Skip to main content
SpringerLink
Log in

Fine Needle Aspiration: Present and Future

  • Chapter
  • First Online:
Book cover Molecular Pathology of Endocrine Diseases

Part of the book series: Molecular Pathology Library ((MPLB,volume 3))

  • 896 Accesses

Abstract

Thyroid nodules are common and they affect up to 7% of US population; they are often seen in women and the majority are benign. Fine-needle aspiration (FNA) is considered an essential tool in providing a rational approach to the clinical management of thyroid nodules. The results of FNA can determine whether a thyroid nodule should be followed clinically or undergo surgical excision.1,2

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Baloch ZW, Cibas ES, Clark DP, et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal. 2008;5:6.

    Article  PubMed  Google Scholar 

  2. Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:109–142.

    Article  PubMed  Google Scholar 

  3. Baskin HJ, Duick DS. The endocrinologists’ view of ultrasound guidelines for fine needle aspiration. Thyroid. 2006;16:207–208.

    Article  PubMed  Google Scholar 

  4. Guidelines of the Papanicolaou Society of Cytopathology for the examination of fine-needle aspiration specimens from thyroid nodules. The Papanicolaou Society of Cytopathology Task Force on Standards of Practice. Diagn Cytopathol. 1996;15:84–89.

    Google Scholar 

  5. 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;12:63–102.

    Google Scholar 

  6. Murray D. The Thyroid Gland. Malden, MA: Blackwell; 1998:295–380.

    Google Scholar 

  7. Baloch Z, LiVolsi VA. Pathology of the thyroid gland. In: LiVolsi VA, Asa S, eds. Endocrine Pathology. Philadelphia, PA: Churchill Livingston; 2002:61–88.

    Google Scholar 

  8. Kini SR. Guides to Clinical Aspiration Biopsy Thyroid. 2nd ed. New York, NY: Igaku-Shoin; 1996.

    Google Scholar 

  9. Layfield LJ, Wax T, Jones C. Cytologic distinction of goiterous nodules from morphologically normal thyroid: analyses of cytomorphologic features. Cancer. 2003;99:217–222.

    Article  PubMed  Google Scholar 

  10. Baloch ZW, Sack MJ, Yu GH, Livolsi VA, Gupta PK. Fine-needle aspiration of thyroid: an institutional experience. Thyroid. 1998;8:565–569.

    Article  CAS  PubMed  Google Scholar 

  11. Oertel YC, Oertel JE. Thyroid cytology and histology. Baillieres Best Pract Res Clin Endocrinol Metab. 2000;14:541–557.

    Article  CAS  PubMed  Google Scholar 

  12. Centeno BA, Szyfelbein WM, Daniels GH, Vickery AL Jr. Fine needle aspiration biopsy of the thyroid gland in patients with prior Graves’ disease treated with radioactive iodine. Morphologic findings and potential pitfalls. Acta Cytol. 1996;40:1189–1197.

    CAS  PubMed  Google Scholar 

  13. Anderson SR, Mandel S, LiVolsi VA, Gupta PK, Baloch ZW. Can cytomorphology differentiate between benign nodules and tumors arising in Graves’ disease? Diagn Cytopathol. 2004;31:64–67.

    Article  PubMed  Google Scholar 

  14. Kim WB, Han SM, Kim TY, et al. Ultrasonographic screening for detection of thyroid cancer in patients with Graves’ disease. Clin Endocrinol (Oxf). 2004;60:719–725.

    Article  Google Scholar 

  15. Cantalamessa L, Baldini M, Orsatti A, Meroni L, Amodei V, Castagnone D. Thyroid nodules in Graves disease and the risk of thyroid carcinoma. Arch Intern Med. 1999;159:1705–1708.

    Article  CAS  PubMed  Google Scholar 

  16. Carson HJ, Castelli MJ, Gattuso P. Incidence of neoplasia in Hashimoto’s thyroiditis: a fine-needle aspiration study. Diagn Cytopathol. 1996;14:38–42.

