Cytopathology in the Thyroid of Graves Disease

  • Jen-Fan HangEmail author


The main role of thyroid fine needle aspiration in Patients with Graves disease is reserved for the evaluation of suspicious nodules, especially nodules showing low radioactive iodine uptake (cold nodules). In addition to neoplastic nodules, there are several nonneoplastic causes for nodularity, including coexisting adenomatous/colloid goiter, pseudonodules of lymphocytic infiltrate, and reactive/degenerative changes. Therefore, to evaluate the nature of thyroid nodules arising from patients with Graves disease is crucial for the clinical management. In fine needle aspiration, it is possible to sample the nonlesional tissue adjacent to the nodule. In addition to the diffuse hyperplastic changes, cytologic atypia is common in patients previously treated with antithyroid drugs or radioactive iodine. For these reasons, the interpretation of fine needle aspiration in Graves disease has been considered one of the most challenging tasks in thyroid cytopathology. In this chapter, we discuss the thyroid cytopathologic characteristics in Graves disease, particularly changes related to treatment as well as the diagnostic criteria of malignancy in this setting.


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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineTaipei Veterans General HospitalTaipeiTaiwan

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