Fine-needle aspiration in the work-up of thyroid nodules

Otolaryngologic Clinics of North America

Volumn 43, Issue 2, 2010, Pages 257-271

  Cibas, Edmund S ^a  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

Cytology; Fine needle aspiration; Indications; Terminology; Thyroid

Indexed keywords

ASPIRATION BIOPSY; BIOPSY TECHNIQUE; CANCER RISK; COMPUTER ASSISTED TOMOGRAPHY; CYTOLOGY; HUMAN; IMAGING; NOMENCLATURE; NUCLEAR MAGNETIC RESONANCE IMAGING; PALPATION; POSITRON EMISSION TOMOGRAPHY; REVIEW; THYROID INCIDENTALOMA; THYROID NODULE; THYROID SCINTISCANNING;

BIOPSY, FINE-NEEDLE; COOPERATIVE BEHAVIOR; DIAGNOSIS, DIFFERENTIAL; DIAGNOSTIC IMAGING; HUMANS; INTERDISCIPLINARY COMMUNICATION; REFERRAL AND CONSULTATION; SENSITIVITY AND SPECIFICITY; TERMINOLOGY AS TOPIC; THYROID DISEASES; THYROID GLAND; THYROID NEOPLASMS; THYROID NODULE;

EID: 77953280156     PISSN: 00306665     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.otc.2010.01.003     Document Type: Review

References (78)

