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Benign

  • Tarik M. Elsheikh
  • Béatrix Cochand-Priollet
  • Pedro Patricio de Agustin
  • Mary K. Sidawy
  • Matthew A. Zarka
Chapter

Abstract

Thyroid FNA derives much of its clinical value from its ability to reliably identify benign thyroid nodules, thus sparing many patients with nodular thyroid disease unnecessary surgery. Since most thyroid nodules are benign, a benign result is the most common FNA interpretation (approx. 65% of all cases).

To report benign thyroid cytopathology results, the term “Benign” is preferred over other terms such as “Negative for malignancy” and “Non-neoplastic.”Benign cytopathology is associated with a very low risk of malignancy, and patients are usually followed conservatively with periodic clinical and radiologic examinations. Benign results are further sub-classified as benign follicular nodules, thyroiditis, or other less common entities. Nodular goiter (NG) is the most commonly sampled lesion by FNA, and lymphocytic (Hashimoto’s) thyroiditis is the most commonly encountered form of thyroiditis.

Keywords

Papillary Thyroid Carcinoma Papillary Carcinoma Follicular Cell Benign Thyroid Nodular Goiter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Yassa L, Cibas ES, Benson CB, et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation.Cancer. 2007;111(6):508-516.CrossRefPubMedGoogle Scholar
  2. 2.
    Gharib H, Goellner JR, Johnson DA. Fine-needle aspiration cytology of the thyroid: a 12-year experience with 11, 000 biopsies.Clin Lab Med. 1993;13:699-709.PubMedGoogle Scholar
  3. 3.
    Baloch ZW, Cibas ES, Clark DP, et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation.Cytojournal. 2008;5:6.CrossRefPubMedGoogle Scholar
  4. 4.
    Baloch ZW, LiVolsi VA, Asa SL, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference.Diagn Cytopathol. 2008;36(6):425-437.CrossRefPubMedGoogle Scholar
  5. 5.
    Grant CS, Hay ID, Gough IR, McCarthy PM, Goellner JR. Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses.Surgery. 1989;106:980-985.PubMedGoogle Scholar
  6. 6.
    Clark DP, Faquin WC.Thyroid Cytopathology. New York: Springer; 2005.Google Scholar
  7. 7.
    Berezowski K, Jovanovic I, Sidawy MK. Thyroid. In: Sidawy MK, Ali SZ, eds.Fine Needle Aspiration Cytology. Churchill:Livingstone 2007 [Chapter 2].Google Scholar
  8. 8.
    Elsheikh TM, Singh HK, Saad R, Silverman JF. Fine needle aspiration of the head and neck. In: Barnes L, ed.Surgical pathology of the head and neck. New York:Informa Healthcare USA 2009.Google Scholar
  9. 9.
    Orell SR, Philips J.The Thyroid. Fine needle biopsy and cytological diagnosis of thyroid lesions. Vols. 14. Basel:Kaarger 1997.Google Scholar
  10. 10.
    Pitman MB, Abele J, Ali S, et al. Techniques for Thyroid FNA: a synopsis of the national cancer institute thyroid fine needle aspiration state of the science conference.Diagn Cytopathol. 2008;36(6):407-424.CrossRefPubMedGoogle Scholar
  11. 11.
    Suen KC. How does one separate cellular follicular lesions of the thyroid by fine-needle aspiration biopsy?Diagn Cytopathol. 1988;4:78-81.CrossRefPubMedGoogle Scholar
  12. 12.
    Tulecke MA, Wang HH. ThinPrep for cytologic evaluation of follicular thyroid lesions: correlation with histologic findings.Diagn Cytopathol. 2004;30(1):7-13.CrossRefPubMedGoogle Scholar
  13. 13.
    Hoda RS. Non-gynecologic cytology on liquid-based preparations: A morphologic review of facts and artifacts.Diagn Cytopathol. 2007;35(10):621-634.CrossRefPubMedGoogle Scholar
  14. 14.
    Cochand-Priollet B, Prat JJ, Polivka M, Thienpont L, Dahan H, Wassef M, et al. Thyroid fine needle aspiration: the morphological features on ThinPrep slide preparations. Eighty cases with histological control.Cytopathology2003;14(6):343–349.Google Scholar
  15. 15.
    Malle D, Valeri RM, Pazaitou-Panajiotou K, Kiziridou A, Vainas I, Destouni C. Use of a thin-layer technique in thyroid fine needle aspiration.Acta Cytol. 2006;50(1):23-27.PubMedGoogle Scholar
