Abstract
Thyroid enlargement, either diffuse or in the form of thyroid nodules (solitary or multiple), is a very frequent finding, mostly by normal thyroid function tests. The prevalence of the thyroid nodules is estimated about 4% in the population of the western countries with a much higher frequency after performance of ultrasonographic studies (Brander et al. 1991; Christensen et al. 1984). Since the thyroid cancer usually appears as a nodular lesion, it seems reasonable to develop safe tests for the detection of cancer among the by far most common benign hyperplastic nodules. The therapeutic approach for benign nodules can be conservative since the morbidity of the surgical complications would exceed the morbidity of cancer if all thyroid nodules would be removed surgically (Mazzaferri et al. 1988). In this context, the fine-needle aspiration of thyroid emerged as the most useful tool in recognizing thyroid cancer as well as the most accurate and cost-effective test, compared with all noninvasive tests and represents therefore the corner stone in most guidelines for the management of thyroid nodules (Gharib et al. 2010). After the introduction of this method, the number of malignancies among the surgical specimens of the thyroid increased dramatically, reflecting a more accurate selection of the suspicious nodules for surgery. However, it does not represent an independent diagnostic test since the cytological findings must be interpreted in relation to all clinical and imaging data prior to the final recommendation for the management. Insofar it is obvious that the cytopathologists involved must be aware of the clinical implications of their report and the clinicians familiar with the pathological substrate of the nodules as well as from wording of the pathologists and the possibilities and limitations of the FNA (Buesseniers and Silver 2007).
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Baloch ZW, Livolsi VA (2004) Fine needle aspiration of thyroid nodules: past, present and future. Endocr Pract 10:234–241
Baloch ZW, Fleisher S, Livolsi VA et al (2002) Diagnosis of “follicular neoplasm”: a gray zone in thyroid fine-needle aspiration cytology. Diagn Cytopathol 26:41–44
Baloch ZW, Livolsi VA, Asa SL et al (2008) Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute thyroid fine needle aspiration state of the science conference. Diagn Cytopathol 36:425–437
Boerner SL, Asa SL (2010) Biopsy interpretation of thyroid. Lippincott, Williams and Wilkins, Philadelphia, pp 13–37
Boon M (1992) Routine cytologic staining procedures. In: Weid GL, Bibbo M, Keebler CM et al (eds) Tutorials of cytology. International Academy of Cytology, Chicago
Brander A, Viikinkoski P, Nickels J et al (1991) Thyroid gland: US screening in a random adult population. Radiology 181:683–687
Buesseniers AE, Silver SA (2007) Fine needle aspiration cytology of the thyroid. In: Oertli D, Udelsman R (eds) Surgery of the thyroid and parathyroid glands. Springer, Berlin/Heidelberg, pp 61–80
Chow LS, Gharib H, Goellner JR et al (2001) Nondiagnostic thyroid fine needle aspiration cytology: management dilemmas. Thyroid 11:1147–1151
Christensen SB, Ericson UB, Janzon L et al (1984) The prevalence of thyroid disorders in a middle-aged female population with special reference to the solitary thyroid nodule. Acta Chir Scand 150:13–19
Crystal BS, Wang HH, Ducatman BS (1993) Comparison of different preparation techniques for fine needle aspiration specimens. A semiquantitative and statistical analysis. Acta Cytol 37:24–28
Delibasis KK, Asvestas PA, Matsopoulos GK, Zoulias E, Tseleni-Balafouta S (2009) Computer-aided diagnosis of thyroid malignancy using an artificial immune system classification algorithm. IEEE Trans Inf Technol Biomed 13(5):680–686
Dong HY, Harris NL, Preffer FI, Pitman MB (2001) Fine needle aspiration biopsy in the diagnosis and classification of primary and recurrent lymphoma: a retrospective analysis of the utility of cytomorphology and flow cytometry. Mod Pathol 14:472–481
Droese M (1995) Aspiration cytology of the thyroid. Schattauer, Stuttgart/New York, pp 3–25
Gharib H (1994) Fine needle aspiration biopsy of thyroid nodules: advantages, limitations and effect. Mayo Clin Proc 69:44–49
Gharib H, Goellner JR (1993) Fine needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 118:282–289
Gharib H, Goellner JR, Johnson DA (1993) Fine needle aspiration cytology of the thyroid: a 12-year experience with 11000 biopsies. Clin Lab Med 13:699–709
Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, Vitti P, 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: executive summary of recommendations. J Endocrinol Invest 33(5 Suppl):51–56
Goellner JR, Gharib H, Grant CS et al (1987) Fine needle aspiration of thyroid, 1980 to 1986. Acta Cytol 31:587–590