1. Hamberger B., Gharib H., Melton L.J., et al. Fine-needle aspiration biopsy of thyroid nodules. Impact on thyroid practice and cost of care. Am J Med 1982, 73(3):381-384.
2. Yassa L., Cibas E.S., Benson C.B., et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer 2007, 111(6):508-516.
3. Cibas E.S., Alexander E.K., Benson C.B., et al. Indications for thyroid FNA and pre-FNA requirements: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008, 36(6):390-399.
4. Baloch Z.W., Cibas E.S., Clark D.P., et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal 2008, 5:6.
5. Layfield L.J., Cibas E.S., Gharib H., et al. Thyroid aspiration cytology: current status. CA Cancer J Clin 2009, 59(2):99-110.
6. Baloch Z.W., LiVolsi V.A., Asa S.L., et al. 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 2008, 36(6):425-437.
7. Cooper D.S., Doherty G.M., Haugen B.R., et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2006, 16:109-140.
8. Ravetto C., Columbo L., Dottorini M.E. Usefulness of fine-needle aspiration in the diagnosis of thyroid carcinoma: a retrospective study in 37,895 patients. Cancer Cytopathol 2000, 90:357-363.
9. Hegedus L. The thyroid nodule. N Engl J Med 2004, 351:1764-1771.
10. Sherman S.I., Angelos P., Ball D., et al. Thyroid carcinoma. J National Compr Canc Netw 2005, 3:404-457.
11. Ross D.S. Evaluation and nonsurgical management of the thyroid nodule. Surgery of the thyroid and parathyroid glands 2003, 139-148. Saunders, Philadelphia. G. Randolph (Ed.).
12. Wong C.K., Wheeler M.H. Thyroid nodules: rational management. World J Surg 2000, 24:934-941.
13. Burch H.B. Evaluation and management of the thyroid nodule. Endocrinol Metab Clin North Am 1995, 24:663.
14. Ashcraft M.W., Van Herle A.J. Management of thyroid nodules. II: scanning techniques, thyroid suppressive therapy, and fine needle aspiration. Head Neck Surg 1981, 3(4):297-322.
15. Are C., Hsu J.F., Schoder H., et al. FDG-PET detected thyroid incidentalomas: need for further investigation?. Ann Surg Oncol 2007, 14:239-247.
16. Chen Y.K., Ding H.J., Chen K.T., et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxyglucose positron emission tomography for cancer screening in healthy subjects. Anticancer Res 2005, 25:1421-1426.
17. Choi J.Y., Lee K.S., Kim H.J., et al. Focal thyroid lesions incidentally identified by integrated 18F-FDG PET/CT: clinical significance and improved characterization. J Nucl Med 2006, 47:609-615.
18. Chu Q.D., Connor M.M., Lilien D.L., et al. Positron emission tomography (PET) positive thyroid incidentaloma: the risk of malignancy observed in a tertiary referral center. Am Surg 2006, 72:272-275.
19. Cohen M.S., Arslan N., Dehdashti F., et al. Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose-positron emission tomography. Surgery 2001, 130:941-946.
20. Kang K.W., Kim S.K., Kang H.S., et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxyglucose positron emission tomography of metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab 2003, 88:4100-4104.
21. Kim T.Y., Kim W.B., Ryu J.S., et al. 18F-fluorodeoxyglucose uptake in thyroid from positron emission tomogram (PET) for evaluation in cancer patients: high prevalence of malignancy in thyroid PET incidentaloma. Laryngoscope 2005, 115:1074-1078.
22. Kresnik E., Gallowitsch H.J., Mikosch P., et al. Fluorine-18-fluorodeoxyglucose positron emission tomography in the preoperative assessment of thyroid nodules in an endemic goiter area. Surgery 2003, 133:294-299.
23. Yi J.G., Marom E.M., Munden R.F., et al. Focal uptake of fluorodeoxyglucose by the thyroid in patients undergoing initial disease staging with combined PET/CT for non-small cell lung cancer. Radiology 2005, 236:271-275.
24. Alonso O., Lago G., Mut F., et al. Thyroid imaging with Tc-99m MIBI in patients with solitary cold single nodules on pertechnetate imaging. Clin Nucl Med 1996, 21:363-367.
25. Hurtado-Lopez L.M., Arellano-Montano S., Torres-Acosta E.M., et al. Combined of fine-needle aspiration biopsy, MIBI scans and frozen section biopsy offers and the best diagnostic accuracy in the assessment of the hypofunctioning solitary thyroid nodule. Eur J Nucl Med Mol Imaging 2004, 31:1273-1279.
26. Kresnik E., Gallowitsch H.J., Mikosch P., et al. Technetium-99M-MIBI scintigraphy of thyroid nodules in an endemic goiter area. J Nucl Med 1997, 38:62-65.
