Focusing on thyroid nodules in suspense: 10-15 mm with repeat cytology, Category III, the Bethesda System for Reporting Thyroid Cytopathology, TBSRTC

Big gain, no pain: Thyroid minimally invasive FNA (Thy MIFNA): Proposal of novelty in terminology

“…While ultrasonography (US) and fine-needle aspiration (FNA) serve as a diagnostic cornerstone to rule out malignancy in thyroid lesions, per se, remaining the main challenge in their management, to a lesser extent, core needle biopsy has been being currently used as another primary diagnostic tool for evaluating this crucial issue. Nevertheless, the debate is still ongoing, and in particular, indeterminate cytology remains to be a highly controversial issue in thyroid cytopathology, a dynamic discipline, to date [1][2][3] . To deal with this compelling state and resolve this issue, clinical data, sonographic features, elastographic pattern, or outcome of other imaging/interventional techniques should be considered together and also can be supported by the relevant molecular testing.…”

Comment on: "Evaluating treatment options in managing thyroid nodules with indeterminate cytology of TBSRTC in thyroidology: addendum aut non?"

“…The size cutoff point of 20 mm, per se , is widely considered by the authorities and also stated as a stage by AJCC/TNM, 8th ed., again, after its 7th ed. 3 In addition, the 2017 American College of Radiology (ACR) guidelines emphasized the size cutoff point of 25 mm 4 . Of note, the 2015 American Thyroid Association (ATA) Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer 5 recommended prophylactic central compartment neck dissection, ipsilateral or bilateral, for cases with papillary thyroid carcinoma with over T3 tumor, by remarking significantly to the size cutoff point of 40 mm [Recommendation 36(B); Weak recommendation, Low-quality evidence], like in the 2009 ATA Management Guidelines.…”

“… 3 Furthermore, the authors declared that they handled indeterminate cytology as Categories III and IV, TBSRTC. Nevertheless, many authorities in thyroidology, even the 2015 ATA Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer 4 , expressed and described indeterminate cytology as thyroid nodules, possessing cytology adjusted to Categories III, IV, and V, TBSRTC, 2nd ed. 6 , which possess the higher risk of malignancies (ROMs) that compared with its 1st ed.…”

A closer look at the size cutoff of 10 mm, below 10 mm in particular, in thyroidology: debate is still ongoing

“…While the recommendations have emphasized the size cutoff of 10 mm 1,3 , the study by Borges et al 5 provides data demonstrating that the nodules ≤10 mm were associated with Categories I and V, TBSRTC, 2nd ed. We have currently focused on thyroid nodules in suspense, 10-15 mm with repeat cytology of Category III, TBSRTC, whether or not necessitating a needful upgrade in thyroidology, has published in issue 2, volume 67, Revista da Associação Médica Brasileira 6 .…”