Guarda LA, Baskin HJ (1987) Inflammatory and lymphoid lesions of the thyroid gland: cytomorphology by fine needle aspiration. Am J Clin Pathol 87:14–22
Hall TL, Layfield LG, Philippe A, Rosenthal DL (1989) Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer 63:718–725
Hamburger JI, Hamburger SW (1986) Fine needle biopsy of thyroid nodules: avoiding the pitfalls. N Y State J Med 86:241–249
Hamburger JI, Hussein M (1988) Semiquantitative criteria for fine needle aspiration diagnosis: reduced false negative diagnosis. Diagn Cytopathol 4:14–17
Henrique RM, Sousa ME, Godinho MI et al (1999) Immunophenotyping by flow cytometry of fine needle aspirates in the diagnosis of lymphoproliferative disorders: a retrospective study. J Clin Lab Anal 13:224–228
Jayaram G, Razak A, Chan SK et al (1999) Fine needle aspiration of the thyroid: a review of experience in 1854 cases. Malays J Pathol 21:17–27
Keebler CM (1991) Cytopreparatory techniques. In: Bibbo M (ed) Comprehensive cytopathology. Saunders, Philadelphia
Kini SR, Miller JM, Hamburger JI et al (1985) Cytopathology of follicular lesions of the thyroid gland. Diagn Cytopathol 1:123–132
Ko HM, JhuIK YSH et al (2003) Clinicopathologic analysis of fine needle aspiration cytology of the thyroid. Acta Cytol 47:727–732
Kocjan G (2006) FNAC technique and slide preparation. In: Fine needle aspiration cytology. Springer, Berlin/Heidelberg, pp 7–33
Lowhagen T, Sprenger E (1974) Cytologic presentation of thyroid tumors in aspiration biopsy smear: a review of 60 cases. Acta Cytol 18:192–197
Matsuzuka F, Miyauchi A, Katayama S, Narabayashi I, Ikeda H, Kuma K, Sugawara M (1993) Clinical aspects of primary thyroid lymphoma: diagnosis and treatment based on our experience of 119 cases. Thyroid 3:93–99
Mazzaferri EL, de los Santos ET, Rofagha Keyhani S et al (1988) Solitary thyroid nodule: diagnosis and management. Med Clin North Am 72:1177–1211
Nguyen GK, Akin MR (2001) Cytopathology of insular carcinoma of the thyroid. Diagn Cytopathol 25:325–330
Nguyen GK, Ginsberg J, Crockford PM (1991) Fine needle aspiration biopsy cytology of the thyroid. Its value and limitations in the diagnosis and management of the solitary thyroid nodules. Pathol Annu 26:63
Orell SR, Philips J (1997) The thyroid: fine needle biopsy and cytological diagnosis of thyroid lesions. Karger, Basel/London/New York, pp 8–29
Papanicolaou Society of Cytopathology Task Force on Standards of Practice (1996) Guidelines of the Papanicolaou society of cytopathology for the examination of fine-needle aspiration specimen from thyroid nodules. Diagn Cytopathol 15:84–89
Pietribiasi F, Sapino A, Papotti M et al (1990) Cytologic features of poorly differentiated “insular” carcinoma of the thyroid, as revealed by fine needle aspiration biopsy. Am J Clin Pathol 94:687–692
Raber W, Kasserer K, Niederle B et al (2000) Risk factors of malignancy of thyroid nodules initially identified as follicular neoplasia by fine needle aspiration: results of a prospective study of one hundred twenty patients. Thyroid 10:109–112
Ravinsky E, Safneck JR (1988) Differentiation of Hashimoto’s thyroiditis from thyroid neoplasms in fine needle aspirates. Acta Cytol 32:854–861
Revetto C, Colombo L, Dottorini ME (2000) Usefulness of fine needle aspiration in the diagnosis of thyroid carcinoma: a retrospective study in 37,895 patients. Cancer 90:357–363
Saxen E, Franssila K, Bjarnason O, Norman T, Ringertz N (1978) Observer variation in histologic classification of thyroid cancer. Acta Pathol Microbiol Scand A 86:483–486
Tseleni S (1986) Fine needle aspiration of thyroid: confusion v. subsequent histology. J Clin Pathol 39(6):697–698
Tseleni-Balafouta S, Kyroudi-Voulgari A, Paizi-Biza P, Papacharalampous NX (1989) Lymphocytic thyroiditis in fine-needle aspirates: differential diagnostic aspects. Diagn Cytopathol 5(4):362–365
Tseleni-Balafouta S, Katsouyanni K, Kitsopanides J, Koutras DA (1991) The outcome of benign thyroid nodules correlates with the findings of fine needle biopsy. Thyroidology 3(2):75–78
Tseleni-Balafouta S, Gakiopoulou H, Kavantzas N, Agrogiannis G, Givalos N, Patsouris E (2007) Parathyroid proliferations: a source of diagnostic pitfalls in FNA of thyroid. Cancer 111(2):130–136
Wang HH (2006) Reporting thyroid fine needle aspiration: literature review and proposal. Diagn Cytopathol 34:67–76
Zito FA, Gadaleta CD, Salvatore C et al (1995) A modified cell block technique for fine needle aspiration cytology. Acta Cytol 39:93–99
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Tseleni-Balafouta, S. (2012). Fine-Needle Aspiration of Thyroid. In: Linos, D., Chung, W. (eds) Minimally Invasive Thyroidectomy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-23696-9_4
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