    Article  CAS  PubMed  Google Scholar 

  17. Liu LH, Bakhos R, Wojcik EM. Concomitant papillary thyroid carcinoma and Hashimoto’s thyroiditis. Semin Diagn Pathol. 2001;18:99–103.

    CAS  PubMed  Google Scholar 

  18. Kumar N, Ray C, Jain S. Aspiration cytology of Hashimoto’s thyroiditis in an endemic area. Cytopathology. 2002;13:31–39.

    Article  PubMed  Google Scholar 

  19. MacDonald L, Yazdi HM. Fine needle aspiration biopsy of Hashimoto’s thyroiditis. Sources of diagnostic error. Acta Cytol. 1999;43:400–406.

    CAS  PubMed  Google Scholar 

  20. Mechler C, Bounacer A, Suarez H, et al. Papillary thyroid carcinoma: 6 cases from 2 families with associated lymphocytic thyroiditis harbouring RET/PTC rearrangements. Br J Cancer. 2001;85:1831–1837.

    Article  CAS  PubMed  Google Scholar 

  21. Kumarasinghe MP, De Silva S. Pitfalls in cytological diagnosis of autoimmune thyroiditis. Pathology. 1999;31:1–8.

    Article  CAS  PubMed  Google Scholar 

  22. Baloch ZW, Fleisher S, LiVolsi VA, Gupta PK. Diagnosis of “follicular neoplasm”: a gray zone in thyroid fine-needle aspiration cytology. Diagn Cytopathol. 2002;26:41–44.

    Article  PubMed  Google Scholar 

  23. Renshaw AA. Follicular lesions of the thyroid. Am J Clin Pathol. 2001;115:782–785.

    CAS  PubMed  Google Scholar 

  24. Sidawy MK, Del Vecchio DM, Knoll SM. Fine-needle aspiration of thyroid nodules: correlation between cytology and histology and evaluation of discrepant cases. Cancer. 1997;81:253–259.

    Article  CAS  PubMed  Google Scholar 

  25. Pu RT, Yang J, Wasserman PG, Bhuiya T, Griffith KA, Michael CW. Does Hurthle cell lesion/neoplasm predict malignancy more than follicular lesion/neoplasm on thyroid fine-needle aspiration? Diagn Cytopathol. 2006;34:330–334.

    Article  PubMed  Google Scholar 

  26. Deveci MS, Deveci G, LiVolsi VA, Baloch ZW. Fine-needle aspiration of follicular lesions of the thyroid. Diagnosis and follow-up. Cytojournal. 2006;3:9.

    Article  PubMed  Google Scholar 

  27. Clary KM, Condel JL, Liu Y, Johnson DR, Grzybicki DM, Raab SS. Interobserver variability in the fine needle aspiration biopsy diagnosis of follicular lesions of the thyroid gland. Acta Cytol. 2005;49:378–382.

    PubMed  Google Scholar 

  28. Tuttle RM, Lemar H, Burch HB. Clinical features associated with an increased risk of thyroid malignancy in patients with follicular neoplasia by fine-needle aspiration. Thyroid. 1998;8:377–383.

    Article  CAS  PubMed  Google Scholar 

  29. Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer. 2007;111:306–315.

    Article  PubMed  Google Scholar 

  30. Elliott DD, Pitman MB, Bloom L, Faquin WC. Fine-needle aspiration biopsy of Hurthle cell lesions of the thyroid gland: a cytomorphologic study of 139 cases with statistical analysis. Cancer. 2006;108:102–109.

    Article  PubMed  Google Scholar 

  31. Oertel YC. Fine-needle aspiration in the evaluation of thyroid neoplasms. Endocr Pathol. 1997;8:215–224.

    Article  PubMed  Google Scholar 

  32. Das DK, Mallik MK, Sharma P, et al. Papillary thyroid carcinoma and its variants in fine needle aspiration smears. A cytomorphologic study with special reference to tall cell variant. Acta Cytol. 2004;48:325–336.