  16. 16.
    Soderstrom N, Nilsson G. Cytologic diagnosis of thyrotoxicosis.Acta Med Scand. 1979;205(4):263-265.PubMedGoogle Scholar
  17. 17.
    Baloch ZW, Sack MJ, Yu GH, Livolsi VA, Gupta PK. Fine-needle aspiration of thyroid: an institutional experience.Thyroid. 1998;8(7):565-569.CrossRefPubMedGoogle Scholar
  18. 18.
    Anderson SR, Mandel S, LiVolsi VA, Gupta PK, Baloch ZW. Can cytomorphology differentiate between benign nodules and tumors arising in Graves’ disease?Diagn Cytopathol. 2004;31(1):64-67.CrossRefPubMedGoogle Scholar
  19. 19.
    Centeno BA, Szyfelbein WM, Daniels GH, Vickery AL. Fine-needle aspiration biopsy of the thyroid gland in patients with prior Graves’ disease treated with radioactive iodine: morphologic findings and potential pitfalls.Acta Cytol. 1996;40:1189-1197.PubMedGoogle Scholar
  20. 20.
    Jayaram G, Marwaha RK, Gupta RK, Sharma SK. Cytomorphologic aspects of thyroiditis. A study of 51 cases with functional, immunologic and ultrasonographic data.Acta Cytol1987;31(6):687–693.Google Scholar
  21. 21.
    Lu CP, Chang TC, Wang CY, Hsiao YL. Serial changes in ultrasound-guided fine needle aspiration cytology in subacute thyroiditis.Acta Cytol. 1997;41(2):238-243.PubMedGoogle Scholar
  22. 22.
    Kumarasinghe MP, De Silva S. Pitfalls in cytological diagnosis of autoimmune thyroiditis.Pathology. 1999;31(1):1-7.CrossRefPubMedGoogle Scholar
  23. 23.
    MacDonald L, Yazdi HM. Fine needle aspiration biopsy of Hashimoto’s thyroiditis. Sources of diagnostic error. Acta Cytol 1999;43(3):400-6.Google Scholar
  24. 24.
    Frost AR, Sidawy MK, Ferfelli M, et al. Utility of thin-layer preparations in thyroid fine-needle aspiration. Diagnostic accuracy, cytomorphology, and optimal sample preparation.Cancer(Cancer Cytopathol) 1998;84:17–25.Google Scholar
  25. 25.
    Harigopal M, Sahoo S, Recant WM, DeMay RM. Fine-needle aspiration of Riedel’s disease: report of a case and review of the literature.Diagn Cytopathol. 2004;30(3):193-197.CrossRefPubMedGoogle Scholar
  26. 26.
    Layfield L, Cochand-Priollet B, LiVolsi V, Abrams J, Merino M, Gharib H.et al. Post Thyroid FNA Testing and Treatment Options: A synopsis of the national cancer institute thyroid fine needle aspiration state of the science conference. Diagnostic Cytopathology; 2008.Google Scholar
  27. 27.
    Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer.Thyroid. 2006;16(2):109-142.CrossRefPubMedGoogle Scholar
  28. 28.
    Bakhos R, Selvaggi SM, DeJong S, et al. Fine-needle aspiration of the thyroid: rate and causes of cytohistopathologic discordance.Diagn Cytopathol. 2000;23(4):233-237.CrossRefPubMedGoogle Scholar
  29. 29.
    Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal.Ann Int Med. 1993;118:282-289.PubMedGoogle Scholar
  30. 30.
    Yeh MW, Demircan O, Ituarte P, Clark OH. False-negative fine-needle aspiration cytology results delay treatment and adversely affect outcome in patients with thyroid carcinoma.Thyroid. 2004;14(3):207-215.CrossRefPubMedGoogle Scholar
  31. 31.
    Tee YY, Lowe AJ, Brand CA, Judson RT. Fine-needle aspiration may miss a third of all malignancy in palpable thyroid nodules: a comprehensive literature review.Ann Surg. 2007;246(5):714-720.CrossRefPubMedGoogle Scholar
  32. 32.
    Liel Y, Ariad S, Barchana M. Long-term follow-up of patients with initially benign thyroid fine-needle aspirations.Thyroid. 2001;11(8):775-778.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Tarik M. Elsheikh
    • 1
  • Béatrix Cochand-Priollet
    • 2
  • Pedro Patricio de Agustin
    • 3
  • Mary K. Sidawy
    • 4
  • Matthew A. Zarka
    • 5
  1. 1.Ball Memorial Hospital/PA LabsMuncieUSA
  2. 2.Department of PathologyLariboisière HospitalParisFrance
  3. 3.Department of PathologyUniversity Hospital “12 de Octubre,”MadridSpain
  4. 4.Department of PathologyGeorgetown University Medical CenterWashingtonUSA
  5. 5.Department of Laboratory Medicine and PathologyMayo Clinic ArizonaScottsdaleUSA

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