Journal of Endocrinological Investigation

, Volume 37, Issue 6, pp 593–599 | Cite as

Italian consensus for the classification and reporting of thyroid cytology

  • Francesco Nardi
  • Fulvio Basolo
  • Anna Crescenzi
  • Guido Fadda
  • Andrea Frasoldati
  • Fabio Orlandi
  • Lucio Palombini
  • Enrico Papini
  • Michele Zini
  • Alfredo Pontecorvi
  • Paolo Vitti
Consensus Statement

Notes

Conflict of interest

Francesco Nardi, Fulvio Basolo, Anna Crescenzi, Guido Fadda, Andrea Frasoldati, Fabio Orlandi, Lucio Palombini, Enrico Papini, Michele Zini, Alfredo Pontecorvi and Paolo Vitti declare they have no conflict of interest.

References

  1. 1.
    Vitti P, Rago T, Elisei R et al (2008) Gestione clinica del paziente con patologia nodulare tiroidea: Consenso Italiano. L’Endocrinologo 9(Suppl. 4):S1–S16 (LoE n.a.)Google Scholar
  2. 2.
    Fadda G, Basolo F, Bondi A et al (2010) Cytological classification of thyroid nodules. Proposal of the SIAPEC-IAP Italian Consensus Working Group. Pathologica 102:405–408 (LoE n.a.)PubMedGoogle Scholar
  3. 3.
    Gharib H, Papini E, Paschke R, AACE/AME/ETA Task Force on Thyroid Nodules et al (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. Endocr Pract 33(5):1–56 (LoE n.a.)CrossRefGoogle Scholar
  4. 4.
    Cooper DS, Doherty GM, Haugen BR et al (2009) Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214 (LoE n.a.)PubMedCrossRefGoogle Scholar
  5. 5.
    Ross DS (2002) Nonpalpable thyroid nodules—managing an epidemic. J Clin Endocrinol Metab 87:1938–1940 (LoE n.a.)PubMedGoogle Scholar
  6. 6.
    Moon WJ, Jun Moon WJ, Baek JH et al (2011) Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol 12:1–14 (LoE n.a.)PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Bastin S, Bolland MJ, Croxson MS (2009) Role of ultrasound in the assessment of nodular thyroid disease. J Med Imaging Radiat Oncol. 53:177–187 (LoE n.a.)PubMedCrossRefGoogle Scholar
  8. 8.
    Sipos JA (2009) Advances in ultrasound for the diagnosis and management of thyroid cancer. Thyroid 19:1363–1372 (LoE n.a.)PubMedCrossRefGoogle Scholar
  9. 9.
    Bartolazzi A, Orlandi F, Saggiorato E et al (2008) Galectin-3-expression analysis in the surgical selection of follicular thyroid nodules with indeterminate fine-needle aspiration cytology: a prospective multicentre study. Lancet Oncol 95:43–49 (LoE ⊗ ⊗ ◯)Google Scholar
  10. 10.
    Fadda G, Rossi ED, Raffaelli M et al (2011) Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology. Eur J Endocrinol 165:447–453 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  11. 11.
    Cantara S, Capezzone M, Marchisotta S et al (2010) Impact of proto-oncogene mutation detection in cytological specimens from thyroid nodules improves the diagnostic accuracy of cytology. J Clin Endocrinol Metab 95:1365–1369 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  12. 12.
    Nikiforov YE, Steward DL, Robinson-Smith TM et al (2009) Molecular testing for mutations in improving the fine-needle aspiration diagnosis of thyroid nodules. J Clin Endocrinol Metab 94:2092–2098 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  13. 13.
    Chudova D, Wilde JI, Wang ET et al (2010) Molecular classification of thyroid nodules using high-dimensionality genomic data. J Clin Endocrinol Metab 95:5296–5304 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  14. 14.
    Alexander EK, Kennedy GC, Baloch ZW et al (2012) Preoperative diagnosis of thyroid nodules with indeterminate cytology. N Engl J Med 367:705–715 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  15. 15.
    Kloos R, Reynolds JD, Walsh PS et al (2013) Does addition of BRAF V600E molecular testing modify sensitivity or specificity of the Afirma gene expression classifier in cytologically indeterminate thyroid nodules? J Clin Endocrinol Metab 98:E761–E768 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  16. 16.
    Tonacchera M, Agretti P, Rago T et al (2012) Genetic markers to discriminate benign and malignant thyroid nodules with undetermined cytology in an area of borderline iodine deficiency. J Endocrinol Invest 35:754–759PubMedGoogle Scholar
  17. 17.
    Jing X, Michael CW, Pu RT (2008) The clinical and diagnostic impact of using standard criteria of adequacy assessment and diagnostic terminology on thyroid nodule fine needle aspiration. Diagn Cytopathol 36:161–166 (LoE ⊗ ◯◯)PubMedCrossRefGoogle Scholar
  18. 18.