27. Mezosi E., Bajnok L., Gyory F., et al. The role of technetium-99m methoxyisobutylisonitrile scintigraphy in the differential diagnosis of cold thyroid nodules. Eur J Nucl Med 1999, 26:798-803.
28. Sathekge M.M., Mageza R.B., Muthuphei M.N., et al. Evaluation of thyroid nodules with technetium-909m MIBI and technetium-99m pertechnetate. Head Neck 2001, 23:305-310.
29. Academy of Clinical Thyroidologists Position paper on FNA for non-palpable thyroid nodules Available at:, Accessed February 16, 2010. http://www.thyroidologists.com/papers.html.
30. Brander A.E., Viikinkoski V.P., Nickels J.I., et al. Importance of thyroid abnormalities detected in US screening: a 5-year follow-up. Radiology 2000, 215:801-806.
31. Chung W.Y., Chang H.S., Kim E.K., et al. Ultrasonographic mass screening for thyroid carcinoma: a study in women scheduled to undergo a breast examination. Surg Today 2001, 31:763-767.
32. Frates M.C., Benson C.B., Charboneau J.W., et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology 2005, 237:794-800.
33. Kang H.W., No J.H., Chung J.H., et al. Prevalence, clinical and ultrasonographic characteristics of thyroid incidentalomas. Thyroid 2004, 14:29-33.
34. Kim E.K., Park C.S., Chung W.Y., et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002, 178:687-691.
35. Leenhardt L., Hejblum G., Franc B., et al. Indications and limits of ultrasound-guided cytology in the management of nonpalpable thyroid nodules. J Clin Endocrinol Metab 1999, 84:24-28.
36. Liebeskind A., Sikora A.G., Komisar A., et al. Rates of malignancy in incidentally discovered thyroid nodules evaluated with sonography and fine-needle aspiration. J Ultrasound Med 2005, 24:629-634.
37. Nabriski D., Ness-Abramof R., Brosh T., et al. Clinical relevance of non-palpable thyroid nodules as assessed by ultrasound-guided fine needle aspiration biopsy. J Endocrinol Invest 2003, 26:61-64.
38. Nan-Goong I.S., Kim H.Y., Gong G., et al. Ultrasonography-guided fine-needle aspiration of thyroid incidentaloma: correlation with pathological findings. Clin Endocrinol 2004, 60:21-28.
39. Papini E., Guglielmi R., Bianchini A., et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 2002, 87(5):1941-1946.
40. Steele S.R., Martin M.J., Mullenix P.S., et al. The significance of incidental thyroid abnormalities identified during carotid duplex ultrasonography. Arch Surg 2005, 140:981-985.
41. AACE/AME Task Force on Thyroid Nodules American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi: medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 2006, 12:63-101.
42. Layfield L.J., Abrams J., Cochand-Priollet B., et al. Post thyroid FNA testing and treatment options: a synopsis of the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008, 36:442-448.
43. Harach H.R., Franssila K.O., Wasenius V.M. Occult papillary carcinoma of the thyroid. A " normal" finding in Finland. A systematic autopsy study. Cancer 1985, 56(3):531-538.
44. Ito Y., Miyauchi A. A therapeutic strategy for incidentally detected papillary microcarcinoma of the thyroid. Nat Clin Pract Endocrinol Metab 2007, 3(3):240-248.
45. Yousem D.M., Huang T., Loevner L.A., et al. Clinical and economic impact of incidental thyroid lesions found with CT and MR. AJNR Am J Neuroradiol 1997, 18:1423-1428.
46. Shetty S.K., Maher M.M., Hahn P.F., et al. Significance of incidental thyroid lesions detected on CT: correlation among CT, sonography, and pathology. AJR Am J Roentgenol 2006, 187:1349-1356.
47. Marqusee E., Benson C.B., Frates M.C., et al. Utility of ultrasound in the management of nodular thyroid disease. Ann Intern Med 2000, 133:696-700.
48. Carmeci C., Jeffrey R.B., McDougall I.R., et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid 1998, 8(4):283-289.
49. Cesur M., Corapcioglu D., Bulut S., et al. Comparison of palpation-guided fine-needle aspiration biopsy to ultrasound-guided fine-needle aspiration biopsy in the evaluation of thyroid nodules. Thyroid 2006, 16(6):555-561.
50. Danese D., Sciacchitano S., Farsetti A., et al. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid 1998, 8(1):15-21.
51. Yokozawa T., Fukata S., Kuma K., et al. Thyroid cancer detected by ultrasound-guided fine-needle aspiration biopsy. World J Surg 1996, 20(7):848-853.
