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Related Concept Videos

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
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Pitfalls in Thyroid Cytopathology.

Esther Diana Rossi1, Adebowale J Adeniran2, William C Faquin3

  • 1Division of Anatomic Pathology and Histology, Catholic University of Sacred Heart, A. Gemelli Square, 1, Rome 20123, Italy.

Surgical Pathology Clinics
|November 2, 2019
PubMed
Summary

Fine-needle aspiration (FNA) is a key tool for thyroid nodule diagnosis, helping distinguish benign from malignant cases. This review highlights potential pitfalls in thyroid FNA cytology to improve diagnostic accuracy and patient management.

Keywords:
CytologyFalse-negative diagnosesFalse-positive diagnosesFine-needle aspirationThyroid cancerThyroid nodule

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Area of Science:

  • Cytopathology
  • Endocrinology
  • Surgical Pathology

Background:

  • Fine-needle aspiration (FNA) is a primary diagnostic method for thyroid nodules.
  • It aids in classifying lesions as benign or malignant, guiding treatment decisions.
  • The Bethesda System for Reporting Thyroid Cytopathology is widely adopted globally.

Purpose of the Study:

  • To discuss potential diagnostic pitfalls in thyroid fine-needle aspiration (FNA).
  • To identify factors that may lead to inaccurate cytologic evaluation of thyroid lesions.
  • To enhance the reliability of FNA in thyroid nodule assessment.

Main Methods:

  • Review of cytologic evaluation of thyroid lesions.
  • Analysis of potential diagnostic challenges in thyroid FNA.
  • Discussion of factors contributing to false-positive and false-negative results.

Main Results:

  • Thyroid FNA demonstrates high positive predictive value (97%-99%).
  • Sensitivity ranges from 65% to 99%, and specificity from 72% to 100%.
  • Several diagnostic pitfalls can compromise the accuracy of FNA results.

Conclusions:

  • Despite high accuracy, thyroid FNA is subject to diagnostic pitfalls.
  • Awareness of these pitfalls is crucial for accurate cytologic interpretation.
  • Minimizing errors in FNA evaluation optimizes patient management for thyroid nodules.