• Huihong XuEmail author
  • Sandra Cerda
Part of the Practical Anatomic Pathology book series (PAP)


This chapter provides cytopathologists and trainees with brief and clearly formatted reference materials for navigating through various thyroid lesions obtained by thyroid fine needle aspiration (FNA).

These reference materials include current clinical practice guidelines and indications for ultrasound (US)-guided FNA of thyroid nodules, the accuracy rate of thyroid FNA, sample collection and preparation methods, a description of normal and abnormal thyroid elements in the cytologic interpretation, differential diagnosis by using the recommended terminology (the Bethesda System for Reporting Thyroid Cytopathology), and the value of currently established ancillary studies that aid in the interpretation of indeterminate thyroid nodules.

By including a variety of case studies with high-quality images, condensed (table format) diagnostic-related information, and frequently asked questions, we emphasize the strength and challenge of thyroid FNA cytopathology interpretation and its possible implication in management and cancer staging with the recent 8th edition AJCC cancer staging guidelines.

The Bethesda System for Reporting Thyroid Cytopathology is linked to an associated risk for malignancy to each Bethesda category. The recent reclassification of some thyroid neoplasms as noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), and its relation to risk of malignancy and recommended clinical management, also poses a challenge with regard to diagnostic criteria and differentiation from papillary thyroid carcinoma (PTC) and its follicular variant.

Our goal is for readers to find this chapter a useful and practical resource when practicing thyroid FNA cytology.


Thyroid Fine needle aspiration (FNA) Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) Papillary thyroid carcinoma (PTC) Indeterminate thyroid nodules The Bethesda System for Reporting Thyroid Cytopathology The 8th edition AJCC cancer staging manual Clinical practice guideline Molecular testing 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Boston VA Health Care System and Boston University Medical SchoolBostonUSA
  2. 2.Department of Pathology and Laboratory MedicineBoston University Medical CenterBostonUSA

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