Thyroid Aspiration Cytology: Current Status


  • Lester J. Layfield MD,

    Corresponding author
    1. Professor and Head, Anatomic Pathology, University of Utah School of Medicine, University of Utah Hospital and Clinics, Salt Lake City, UT
    • Lester J. Layfield, MD, Department of Pathology, Huntsman Cancer Hospital, 1950 Circle of Hope, Room 3860, Salt Lake City, UT 84112
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  • Edmund S. Cibas MD,

    1. Associate Professor of Pathology, Harvard Medical School Director of the Division of Cytopathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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  • Hossein Gharib MD,

    1. Professor of Medicine, Department of Endocrinology, Mayo Clinic College of Medicine, Rochester, MN
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  • Susan J. Mandel MD, MPH

    1. Professor of Medicine, Associate Chief of the Division of Endocrinology, Diabetes and Metabolism, Hospital of the University of Pennsylvania, Philadelphia, PA
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  • DISCLOSURES: Dr. Gharib received a research grant from Genzyme Corporation for research completed in 2008. No other conflict of interest relevant to this article was reported.


In the adult population, thyroid nodules are common and are increasingly detected by ultrasound examination or other scanning techniques. Depending on their size and ultrasonographic features, these nodules may require further investigation, including tissue diagnosis. Fine-needle aspiration (FNA) has become the predominant method to obtain tissue for microscopic analysis. In October 2007, the National Cancer Institute sponsored a conference to review the state of the science for the use of FNA in the management of thyroid nodules. This conference reviewed indications for thyroid FNA and pre-FNA requirements, training and credentialing, techniques for thyroid FNA, diagnostic terminology and morphologic criteria, utilization of ancillary studies, and post-FNA testing and treatment options. The results of those discussions have been published in both print and electronic versions. The aim of the current article was to discuss indications for FNA, diagnostic terminology, and post-FNA options, issues that are important to physicians who are managing patients with thyroid nodules. CA Cancer J Clin 2009;59:99–110. © 2009 American Cancer Society, Inc.