 1.
    Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proc. 1994;69:44–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Holleman F, Hoekstra JB, Ruitenberg HM. Evaluation of fine needle aspiration (FNA) cytology in the diagnosis of thyroid nodules. Cytopathology. 1995;6:168–75.CrossRefPubMedGoogle Scholar
  3. 3.
    Mandreker SR, Nadkarni NS, Pinto RG, Menezes S. Role of fine needle aspiration cytology as the initial modality in the investigation of thyroid lesions. Acta Cytol. 1995;39:898–904.PubMedGoogle Scholar
  4. 4.
    Zagorianakou P, Malamou-Mitsi V, Zagorianakou N, Stefanou D, Tsatsoulis A, Agnantis NJ. The role of fine-needle aspiration biopsy in the management of patients with thyroid nodules. In Vivo. 2005;19:605–9.PubMedGoogle Scholar
  5. 5.
    Danese D, Sciacchitano S, Farsetti A, Andreoli M, Pontecorvi A. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid. 1998;8:15–21.CrossRefPubMedGoogle Scholar
  6. 6.
    Carmeci C, Jeffrey RB, McDougall IR, Nowels KW, Weigel RJ. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid. 1998;8:283–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Can AS. Cost-effectiveness comparison between palpation- and ultrasound-guided thyroid fine-needle aspiration biopsies. BMC Endocr Disord. 2009;9:14.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Can AS, Peker K. Comparison of palpation- versus ultrasound-guided fine-needle aspiration biopsies in the evaluation of thyroid nodules. BMC Res Notes. 2008;1:12.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid Cancer. Thyroid. 2016;26:1–133.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132:658–65.CrossRefPubMedGoogle Scholar
  11. 11.
    Nikiforov YE, Seethala RR, Tallini G, Baloch ZW, Basolo F, Thompson LD, et al. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: a paradigm shift to reduce overtreatment of indolent tumors. JAMA Oncol. 2016;2:1023–9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Strickland KC, Howitt BE, Marqusee E, Alexander EK, Cibas ES, Krane JF, et al. The impact of noninvasive follicular variant of papillary thyroid carcinoma on rates of malignancy for fine-needle aspiration diagnostic categories. Thyroid. 2015;25:987–92.CrossRefPubMedGoogle Scholar
  13. 13.
    Faquin WC, Wong LQ, Afrogheh AH, Ali SZ, Bishop JA, Bongiovanni M, et al. Impact of reclassifying noninvasive follicular variant of papillary thyroid carcinoma on the risk of malignancy in the Bethesda system for reporting thyroid cytopathology. Cancer Cytopathol. 2016;124:181–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Layfield LJ, Baloch ZW, Esebua M, Kannuswamy R, Schmidt RL. Impact of the reclassification of the non-invasive follicular variant of papillary carcinoma as benign on the malignancy risk of the Bethesda system for reporting thyroid cytopathology: a meta-analysis study. Acta Cytol. 2017;61(3):187–93.CrossRefPubMedGoogle Scholar
  15. 15.
    Li W, Sciallis A, Lew M, Pang J, Jing X. Implementing noninvasive follicular thyroid neoplasm with papillary-like nuclear features may potentially impact the risk of malignancy for thyroid nodules categorized as AUS/FLUS and FN/SFN. Diagn Cytopathol. 2017;46(2):148–53.CrossRefPubMedGoogle Scholar
  16. 16.
    Nishino M. Molecular cytopathology for thyroid nodules: a review of methodology and test performance. Cancer Cytopathol. 2016;124:14–27.CrossRefPubMedGoogle Scholar
  17. 17.
    Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer. 2007;111:306–15.CrossRefPubMedGoogle Scholar
  18. 18.
    Jing X, Michael CW. The Bethesda system for reporting thyroid cytopathology: current status and future directions. J Basic Clin Med. 2015;4:52–64.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyThe University of Michigan-Michigan MedicineAnn ArborUSA

Personalised recommendations