Fine-needle aspiration cytology of the thyroid

Abstract

Fine‐needle aspiration cytology is the single most important diagnostic test for the evaluation of patients with thyroid nodules. Prerequisites for attaining high degrees of diagnostic accuracy include adherence to the appropriate methods of specimen procurement and processing and exposure to a significant volume of cases. See also pages 330–334 and 357–363, this issue.

Diagnostic accuracy of fine needle aspiration cytology of thyroid and evaluation of discordant cases

“…It is simple, reliable, time saving, minimally invasive and cost effective [1][2][3][4][5][6][7]. However there are some limitations of FNAC which a pathologist must be aware of [11][12][13][14].…”

“…This distinction has dramatically reduced the surgery rates in thyroid pathologies [10]. Though the accuracy rates as high as 95-98% have been reported in best hands FNAC has some limitations, and false positive and false negative results do occur [3,5].…”

“…Thyroid FNA is a safe and relatively simple test that is widely recognized as the critical, primary diagnostic procedure of first choice for the evaluation of patients presenting with thyroid nodules [2][3][4][5][6][7]. One of the major advantages is that FNAC can be done as an out-patient procedure.…”

Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis

“…Approximately 10-20 million Americans have clinically detectable thyroid nodules; however, only 4-7% of the nodules are malignant [1,2]. Ultrasound (US) and fine-needle aspiration (FNA) are commonly used to evaluate the nature of thyroid nodules.…”

Update in Thyroid Fine Needle Aspiration

“…Over 350,000 thyroid FNAs are performed each year in the USA, and approximately 60-70% of these are diagnosed as "benign," avoiding the need for surgery in these patients [3]. In experienced hands, the mean reported accuracy of thyroid FNA is 76.8%, with a range from 53% to 95%; however, it is difficult to evaluate the accuracy for benign thyroid aspirates because these nodules are infrequently resected [3,[5][6][7][8][9][10][11][12]. Thyroid FNA specimens containing follicular cell-derived lesions are the most commonly encountered and include various forms of benign thyroid nodules (e.g., colloid nodules, adenomatous nodules, follicular adenomas), follicular carcinomas, papillary carcinomas and its many variants, poorly differentiated thyroid carcinomas, and undifferentiated carcinomas.…”