Abstract
Fine needle aspiration biopsy (FNAB) is a diagnostic test routinely used in the evaluation of thyroid nodule disease and it is crucial to stratify the risk of malignancy. Furthermore, FNAB can also be used to evacuate large cystic nodules and is helpful in patient with thyroid cancer to detect lymph nodes metastases. FNAB is a minimally invasive procedure with low risks and can be usually performed on an outpatient basis by experienced physicians. It is fundamental to obtain an adequate signed consent after the patient has been fully informed. US guidance is routinely used. Biopsy specimens may be obtained with two widely used acquisition methods. The choice between “nonaspiration” and “aspiration” is a matter of operator preference. The only serious contraindication is hemorrhagic diathesis.
The material collected during FNAB can be processed in two different ways: conventional smear or thin prep. The cytopathologic finding is reported using the Bethesda criteria.
The measurement of thyroglobulin in the washout fluid of lymph node FNAB has been proposed as a useful diagnostic method in detecting metastatic lymph nodes of DTC patients.
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References
Hegedus L (2004) Clinical practice. The thyroid nodule. N Engl J Med 351:1764–1771
Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, Vitti P for the AACE/AME/ETA Task Force on Thyroid Nodules (2010) American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 16(Suppl 1):1–43
De Vos Toto Nederveen Cappel RJ, Bouvy ND, Bonjer HJ et al (2001) Fine needle aspiration cytology of thyroid nodules: how accurate is it and what are the causes of discrepant cases? Cytopathology 12:399–405
Chen W, Parsons M, Torigian DA, Zhuang H, Alavi A (2009) Evaluation of thyroid FDG uptake incidentally identified on FDG-PET/CT imaging. Nucl Med Commun 30(3):240–244
Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11):1167–1214
Brito JP, Morris JC, Montori VM (2013) Thyroid cancer: zealous imaging has increased detection and treatment of low risk tumours. BMJ 347:f4706
Kim MJ, Kim EK, Park SI, Kim BM, Kwak JY, Kim SJ, Youk JH, Park SH (2008) US-guided fine-needle aspiration of thyroid nodules: indications, techniques, results. Radiographics 28(7):1869–1886
Serna de la Saravia C, Cuellar F, Saravio Day E, Harach HR (2006) Accuracy of aspiration cytology in thyroid cancer: a study in 1 institution. Acta Cytol 50:384–387
Danese D, Sciacchitano S, Farsetti A, Andreoli M, Pontecorvi A (1998) Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid 8:15–21
Papanicolaou Society of Cytopathology Task Force on Standards of Practice (1997) Guidelines of the Papanicolaou Society of Cytopathology for fine-needle aspiration procedure and reporting. Diagn Cytopathol 17:239–247
Duncan LD, Forrest L, Law WM Jr, Hubbard E, Stewart LE (2011) Evaluation of thyroid fine-needle aspirations: can ThinPrep be used exclusively to appropriately triage patients having a thyroid nodule? Diagn Cytopathol 39(5):341–348
Lee SH, Jung CK, Bae JS, Jung SL, Choi YJ, Kang CS (2014) Liquid-based cytology improves preoperative diagnostic accuracy of the tall cell variant of papillary thyroid carcinoma. Diagn Cytopathol 42(1):11–17
Cibas ES, Ali SZ, NCI Thyroid FNA State of the Science Conference (2009) The bethesda system for reporting thyroid cytopathology. Am J Clin Pathol 132(5):658–665
Alexander EK, Kennedy GC, Baloch ZW, Cibas ES, Chudova D, Diggans J, Friedman L, Kloos RT, LiVolsi VA, Mandel SJ, Raab SS, Rosai J, Steward DL, Walsh PS, Wilde JI, Zeiger MA, Lanman RB, Haugen BR (2012) Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med 367(8):705–715
Nikiforov YE, Carty SE, Chiosea SI, Coyne C, Duvvuri U, Ferris RL, Gooding WE, Hodak SP, LeBeau SO, Ohori NP, Seethala RR, Tublin ME, Yip L, Nikiforova MN (2014) Highly accurate diagnosis of cancer in thyroid nodules with follicular neoplasm/suspicious for a follicular neoplasm cytology by ThyroSeq v2 next-generation sequencing assay. Cancer 120(23):3627–3634
Nasrollah N, Trimboli P, Guidobaldi L, Cicciarella Modica DD, Ventura C, Ramacciato G, Taccogna S, Romanelli F, Valabrega S, Crescenzi A (2013) Thin core biopsy should help to discriminate thyroid nodules cytologically classified as indeterminate. A new sampling technique. Endocrine 43(3):659–665
Nishihara E, Miyauchi A, Matsuzuka F, Sasaki I, Ohye H, Kubota S, Fukata S, Amino N, Kuma K (2005) Acute suppurative thyroiditis after fine-needle aspiration causing thyrotoxicosis. Thyroid 15(10):1183–1187
Schlumberger M, Pacini F, Wiersinga WM, Toft A, Smit JW, Sanchez Franco F, Lind P, Limbert E, Jarzab B, Jamar F, Duntas L, Cohen O, Berg G (2004) Follow-up and management of differentiated thyroid carcinoma: a European perspective in clinical practice. Eur J Endocrinol 151(5):539–548
Pacini F, Fugazzola L, Lippi F et al (1992) Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. J Clin Endocrinol Metab 74:1401–1404
Frasoldati A, Toschi E, Zini M et al (1999) Role of thyroglobulin measurement in fine-needle aspiration biopsies of cervical lymph nodes in patients with differentiated thyroid cancer. Thyroid 9:105–111
Snozek CL, Chambers EP, Reading CC, Sebo TJ, Sistrunk JW, Singh RJ, Grebe SK (2007) Serum thyroglobulin, high-resolution ultrasound, and lymph node thyroglobulin in diagnosis of differentiated thyroid carcinoma nodal metastases. J Clin Endocrinol Metab 92(11):4278–4281
Boi F, Maurelli I, Pinna G, Atzeni F, Piga M, Lai ML, Mariotti S (2007) Calcitonin measurement in wash-out fluid from fine needle aspiration of neck masses in patients with primary and metastatic medullary thyroid carcinoma. J Clin Endocrinol Metab 92(6):2115–2118
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Locantore, P., Ianni, F., Pontecorvi, A. (2016). Fine Needle Aspiration Biopsy. In: Lombardi, C., Bellantone, R. (eds) Minimally Invasive Therapies for Endocrine Neck Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-20065-1_2
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DOI: https://doi.org/10.1007/978-3-319-20065-1_2
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