title: Thyroid Atypia/Follicular Lesion of Undetermined Significance: Attitudes towards the Diagnosis of Bethesda System III Nodules.
abstract: OBJECTIVE
  To review our institutional experience and to analyze the clinical decisions made after a cytological diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS).
  
  
  METHODS
  This is a retrospective review of all thyroid fine-needle aspiration (FNA) cytologies performed in the Hospital Clínico San Carlos (Madrid) between 2010 and 2014.
  
  
  RESULTS
  One hundred thirty thyroid FNA were categorized as AUS/FLUS (5%). One hundred six (81.5%) patients were women, and the mean age was 59 years. In 61 patients a repeated FNA was performed (46%). Fifty-five nodules were treated surgically (42.3%), with a histopathological diagnosis of nodular hyperplasia in 36 cases (65%), adenoma in 11 (20%), and carcinoma in 8 (14.5%). In the group of nonsurgical patients (n = 75), a repeated FNA was performed in 43 (57.3%) cases. We found no statistically significant association between sex or age and clinical management (p = 0.13 and p = 0.31, respectively).
  
  
  CONCLUSIONS
  Clinical management after an AUS/FLUS FNA diagnosis is erratic and does not match standardized management protocols. The AUS/FLUS classification has not led to new diagnostic tests in a relevant percentage of patients. The implementation of consensual institutional strategies could lead to better management of these cases.
authors.affiliation: Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Estrada Muñoz
authors.forename: Cristina
authors.initials: C
authors.lastname: Díaz Del Arco
authors.forename: Luis
authors.initials: L
authors.lastname: Ortega Medina
authors.forename: M Jesús
authors.initials: MJ
authors.lastname: Fernández Aceñero
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis* / Q000473:pathology; D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology