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Specimen Adequacy and Non-diagnostic Thyroid Nodules

  • Pichet Sampatanukul
  • Andrey BychkovEmail author
Chapter

Abstract

The assessment of adequacy is the first step in the evaluation of a thyroid fine-needle aspiration (FNA) sample. A specimen with adequate cellularity is a key to the success of thyroid cytology because it assures minimal false-negative rate. The adequacy of a thyroid FNA is defined by both the quantity and quality of the cellular and colloid components. According to the Bethesda system for reporting thyroid cytopathology, a specimen is defined as non-diagnostic if it fails to meet the adequacy criteria (at least 6 groups × 10 benign-appearing, well-visualized follicular cells), with exceptions for thyroiditis, abundant colloid, or any degree of atypia. This chapter discusses cytologic criteria of adequacy along with some controversial or currently evolving topics, such as cyst fluid-only aspirates, adequacy in liquid-based preparations, and proposed modifications of the adequacy criteria. A clinically oriented part is devoted to non-diagnostic thyroid nodules and their management. The last section describes some practical hints and techniques to improve adequacy. The chapter is addressed primarily to cytopathologists; however, it would be useful for each member of the thyroid patient care team, including clinicians (FNA operator and physician in charge) and cytotechnologists.

Keywords

Cytology Fine-needle aspiration Thyroid Adequacy Non-diagnostic Unsatisfactory Ultrasound-guided FNA Rapid on-site evaluation 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Faculty of Medicine, Department of PathologyChulalongkorn UniversityBangkokThailand
  2. 2.Department of PathologyKameda Medical CenterKamogawaJapan

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