American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules

Gharib, Hossein; Papini, Enrico; Valcavi, Roberto; Baskin, H. Jack; Crescenzi, Anna; Dottorini, Massimo E.; Duick, Daniel S.; Guglielmi, Rinaldo; Hamilton, Carlos R.; Zeiger, Martha A.; Zini, Michele; Brett, Elise M.; Camacho, Pauline M.; Dagogo‐Jack, Samuel; Fonseca, Vivian; Gagel, Robert F.; González-Campoy, J. Michael; Handelsman, Yehuda; Harrell, R. Mack; Khardori, Romesh; Laufgraben, Marc J.; Levy, Philip; LiVolsi, Virginia A.; Mechanick, Jeffrey I.; Odugbesan, A. Ola; Ovalle, Fernando; Petak, Steven M.; Reddy, S. Sethu K.; Rettinger, Herbert I.; Roberts, V.; Shankar, Talla P.; Torre, Joseph J.; Trence, Dace L.; Weiss, Roy E.; Wong, Milton K.

doi:10.4158/ep.12.1.63

Cited by 543 publications

(138 citation statements)

References 122 publications

(86 reference statements)

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“…As reported by the EFCS working group, terminologies proposed in the USA [14,15,16,17] and the UK (BTA/RCPath) [17] are not universally used (table 4). Except for Italy and the UK, no European country has a national terminology for reporting the results of FNA of thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

The Bethesda Terminology for Reporting Thyroid Cytopathology: From Theory to Practice in Europe

Cochand‐Priollet

Schmitt²,

Tötsch³

et al. 2011

Acta Cytologica

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Objectives: A 2007 conference held at the National Cancer Institute, Bethesda, Md., USA, proposed a new terminology for classifying the results of thyroid fine-needle aspiration (FNA) – The Bethesda System for Reporting Thyroid Cytology (TBSRTC). The need to standardize thyroid FNA terminology was emphasized during the 35th European Congress of Cytology in 2009. An interobserver review study to assess the new terminology for analyzing the results of thyroid FNA was organized by the scientific committee of the European Federation of Cytology Societies. Study Design: Four experts in thyroid FNA examined and classified 116 FNAs according to the 6 levels of TBSRTC which are: nondiagnostic (ND); benign; atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS); follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN), with those of Hürthle cell type reported as follicular neoplasm, Hürthle cell type/suspicious for a follicular neoplasm, Hürthle cell type (FNHCT/SFNHCT); suspicious (SUS), and malignant. Results: The total consensus was 62.1%; the cytopathologists disagreed on 44 cases, including 8 cases of AUS/FLUS and 18 of FN/SFN; 59% of the cases had no consensus. They agreed on 73 and 80% of the cases classified as benign and malignant, respectively, and on 58.3% of the SUS cases. The percentage of no consensus for each expert was between 32 and 39%. Conclusions: Disagreement regarding the use of TBSRTC terminology for classifying the results of thyroid FNA mainly occurred in the most-often criticized categories of AUS/FLUS and FN/SFN.

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Section: Discussionmentioning

confidence: 99%

The Bethesda Terminology for Reporting Thyroid Cytopathology: From Theory to Practice in Europe

Cochand‐Priollet

Schmitt²,

Tötsch³

et al. 2011

Acta Cytologica

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“…Thyroid nodules are very common lesions, and sampling these lesions to rule out malignancy and further characterization by fine needle aspiration (FNA) are very common practices [1,2,3]. Essentially, in our hospital, thyroid FNA biopsy samples are the most frequent FNA material that our cytology laboratory service receives.…”

Section: Introductionmentioning

confidence: 99%

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: Phase I Pilot Retrospective Analysis

et al. 2013

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We analyzed and evaluated our adequacy rate and the classification of our thyroid aspirates using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). All thyroid fine needle aspirates that were collected or referred to our institution were reviewed and reclassified according to the BSRTC. The results were tabulated and analyzed. Those with histological resection were correlated with our revised cytopathological evaluation using the BSRTC. A total of 205 thyroid aspirates from 186 patients were reviewed. There were 149 females (80%) and 37 males (20%) ranging in age from 23 to 81 (average age 48) years. All slides were reclassified using the BSRTC. The previous interpretations were not consistent with any apparent standards. The nondiagnostic rate was found to be 22%. Five cases were considered false negative and were upgraded to a more serious category with higher risk of malignancy. The high unsatisfactory rates can be reduced by an adequacy interpretation at the time of the procedure. The risk of malignancy in our cohort increased with each increase in the BSRTC category (I-VI). Communication about and awareness of the BSRTC and its implications by all our clinicians is a prime target of this study and is still work in progress. Hopefully, this study will increase the awareness of the BSRTC and its intended benefits in our region.

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“…This allows the endocrine specialist to determine the treatment and urgency of histopathologic verification. Our formulation practice corresponds quite reasonably with the diagnostic categories TIR3 and TIR4 of the American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi guidelines for the diagnosis and management of thyroid nodules [118] and also with the newly created Bethesda System terminology [119]. …”

Section: Discussionmentioning

confidence: 99%

Papillary Thyroid Carcinoma: An Easy Fine Needle Aspiration Biopsy Diagnosis?

Dušková

Tretiník²

2011

Acta Cytologica

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Objective: To analyze reasons for unclear or missed diagnoses in fine needle aspiration biopsy (FNAB) of papillary thyroid carcinoma (PTC). Study Design: Among 35,000 thyroid FNAB diagnoses made during 1989–2009, 135 PTC FNAB diagnoses were divided into 3 categories by expressed probability. A group of 10 cases with histologic PTC diagnosis not mentioned in our previous FNAB sample was also analyzed. Results: Of the 75 PTC FNAB diagnoses, 71 were confirmed; the remaining 4 were hyperplastic goiters. In the group of 45 cases with PTC, in which FNAB diagnosis was the next most probable differential diagnosis, 23 were confirmed. In the group of 15 cases, in which the PTC FNAB diagnosis was considered the less probable differential diagnosis, 3 PTCs were found. The other cases in both groups were usually histologically diagnosed as lymphocytic thyroiditis. In the group of 10 cases with histologic PTC diagnosis, 6 were evaluated as suspicious for (other) malignancy, 3 were diagnosed as hyperplasia with oncocytes and 1 as low cellularity; sample reaspiration was recommended. Conclusion: FNAB diagnosis of PTC is not always possible, with success rate influenced by lesion type and size, accompanying diagnoses, representativeness of cytology sample and experience of the cytopathologist.

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American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules

Cited by 543 publications

References 122 publications

The Bethesda Terminology for Reporting Thyroid Cytopathology: From Theory to Practice in Europe

The Bethesda Terminology for Reporting Thyroid Cytopathology: From Theory to Practice in Europe

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: Phase I Pilot Retrospective Analysis

Papillary Thyroid Carcinoma: An Easy Fine Needle Aspiration Biopsy Diagnosis?

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