Pitfalls in Thyroid Cytopathology

Surg Pathol Clin. 2019 Dec;12(4):865-881. doi: 10.1016/j.path.2019.08.001.

Abstract

Fine-needle aspiration (FNA) is among the first diagnostic tools used in the evaluation of thyroid nodules. It has the ability to triage patients with benign and malignant lesions, thus defining the optimum clinical and/or surgical management. The Bethesda System for Reporting Thyroid Cytopathology has found worldwide acceptance. Thyroid FNA offers high positive predictive value (97%-99%), with sensitivities and specificities of 65% to 99% and 72% to 100%, respectively. Nonetheless, many potential diagnostic pitfalls exist that can lead to false-positive and/or false-negative results. This article discusses several of the potential pitfalls in the cytologic evaluation of thyroid lesions.

Keywords: Cytology; False-negative diagnoses; False-positive diagnoses; Fine-needle aspiration; Thyroid cancer; Thyroid nodule.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma, Follicular / diagnostic imaging
  • Adenocarcinoma, Follicular / pathology*
  • Biopsy, Fine-Needle*
  • False Positive Reactions
  • Graves Disease / diagnostic imaging
  • Graves Disease / pathology*
  • Guideline Adherence
  • Guidelines as Topic
  • Humans
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology*
  • Thyroid Nodule / diagnostic imaging
  • Thyroid Nodule / pathology*
  • Thyroiditis / diagnostic imaging
  • Thyroiditis / pathology*
  • Ultrasonography, Doppler