The evaluation of thyroid nodules by fine needle aspiration (FNA) is one of the most challenging tasks in all of cytopathology. A cytologist must understand the clinical presentation of thyroid diseases, their defining histopathologic and cytopathologic features, and even the intricacies of patient management. Drs. Clark and Faquin have provided a valuable framework for cytologists learning (and continuing to learn) this exacting discipline. Organized around a practical algorithm, the authors lay out a rational and concise approach toward acquiring the necessary skills for the cytologic diagnosis of thyroid nodules. The first edition, published in 2005, was a very welcome addition to the cytology literature. This new edition, with updated terminology for reporting thyroid FNA results, builds on the success of their approach.
Why are we examining such challenging specimens? Clearly, the clinical need is there. Over 50% of adults have one or more thyroid nodules. Surgical excision of all nodules is certainly neither practical nor desirable. Enter FNA, a minimally invasive cellular sampling method that has proven to be a highly useful screening test for thyroid cancer. Because of it, thousands of patients with a benign diagnosis are spared unnecessary surgery every year, and those with cancer are reliably triaged for appropriate therapy.
The large number of FNAs performed in the US is a tribute to its success as a screening test. In many institutions, the thyroid FNA is the most common FNA specimen. For a relatively new diagnostic test, this is a remarkable state of affairs. Thirty years ago, few thyroid cancers were diagnosed by FNA in the US, and in the 1980s some prominent pathologists still questioned the value of FNA for thyroid nodules. There is no more debate: FNA has proven its value. In 2009, an estimated 37,200 thyroid cancers will be diagnosed in the United States, and virtually all of them will have been diagnosed directly or triaged for a diagnostic lobectomy by FNA. If approximately nine FNAs are performed for every thyroid cancer that is discovered, then roughly 335,000 thyroid FNAs will have been performed in the US in 2009.
Cytologists must be armed and ready to evaluate these clinically vital specimens. This book, with its practical algorithm, cogent text, and beautiful illustrations, provides the ammunition a cytologist needs to master thyroid FNA interpretation.
Contents
1 Introduction and Clinical Aspects
2 How to Perform and Process a Thyroid FNA
3 Approach to Thyroid FNA Cytopathology: An Overview
4 Inflammatory Lesions and Lymphoma
5 Colloid-Predominant Lesions
6 Follicular Lesions
7 Hurthle Cell Lesions
8 Cystic Lesions of the Thyroid
9 Papillary Thyroid Carcinoma
10 Medullary Thyroid Carcinoma
11 Undifferentiated (Anaplastic) Carcinoma and Secondary Tumors
Index
Why are we examining such challenging specimens? Clearly, the clinical need is there. Over 50% of adults have one or more thyroid nodules. Surgical excision of all nodules is certainly neither practical nor desirable. Enter FNA, a minimally invasive cellular sampling method that has proven to be a highly useful screening test for thyroid cancer. Because of it, thousands of patients with a benign diagnosis are spared unnecessary surgery every year, and those with cancer are reliably triaged for appropriate therapy.
The large number of FNAs performed in the US is a tribute to its success as a screening test. In many institutions, the thyroid FNA is the most common FNA specimen. For a relatively new diagnostic test, this is a remarkable state of affairs. Thirty years ago, few thyroid cancers were diagnosed by FNA in the US, and in the 1980s some prominent pathologists still questioned the value of FNA for thyroid nodules. There is no more debate: FNA has proven its value. In 2009, an estimated 37,200 thyroid cancers will be diagnosed in the United States, and virtually all of them will have been diagnosed directly or triaged for a diagnostic lobectomy by FNA. If approximately nine FNAs are performed for every thyroid cancer that is discovered, then roughly 335,000 thyroid FNAs will have been performed in the US in 2009.
Cytologists must be armed and ready to evaluate these clinically vital specimens. This book, with its practical algorithm, cogent text, and beautiful illustrations, provides the ammunition a cytologist needs to master thyroid FNA interpretation.
Contents
1 Introduction and Clinical Aspects
2 How to Perform and Process a Thyroid FNA
3 Approach to Thyroid FNA Cytopathology: An Overview
4 Inflammatory Lesions and Lymphoma
5 Colloid-Predominant Lesions
6 Follicular Lesions
7 Hurthle Cell Lesions
8 Cystic Lesions of the Thyroid
9 Papillary Thyroid Carcinoma
10 Medullary Thyroid Carcinoma
11 Undifferentiated (Anaplastic) Carcinoma and Secondary Tumors
Index