    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 (LoE n.a.)PubMedCrossRefGoogle Scholar
  19. 19.
    Ali SZ, Cibas ES (2010) The Bethesda system for reporting thyroid cytopathology: definitions, criteria and explanatory notes. Springer, New York (LoE n.a.)CrossRefGoogle Scholar
  20. 20.
    Kocjan G, Cochand-Priollet B, de Agustin PP et al (2010) Diagnostic terminology for reporting thyroid fine needle aspiration cytology: European Federation of Cytology Societies thyroid working party symposium, Lisbon 2009. Cytopathology 21:86–92 (LoE n.a.)PubMedCrossRefGoogle Scholar
  21. 21.
    British Thyroid Association Royal College of Physicians (2007) Guidelines for the management of thyroid cancer. In: Perros P (ed.) Report of the Thyroid Cancer Guidelines Update Group. Royal College of Physicians, London, UK, 2nd edition (LoE n.a.)Google Scholar
  22. 22.
    Cross PA, Chandra A, Giles T, et al (2009) The Royal College of Pathologists. Guidance on the reporting of thyroid cytology specimens. http://www.rcpath.org/resources/pdf/g089guidance on the reporting of thyroid cytology final.pdf (LoE n.a.)
  23. 23.
    GRADE Working Group website. http://www.gradeworkinggroup.org. (LoE n.a.)
  24. 24.
    Atkins D, GRADE Working Group et al (2004) Grading quality of evidence and strength of recommendations. Br Med J 328:1490 (LoE n.a.)CrossRefGoogle Scholar
  25. 25.
    Swiglo BA, Murad MH, Schünemann HJ et al (2008) A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system. J Clin Endocrinol Metab 93:666–673 (LoE n.a.)PubMedCrossRefGoogle Scholar
  26. 26.
    Frates MC, Benson CB, Charboneau JW et al (2005) Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 237:794–800 (LoE n.a.)PubMedCrossRefGoogle Scholar
  27. 27.
    Kim MJ, Kim EK, Park SI et al (2008) US-guided fine needle aspiration of thyroid nodules: indications, techniques, results. Radiographics 28:1869–1886PubMedCrossRefGoogle Scholar
  28. 28.
    Park JM, Choi Y, Kwag HJ (2012) Partially cystic thyroid nodules: ultrasound findings of malignancy. Korean J Radiol 13:530–535 (LoE ⊗ ◯◯)PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Lee MJ, Kim EK, Kwak JY, Kim MJ (2009) Partially cystic thyroid nodules on ultrasound: probability of malignancy and sonographic differentiation. Thyroid 19:341–346 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  30. 30.
    Sohn YM, Yoon JH, Moon HJ, Kim EK, Kwak JY (2012) Mixed echoic thyroid nodules on ultrasound: approach to management. Yonsei Med J 53:812–819 (LoE ⊗ ◯◯)PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Pitman MB, Abele J, Ali SZ et al (2008) Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 36:407–424 (LoE n.a.)PubMedCrossRefGoogle Scholar
  32. 32.
    Bibbo M, Wilbur DC (2008) Comprehensive Cytopathology, 3rd Edition. Saunders, Elsevier (LoE n.a.)Google Scholar
  33. 33.
    Park KT, Ahn SH, Mo JH et al (2011) Role of core needle biopsy and ultrasonographic finding in management of indeterminate thyroid nodules. Head Neck 33:160–165 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  34. 34.
    Na DG, Kim JH, Sung JY et al (2012) Core-needle biopsy is more useful than repeat fine-needle aspiration in thyroid nodules read as nondiagnostic or atypia of undetermined significance by the Bethesda system for reporting thyroid cytopathology. Thyroid 22:468–475 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  35. 35.
    Samir AE, Vij A, Seale MK et al (2012) Ultrasound-guided percutaneous thyroid nodule core biopsy: clinical utility in patients with prior nondiagnostic fine-needle aspirate. Thyroid 22:461–467 (LoE ⊗ ⊗◯)PubMedCentralPubMedCrossRefGoogle Scholar
  36. 36.
    Fadda G, Rossi ED (2011) Liquid-based cytology in fine-needle aspiration biopsies of the thyroid gland. Acta Cytol 55:389–400 (LoE ⊗ ◯◯)PubMedCrossRefGoogle Scholar
  37. 37.
    Rossi ED, Raffaelli M, Zannoni GF et al (2009) Diagnostic efficacy of conventional as compared to liquid-based cytology in thyroid lesions. Evaluation of 10,360 fine needle aspiration cytology cases. Acta Cytol 53:659–666PubMedCrossRefGoogle Scholar
  38. 38.
    Nasrollah N, Trimboli P, Guidobaldi L (2013) Thin core biopsy should help to discriminate thyroid nodules cytologically classified as indeterminate. A new sampling technique. Endocrine 43:659–665 (LoE ⊗ ◯◯)PubMedCrossRefGoogle Scholar
  39. 39.
    Gharib H, Goellner JR, Johnson DA (1993) Fine-needle aspiration cytology of the thyroid. A 12-year experience with 11,000 biopsies. Clin Lab Med 13:699–709 (LoE n.a.)PubMedGoogle Scholar
  40. 40.
    Nasuti JF, Gupta PK, Baloch ZW (2002) Diagnostic value and cost-effectiveness of on site evaluation of fine needle aspiration specimens: Review of 5,688 cases. Diagn Cytopatol 27:1–4 (LoE ⊗ ◯◯)CrossRefGoogle Scholar
  41. 41.
    Goellner JR, Gharib H, Grant CS, Johnson DA (1987) Fine needle aspiration cytology of the thyroid, 1980–1986. Acta Cytol 31:587–590 (LoE ⊗ ◯◯)PubMedGoogle Scholar
  42. 42.
    Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW (2012) The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytol 56:333–339 (LoE ⊗ ⊗ ⊗)PubMedCrossRefGoogle Scholar
  43. 43.
    Bongiovanni M, Crippa S, Baloch Z et al (2012) Comparison of 5-tiered and 6-tiered diagnostic systems for the reporting of thyroid cytopathology: a multi-institutional study. Cancer Cytopathol 120:117–125 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  44. 44.
    Nou E, Kwong N, Alexander LK, et al (2014) Determination of the optimal time interval for repeat evaluation following a benign thyroid nodule aspiration. J Clin Endocrinol Metab 99:510–516 (LoE ⊗ ⊗◯)Google Scholar
  45. 45.
    Piana S, Frasoldati A, Ferrari M et al (2011) Is a five-category reporting scheme for thyroid fine needle aspiration cytology accurate? Experience of over 18000 FNAs reported at the same institution during 1998–2007. Cytopathology 22:164–173 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  46. 46.
    Pagni F, Prada M, Goffredo P, et al (2013) Indeterminate for malignancy (Tir3/Thy3 in the Italian and British system for classification) thyroid fine needle aspiration (FNA) cytology reporting: morphologic criteria and clinical impact Cytopathology: 1–7 (Epub) (LoE ⊗ ⊗◯)Google Scholar
  47. 47.
    Rago T, Di Coscio G, Basolo F et al (2007) Combined clinical, thyroid ultrasound and cytological features help to predict thyroid malignancy in follicular and Hurthle cell thyroid lesions: results from a series of 505 consecutive patients. Clin Endocrinol (Oxf) 66:13–20 (LoE ⊗ ⊗◯)Google Scholar
  48. 48.
    Renshaw AA (2010) Should “atypical follicular cells” in thyroid fine-needle aspirates be subclassified? Cancer Cytopathol 118:186–189 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  49. 49.
    Vanderlaan PA, Marqusee E, Krane JF (2011) Usefulness of diagnostic qualifiers for thyroid, fine-needle aspirations with atypia of undetermined significance. Am J Clin Pathol 136:572–577 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  50. 50.
    Alexander EK (2008) Approach to the patient with a cytologically indeterminate thyroid nodule. J Clin Endocrinol Metab 93:4175–4182 (LoE n.a.)PubMedCrossRefGoogle Scholar
  51. 51.
    Yoon JH, Kwak JY, Kim EK et al (2010) How to approach thyroid nodules with indeterminate cytology. Ann Surg Oncol 17:2147–2155 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar
  52. 52.
    Faquin WC, Baloch ZW (2010) Fine-Needle aspiration of follicular patterned lesions of the thyroid: diagnosis, management, and follow-up according to National Cancer Institute (NCI) recommendations. Diagn Cytopathol 38:731–739 (LoE ⊗ ⊗◯)PubMedGoogle Scholar
  53. 53.
    Yang J, Schnadig V, Logrono R, Wasserman PG (2007) Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer 5:306–315 (LoE ⊗ ⊗◯)CrossRefGoogle Scholar
  54. 54.
    Yoder BJ, Redman R, Massoll NA (2006) Validation of a five-tier cytodiagnostic system for thyroid fine needle aspiration biopsies using cytohistologic correlation. Thyroid 16:781–786 (LoE ⊗ ⊗◯)PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2014

Authors and Affiliations

  • Francesco Nardi
    • 1
  • Fulvio Basolo
    • 2
  • Anna Crescenzi
    • 3
  • Guido Fadda
    • 4
  • Andrea Frasoldati
    • 5
  • Fabio Orlandi
    • 6
  • Lucio Palombini
    • 7
  • Enrico Papini
    • 3
  • Michele Zini
    • 5
  • Alfredo Pontecorvi
    • 4
  • Paolo Vitti
    • 2
  1. 1.Sapienza University of RomeRomeItaly
  2. 2.University of PisaPisaItaly
  3. 3.Regina Apostolorum Hospital of AlbanoRomeItaly
  4. 4.Università Cattolica Del Sacro Cuore Agostino Gemelli, University HospitalRomeItaly
  5. 5.Hospital Santa Maria Nuova IRCCSReggio EmiliaItaly
  6. 6.University of TurinTurinItaly
  7. 7.University of Naples Federico IINaplesItaly

Personalised recommendations