    PubMed  Google Scholar 

  33. Baloch ZW, LiVolsi VA. Cytologic and architectural mimics of papillary thyroid carcinoma. Diagnostic challenges in fine-needle aspiration and surgical pathology specimens. Am J Clin Pathol. 2006;125 Suppl:S135-S144.

    PubMed  Google Scholar 

  34. Albores-Saavedra J, Wu J. The many faces and mimics of papillary thyroid carcinoma. Endocr Pathol. 2006;17:1–18.

    Article  PubMed  Google Scholar 

  35. Zacks JF, de las Morenas A, Beazley RM, O’Brien MJ. Fine-needle aspiration cytology diagnosis of colloid nodule versus follicular variant of papillary carcinoma of the thyroid. Diagn Cytopathol. 1998;18:87–90.

    Article  CAS  PubMed  Google Scholar 

  36. Solomon A, Gupta PK, LiVolsi VA, Baloch ZW. Distinguishing tall cell variant of papillary thyroid carcinoma from usual variant of papillary thyroid carcinoma in cytologic specimens. Diagn Cytopathol. 2002;27:143–148.

    Article  PubMed  Google Scholar 

  37. Baloch ZW, LiVolsi VA. Warthin-like papillary carcinoma of the thyroid. Arch Pathol Lab Med. 2000;124:1192–1195.

    CAS  PubMed  Google Scholar 

  38. Collins BT, Cramer HM, Tabatowski K, Hearn S, Raminhos A, Lampe H. Fine needle aspiration of medullary carcinoma of the thyroid. Cytomorphology, immunocytochemistry and electron microscopy. Acta Cytol. 1995;39:920–930.

    CAS  PubMed  Google Scholar 

  39. Cheung CC, Ezzat S, Freeman JL, Rosen IB, Asa SL. Immunohistochemical diagnosis of papillary thyroid carcinoma. Mod Pathol. 2001;14:338–342.

    Article  CAS  PubMed  Google Scholar 

  40. Sapio MR, Guerra A, Posca D, et al. Combined analysis of galectin-3 and BRAFV600E improves the accuracy of fine-needle aspiration biopsy with cytological findings suspicious for papillary thyroid carcinoma. Endocr Relat Cancer. 2007;14:1089–1097.

    Article  CAS  PubMed  Google Scholar 

  41. Barroeta JE, Baloch ZW, Lal P, Pasha TL, Zhang PJ, LiVolsi VA. Diagnostic value of differential expression of CK19, Galectin-3, HBME-1, ERK, RET, and p16 in benign and malignant follicular-derived lesions of the thyroid: an immunohistochemical tissue microarray analysis. Endocr Pathol. 2006;17:225–234.

    Article  CAS  PubMed  Google Scholar 

  42. Nikiforov YE. RET/PTC rearrangement in thyroid tumors. Endocr Pathol. 2002;13:3–16.

    Article  CAS  PubMed  Google Scholar 

  43. Fischer AH, Bond JA, Taysavang P, Battles OE, Wynford-Thomas D. Papillary thyroid carcinoma oncogene (RET/PTC) alters the nuclear envelope and chromatin structure. Am J Pathol. 1998;153:1443–1450.

    CAS  PubMed  Google Scholar 

  44. Zou M, Shi Y, Farid NR. Low rate of ret proto-oncogene activation (PTC/retTPC) in papillary thyroid carcinomas from Saudi Arabia. Cancer. 1994;73:176–180.

    Article  CAS  PubMed  Google Scholar 

  45. Motomura T, Nikiforov YE, Namba H, et al. Ret rearrangements in Japanese pediatric and adult papillary thyroid cancers. Thyroid. 1998;8:485–489.

    Article  CAS  PubMed  Google Scholar 

  46. Domingues R, Mendonca E, Sobrinho L, Bugalho MJ. Searching for RET/PTC rearrangements and BRAF V599E mutation in thyroid aspirates might contribute to establish a preoperative diagnosis of papillary thyroid carcinoma. Cytopathology. 2005;16:27–31.

