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Cellular adequacy for thyroid aspirates prepared by ThinPrep: how many cells are needed?

Claire W Michael1, Yijun Pang, Robert T Pu

  • 1Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA. clairemi@umich.edu

Diagnostic Cytopathology
|November 17, 2007
PubMed
Summary

Establishing specimen adequacy for ThinPrep thyroid aspirates is crucial. A minimum of 180-320 cells per cluster is recommended for accurate diagnosis and treatment triage, improving diagnostic agreement significantly.

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Area of Science:

  • Cytopathology
  • Surgical Pathology
  • Thyroid Diagnostics

Background:

  • ThinPrep (TP) artifacts in thyroid aspirates are known, but clear adequacy criteria are lacking.
  • Accurate diagnosis of thyroid aspirates is essential for appropriate patient management.

Purpose of the Study:

  • To evaluate the minimum number of cells required for an adequate ThinPrep thyroid aspirate specimen.
  • To establish criteria for diagnostic adequacy based solely on ThinPrep cytology.

Main Methods:

  • Reviewed 218 ThinPrep thyroid aspirates with surgical pathology correlation.
  • Calculated cellularity by counting cells per cluster and total clusters.
  • Correlated cell counts with cytologic and histologic diagnoses and treatment triage using logistic regression.

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Last Updated: Jul 10, 2026

An Ex vivo Culture System to Study Thyroid Development
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Reaggregate Thymus Cultures
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Main Results:

  • 67% of cases were cellular; 33% were acellular.
  • Diagnostic agreement was below 50% with ≤180 cells, increasing to 80% with 180-320 cells.
  • Average cells per cluster, not total clusters, significantly correlated with diagnostic agreement.

Conclusions:

  • A minimum cellularity threshold is necessary for reliable ThinPrep thyroid aspirate diagnosis.
  • Increasing average cells per cluster significantly improves diagnostic accuracy and treatment triage.
  • This study provides data-driven criteria for ThinPrep thyroid aspirate adequacy.