52. Yokozawa T., Miyauchi A., Kuma K., et al. Accurate and simple method of diagnosing thyroid nodules the modified technique of ultrasound-guided fine needle aspiration biopsy. Thyroid 1995, 5(2):141-145.
53. Court-Payen M., Nygaard B., Horn T., et al. US-guided fine-needle aspiration biopsy of thyroid nodules. Acta Radiol 2002, 43(2):131-140.
54. Pitman M.B., Abele J., Ali S.Z., et al. Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008, 36(6):407-424.
55. Centers for Medicare and Medicaid Services Laboratory requirements Available at:, Accessed November 27, 2007. http://www.cdc.gov/clia/pdf/42cfr493_2003.pdf.
56. Ali S.Z., Cibas E.S. The Bethesda system for reporting thyroid cytopathology 2009, Springer, New York.
57. Goellner J.R., Gharib H., Grant C.S., et al. Fine-needle aspiration cytology of the thyroid, 1980 to 1986. Acta Cytol 1987, 31:587-590.
58. Grant C.S., Hay I.D., Gough I.R., et al. Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses. Surgery 1989, 106:980-985.
59. Renshaw A.A. Accuracy of thyroid fine-needle aspiration using receiver operator characteristic curves. Am J Clin Pathol 2001, 116:477-482.
60. Yang J., Schnadig V., Logrono R., et al. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer 2007, 111(5):306-315.
61. Amrikachi M., Ramzy I., Rubenfeld S., et al. Accuracy of fine-needle aspiration of thyroid: a review of 6226 cases and correlation with surgical or clinical outcome. Arch Pathol Lab Med 2001, 125:484-488.
62. Gharib H., Goellner J.R., Johnson D.A. Fine-needle aspiration cytology of the thyroid: a 12-year experience with 11,000 biopsies. Clin Lab Med 1993, 13:699-709.
63. McHenry C.R., Walfish P.G., Rosen I.B. Non-diagnostic fine-needle aspiration biopsy: a dilemma in management of nodular thyroid disease. Am Surg 1993, 59:415-419.
64. van Hoeven K.H., Gupta P.K., LiVolsi V.A. Value of repeat fine needle aspiration (FNA) of the thyroid. Mod Pathol 1994, 7:43A. [abstract].
65. Mazzaferri E.L. NCCN thyroid carcinoma practice guidelines. Oncology 1999, 13:391-442.
66. Deveci M.S., Deveci G., LiVolsi V.A., et al. Fine-needle aspiration of follicular lesions of the thyroid. Diagnosis and follow-Up. Cytojournal 2006, 3:9.
67. Baloch Z.W., Fleisher S., LiVolsi V.A., et al. Diagnosis of " follicular neoplasm": a gray zone in thyroid fine-needle aspiration cytology. Diagn Cytopathol 2002, 26(1):41-44.
68. Schlinkert R.T., van Heerden J.A., Goellner J.R., et al. Factors that predict malignant thyroid lesions when fine-needle aspiration is " suspicious for follicular neoplasm" Mayo Clin Proc 1997, 72(10):913-916.
69. Kelman A.S., Rathan A., Leibowitz J., et al. Thyroid cytology and the risk of malignancy in thyroid nodules: importance of nuclear atypia in indeterminate specimens. Thyroid 2001, 11(3):271-277.
70. Gharib H., Goellner J.R. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 1993, 118:282-289.
71. Suen K.C. How does one separate cellular follicular lesions of the thyroid by fine-needle aspiration biopsy?. Diagn Cytopathol 1988, 4:78-81.
72. DeLellis R.A., Lloyd R.V., Heitz P.U., et al. World Health Organization classification of tumours. Pathology and genetics of tumours of endocrine organs 2004, IARC Press, Lyon.
73. French C.A., Alexander E.K., Cibas E.S., et al. Genetic and biological subgroups of low-stage follicular thyroid cancer. Am J Pathol 2003, 162(4):1053-1060.
74. Pu R.T., Yang J., Wasserman P.G., et al. Does Hurthle cell lesion/neoplasm predict malignancy more than follicular lesion/neoplasm on thyroid fine-needle aspiration?. Diagn Cytopathol 2006, 34(5):330-334.
75. Giorgadze T., Rossi E.D., Fadda G., et al. Does the fine-needle aspiration diagnosis of " Hurthle-cell neoplasm/follicular neoplasm with oncocytic features" denote increased risk of malignancy?. Diagn Cytopathol 2004, 31(5):307-312.
76. Chung D., Ghossein R.A., Lin O. Macrofollicular variant of papillary carcinoma: a potential thyroid FNA pitfall. Diagn Cytopathol 2007, 35(9):560-564.
77. Renshaw A.A. Focal features of papillary carcinoma of the thyroid in fine-needle aspiration material are strongly associated with papillary carcinoma at resection. Am J Clin Pathol 2002, 118(2):208-210.
78. Logani S., Gupta P.K., LiVolsi V.A., et al. Thyroid nodules with FNA cytology suspicious for follicular variant of papillary thyroid carcinoma: follow-up and management. Diagn Cytopathol 2000, 23(6):380-385.