Perceptions of diagnostic terminology and cytopathologic reporting of fine-needle aspiration biopsies of thyroid nodules: a survey of clinicians and pathologists.
BACKGROUND
Guidelines on thyroid fine-needle aspiration biopsy (FNABs) reporting calls for unambiguous diagnostic terminology in order to maximize treatment. This study evaluates how pathologists follow the guidelines and clinicians understand the diagnostic categories in terms of patient care.


METHODS
Survey 1 asked pathologists who perform/interpret FNABs which of "atypical," "indeterminate," "suspicious," and "nondiagnostic" they routinely use. Survey 2 asked clinicians who treat thyroid nodules to correlate these categories to the options of "negative FNAB/follow-up," "repeat FNAB," and "proceed to surgery." The anonymous, voluntary results were entered into a database and analyzed.


RESULTS
Pathologists' and clinicians' response rates were 70% and 35%, respectively. Survey 1: 27% of pathologists used three, 27% used one, and 44% used two categories. Survey 2: 98% clinicians would repeat the FNAB with a "nondiagnostic" and 96% opted for surgery with a "suspicious" diagnosis. "Indeterminate" prompted 58% to repeat the FNAB and 32% to send the patient to surgery. "Atypical" would lead 37% to repeat the FNAB and 52% to send the patient to surgery.


CONCLUSIONS
Pathologists actively use the terminology "suspicious," "indeterminate," or "atypical," which cause confusion in some clinicians. These results support the need for a more standardized terminology for FNAB reporting and education of the clinicians on that terminology.
Redman
Rachel
R
Department of Pathology, University of Florida College of Medicine, Gainesville, Florida 32610-0275, USA. redmar@pathology.ufl.edu
Yoder
Brian J
BJ
Massoll
Nicole A
NA
D044963:Biopsy, Fine-Needle; D003625:Data Collection / Q000379:methods; D003937:Diagnosis, Differential; D006123:Group Practice; D006801:Humans; D008511:Medicine; D010336:Pathology; D013038:Specialization; D011795:Surveys and Questionnaires; D016606:Thyroid Nodule / Q000473:pathology*