    Article  CAS  PubMed  Google Scholar 

  47. Sapio MR, Posca D, Raggioli A, et al. Detection of RET/PTC, TRK and BRAF mutations in preoperative diagnosis of thyroid nodules with indeterminate cytological findings. Clin Endocrinol (Oxf). 2007;66:678–683.

    Article  CAS  Google Scholar 

  48. Pizzolanti G, Russo L, Richiusa P, et al. Fine-needle aspiration molecular analysis for the diagnosis of papillary thyroid carcinoma through BRAF V600E mutation and RET/PTC rearrangement. Thyroid. 2007;17:1109–1115.

    Article  CAS  PubMed  Google Scholar 

  49. Papotti M, Volante M, Giuliano A, et al. RET/PTC activation in hyalinizing trabecular tumors of the thyroid. Am J Surg Pathol. 2000;24:1615–1621.

    Article  CAS  PubMed  Google Scholar 

  50. Wirtschafter A, Schmidt R, Rosen D, et al. Expression of the RET/PTC fusion gene as a marker for papillary carcinoma in Hashimoto’s thyroiditis [see comments]. Laryngoscope. 1997;107:95–100.

    Article  CAS  PubMed  Google Scholar 

  51. Elisei R, Romei C, Vorontsova T, et al. RET/PTC rearrangements in thyroid nodules: studies in irradiated and not irradiated, malignant and benign thyroid lesions in children and adults. J Clin Endocrinol Metab. 2001;86:3211–3216.

    Article  CAS  PubMed  Google Scholar 

  52. Inaba M, Umemura S, Satoh H, et al. Expression of RET in follicular cell-derived tumors of the thyroid gland: prevalence and implication of morphological type. Pathol Int. 2003;53:146–153.

    Article  CAS  PubMed  Google Scholar 

  53. Daum G, Eisenmann-Tappe I, Fries HW, Troppmair J, Rapp UR. The ins and outs of Raf kinases. Trends Biochem Sci. 1994;19:474–480.

    Article  CAS  PubMed  Google Scholar 

  54. Cohen Y, Xing M, Mambo E, et al. BRAF mutation in papillary thyroid carcinoma. J Natl Cancer Inst. 2003;95:625–627.

    Article  CAS  PubMed  Google Scholar 

  55. Kimura ET, Nikiforova MN, Zhu Z, Knauf JA, Nikiforov YE, Fagin JA. High prevalence of BRAF mutations in thyroid cancer: genetic evidence for constitutive activation of the RET/PTC-RAS-BRAF signaling pathway in papillary thyroid carcinoma. Cancer Res. 2003;63:1454–1457.

    CAS  PubMed  Google Scholar 

  56. Fagin JA. How thyroid tumors start and why it matters: kinase mutants as targets for solid cancer pharmacotherapy. J Endocrinol. 2004;183:249–256.

    Article  CAS  PubMed  Google Scholar 

  57. Soares P, Trovisco V, Rocha AS, et al. BRAF mutations and RET/PTC rearrangements are alternative events in the etiopathogenesis of PTC. Oncogene. 2003;22:4578–4580.

    Article  CAS  PubMed  Google Scholar 

  58. Lubitz CC, Ugras SK, Kazam JJ, et al. Microarray analysis of thyroid nodule fine-needle aspirates accurately classifies benign and malignant lesions. J Mol Diagn. 2006;8:490–498.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA, USA

    Zubair W. Baloch MD, PhD (Professor)

  2. Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Virginia A. LiVolsi MD (Professor)

Authors
  1. Zubair W. Baloch MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Virginia A. LiVolsi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Pathology Service, WRN202, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, USA

    Jennifer L. Hunt

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Baloch, Z.W., LiVolsi, V.A. (2010). Fine Needle Aspiration: Present and Future. In: Hunt, J. (eds) Molecular Pathology of Endocrine Diseases. Molecular Pathology Library, vol 3. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1707-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-1707-2_7

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-1706-5

  • Online ISBN: 978-1-4419-1707-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation