Journal ArticleDOI
Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations.
TLDR
Using 6 diagnostic categories for the classification of thyroid fine‐needle aspiration (FNA) cytology, the experience with FNA from 2 institutions was studied with emphasis on cytologic‐histologic correlation, source of errors, and clinical management.Abstract:
BACKGROUND.
The Papanicolaou Society of Cytopathology recently proposed 6 diagnostic categories for the classification of thyroid fine-needle aspiration (FNA) cytology. Using these categories, the experience with FNA from 2 institutions was studied with emphasis on cytologic-histologic correlation, source of errors, and clinical management.
METHODS.
Patient cytology data were retrieved by a retrospective search of thyroid FNA in the institutional databases. Cytologic diagnoses were classified as unsatisfactory, benign, atypical cellular lesion (ACL), follicular neoplasm (FN), suspicious for malignancy, and positive for malignancy. Samples with a histologic discrepancy were re-evaluated, and clinical follow-up information was recorded.
RESULTS.
Of of 4703 FNA samples, 10.4% were classified as unsatisfactory, 64.6% were classified as benign, 3.2% were classified as ACL, 11.6% were classified as FN, 2.6% were classified as suspicious, and 7.6% were classified as malignant. Five hundred twelve patients had at least 1 repeat FNA, mainly for results in the unsatisfactory and ACL categories. One thousand fifty-two patients had surgical follow-up, including 14.9% of patients with unsatisfactory FNA results, 9.8% of patients with benign results, 40.6% of patients with ACL results, 63.1% of patients with FN results, 86.1% of patients with suspicious results, and 79.3% of patients with malignant results. The rates for histologically confirmed malignancy in these categories were 10.9%, 7.3%, 13.5%, 32.2%, 64.7%, and 98.6%, respectively. The cytologic-histologic diagnostic discrepancy rate was 15.3%. Sources of errors included diagnoses on inadequate specimens, sample errors, and overlapping cytologic features between hyperplastic nodules and follicular adenoma. The sensitivity and specificity of thyroid FNA for the diagnosis of malignancy were 94% and 98.5%, respectively.
CONCLUSIONS.
The current results indicated that FNA provides an accurate diagnosis of thyroid malignancy. The 6 diagnostic categories were beneficial for triaging patients for either clinical follow-up or surgical management. Cancer (Cancer Cytopathol) 2007. © 2007 American Cancer Society.read more
Citations
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Journal ArticleDOI
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.
Bryan R. Haugen,Erik K. Alexander,Keith C. Bible,Gerard M. Doherty,Susan J. Mandel,Yuri E. Nikiforov,Furio Pacini,Gregory W. Randolph,Anna M. Sawka,Martin Schlumberger,Kathryn G. Schuff,Steven I. Sherman,Julie Ann Sosa,David L. Steward,R. Michael Tuttle,Leonard Wartofsky +15 more
TL;DR: Evidence-based recommendations are developed to inform clinical decision-making in the management of thyroid nodules and differentiated thyroid cancer and represent, in the authors' opinion, contemporary optimal care for patients with these disorders.
Journal ArticleDOI
Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer
David S. Cooper,Gerard M. Doherty,Bryan R. Haugen,Richard T. Kloos,Stephanie L. Lee,Susan J. Mandel,Ernest L. Mazzaferri,Bryan McIver,Furio Pacini,Martin Schlumberger,Steven I. Sherman,David L. Steward,R. Michael Tuttle +12 more
TL;DR: Evidence-based recommendations in response to the appointment as an independent task force by the American Thyroid Association to assist in the clinical management of patients with thyroid nodules and differentiated thyroid cancer represent, in the authors' opinion, contemporary optimal care for patients with these disorders.
Journal ArticleDOI
The Bethesda System for Reporting Thyroid Cytopathology.
Edmund S. Cibas,Syed Z. Ali +1 more
TL;DR: The project participants hope that the adoption of this framework will facilitate communication among cytopathologists, endocrinologists, surgeons, and radiologists; facilitate cytologic-histologic correlation for thyroid diseases; facilitate research into the understanding of Thyroid diseases; and allow easy and reliable sharing of data from different laboratories for national and international collaborative studies.
Journal ArticleDOI
The Bethesda System for Reporting Thyroid Cytopathology
Edmund S. Cibas,Syed Z. Ali +1 more
TL;DR: The conclusions regarding terminology and morphologic criteria from the NCI meeting led to the Bethesda Thyroid Atlas Project and form the framework for The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), a flexible framework for communication and research into thyroid diseases.
Journal ArticleDOI
The 2017 Bethesda System for Reporting Thyroid Cytopathology.
Edmund S. Cibas,Syed Z. Ali +1 more
TL;DR: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) established a standardized, category-based reporting system for thyroid fine-needle aspiration specimens, and the 2017 revision reaffirms that every thyroid FNA report should begin with one of six diagnostic categories.
References
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