title: Thyroid fine-needle aspiration cytology: performance data of neoplastic and malignant cases as identified from 1558 responses in the ASCP Non-GYN Assessment program thyroid fine-needle performance data.
abstract: BACKGROUND
  Fine-needle aspiration of the thyroid is a common procedure, with an established role in reducing unnecessary thyroid surgery and identifying neoplasms and malignancies.
  
  
  METHODS
  The study evaluated 1558 responses in the American Society for Clinical Pathology (ASCP) Non-GYN Assessment program of aspirates of thyroid neoplasms and malignancies and placed them into the following groups: group A (target or correct interpretation), group B (incorrect interpretation as a benign thyroid nodule), group C (incorrect interpretation malignant aspirate as thyroid neoplasm), and group D (malignant diagnosis with incorrect interpretation). In clinical practice, responses in groups A, C, and D would lead to surgical excision, whereas responses in group B would not.
  
  
  RESULTS
  Of a total of 1558 responses, 78.5% of the responses were in group A, 8.5% in group B, 3.75% in group C, and 9.25% in group D. By individual diagnosis, the group rates were 86.5%, 0%, 11%, and 2.5% for anaplastic thyroid carcinoma; 83%, 5.5%, 4.25%, and 7.25% for papillary thyroid carcinoma; 79%, 7%, 6%, and 8% for medullary thyroid carcinoma; 83.5% 6.75%, 0%, and 9.75% for Hürthle cell neoplasm; and 61%, 22%, 0%, and 17% for follicular neoplasm in groups A, B, C, and D respectively.
  
  
  CONCLUSIONS
  Fine-needle aspiration was effective in diagnosing thyroid neoplasms and malignancies and in separating thyroid nodules into surgical and nonsurgical categories. Data from a large group of cytology professionals showed good performance; however, there is room for improvement, especially in making specific diagnoses. In particular, follicular neoplasm and follicular variant of papillary thyroid carcinoma were challenging diagnoses for participants.
authors.affiliation: Mercy Medical Center, Cedar Rapids, Iowa.
authors.forename: Stan G
authors.initials: SG
authors.lastname: Eilers
authors.forename: Paula
authors.initials: P
authors.lastname: LaPolice
authors.forename: Perkins
authors.initials: P
authors.lastname: Mukunyadzi
authors.forename: Umesh
authors.initials: U
authors.lastname: Kapur
authors.forename: Amy
authors.initials: A
authors.lastname: Wendel Spiczka
authors.forename: Ajay
authors.initials: A
authors.lastname: Shah
authors.forename: Husain
authors.initials: H
authors.lastname: Saleh
authors.forename: Adebowale
authors.initials: A
authors.lastname: Adeniran
authors.forename: Amberly
authors.initials: A
authors.lastname: Nunez
authors.forename: Indra
authors.initials: I
authors.lastname: Balachandran
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Clark
authors.forename: Larry
authors.initials: L
authors.lastname: Lemon
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000601:surgery; D018249:Adenoma, Oxyphilic / Q000473:pathology / Q000601:surgery; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D018278:Carcinoma, Neuroendocrine; D002291:Carcinoma, Papillary; D003581:Cytodiagnosis / Q000379:methods; D016208:Databases, Factual; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018570:Risk Assessment; D012955:Societies, Medical; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods
keywords: Hurthle cell thyroid neoplasia; follicular; follicular thyroid neoplasm; thyroid cancer; thyroid cancer, Hurthle cell; thyroid carcinoma, anaplastic; thyroid carcinoma, follicular; thyroid carcinoma, medullary; thyroid carcinoma, papillary