Objective: To analyze reasons for unclear or missed diagnoses in fine needle aspiration biopsy (FNAB) of papillary thyroid carcinoma (PTC). Study Design: Among 35,000 thyroid FNAB diagnoses made during 1989–2009, 135 PTC FNAB diagnoses were divided into 3 categories by expressed probability. A group of 10 cases with histologic PTC diagnosis not mentioned in our previous FNAB sample was also analyzed. Results: Of the 75 PTC FNAB diagnoses, 71 were confirmed; the remaining 4 were hyperplastic goiters. In the group of 45 cases with PTC, in which FNAB diagnosis was the next most probable differential diagnosis, 23 were confirmed. In the group of 15 cases, in which the PTC FNAB diagnosis was considered the less probable differential diagnosis, 3 PTCs were found. The other cases in both groups were usually histologically diagnosed as lymphocytic thyroiditis. In the group of 10 cases with histologic PTC diagnosis, 6 were evaluated as suspicious for (other) malignancy, 3 were diagnosed as hyperplasia with oncocytes and 1 as low cellularity; sample reaspiration was recommended. Conclusion: FNAB diagnosis of PTC is not always possible, with success rate influenced by lesion type and size, accompanying diagnoses, representativeness of cytology sample and experience of the cytopathologist.

Keywords:
Thyroid nodule, Diagnostic probability, Fine needle aspiration biopsy, Papillary thyroid carcinoma
1.
Zajicek J: Aspiration Biopsy Cytology of Head and Neck Lesions. IAC Slide Sets. TOC, Chicago, 1973, vol II.
2.
Zajicek J: Introduction to aspiration biopsy. Monogr Clin Cytol 1974;4:1–211.
3.
Kini SR, Miller JM, Hamburger JI, Smith MJ: Cytopathology of papillary carcinoma of the thyroid by fine needle aspiration. Acta Cytol 1980;24:511–521.
4.
Akhtar M, Ali MA, Huq M, Bakry M: Fine-needle aspiration biopsy of papillary thyroid carcinoma: cytologic, histologic, and ultrastructural correlations. Diagn Cytopathol 1991;7:373–379.
5.
Guiter GE, DeLellis RA: Multinucleate giant cells in papillary thyroid carcinoma: a morphologic and immunohistochemical study. Am J Clin Pathol 1996;106:765–768.
6.
Shabb NS, Tawil A, Gergeos F, Saleh M, Azar S: Multinucleated giant cells in fine-needle aspiration of thyroid nodules: their diagnostic significance. Diagn Cytopathol 1999;21:307–312.
7.
Kelman AS, Rathan A, Leibowitz J, Burstein DE, Haber RS: Thyroid cytology and the risk of malignancy in thyroid nodules: importance of nuclear atypia in indeterminate specimens. Thyroid 2001;11:271–277.
8.
Renshaw AA: ‘Histiocytoid’ cells in fine-needle aspirations of papillary carcinoma of the thyroid: frequency and significance of an under-recognized cytologic pattern. Cancer 2002;96:240–243.
9.
Tsou PL, Hsiao YL, Chang TC: Multinucleated giant cells in fine needle aspirates: can they help differentiate papillary thyroid cancer from benign nodular goiter? Acta Cytol 2002;46:823–827.
10.
Castro-Gómez L, Córdova-Ramírez S, Duarte-Torres R, Alonso de Ruiz P, Hurtado-López LM: Cytologic criteria of cystic papillary carcinoma of the thyroid. Acta Cytol 2003;47:590–594.
11.
Szporn AH, Yuan S, Wu M, Burstein DE: Cellular swirls in fine needle aspirates of papillary thyroid carcinoma: a new diagnostic criterion. Mod Pathol 2006;19:1470–1473.
12.
Harshan M, Crapanzano JP, Aslan DL, Vazquez MF, Saqi A: Papillary thyroid carcinoma with atypical histiocytoid cells on fine-needle aspiration. Diagn Cytopathol 2009;37:244–250.
13.
Orell SR, Sterrett GF, Walters MN-I, Whitaker D (eds): Manual and Atlas of Fine Needle Aspiration Cytology. Edinburgh, Churchill Livingstone, 1986.
14.
Hugh JC, Duggan MA, Chang-Poon V: The fine-needle aspiration appearance of the follicular variant of thyroid papillary carcinoma: a report of three cases. Diagn Cytopathol 1988;4:196–201.
15.
Hui PK, Chan JK, Cheung PS, Gwi E: Columnar cell carcinoma of the thyroid: fine needle aspiration findings in a case. Acta Cytol 1990;34:355–358.
16.
Caruso G, Tabarri B, Lucchi I, Tison V: Fine needle aspiration cytology in a case of diffuse sclerosing carcinoma of the thyroid. Acta Cytol 1990;34:352–354.
17.
Harach HR, Zusman SB: Cytopathology of the tall cell variant of thyroid papillary carcinoma. Acta Cytol 1992;36:895–899.
18.
Woyke S, al-Jassar AK, al-Jarallah MA, Temmim L: Papillary carcinoma of the thyroid with numerous spindle-shaped tumor cells in fine needle aspiration smears: a case report. Acta Cytol 1994;38:226–230.
19.
Doria MI Jr, Attal H, Wang HH, Jensen JA, DeMay RM: Fine needle aspiration cytology of the oxyphil variant of papillary carcinoma of the thyroid: a report of three cases. Acta Cytol 1996;40:1007–1011.
20.
Gamboa-Domínguez A, Candanedo-González F, Uribe-Uribe NO, Angeles-Angeles A: Tall cell variant of papillary thyroid carcinoma: a cytohistologic correlation. Acta Cytol 1997;41:672–676.
21.
Putti TC, Bhuiya TA, Wasserman PG: Fine needle aspiration cytology of mixed tall and columnar cell papillary carcinoma of the thyroid: a case report. Acta Cytol 1998;42:387–390.
22.
Pérez F, Llobet M, Garijo G, Barceló C, Castro P, Bernadó L: Fine-needle aspiration cytology of columnar-cell carcinoma of the thyroid: report of two cases with cytohistologic correlation. Diagn Cytopathol 1998;18:352–356.
23.
Kumarasinghe MP: Cytomorphologic features of diffuse sclerosing variant of papillary carcinoma of the thyroid: a report of two cases in children. Acta Cytol 1998;42:983–986.
24.
Kuhel WI, Kutler DI, Santos-Buch CA: Poorly differentiated insular thyroid carcinoma: a case report with identification of intact insulae with fine needle aspiration biopsy. Acta Cytol 1998;42:991–997.
25.
Woyke S, al-Jassar AK, al-Jazzaf H: Macrofollicular variant of papillary thyroid carcinoma diagnosed by fine needle aspiration biopsy: a case report. Acta Cytol 1998;42:1184–1188.
26.
Vasei M, Kumar PV, Malekhoseini SA, Kadivar M: Papillary Hürthle cell carcinoma (Warthin-like tumor) of the thyroid: report of a case with fine needle aspiration findings. Acta Cytol 1998;42:1437–1440.
27.
Hirokawa M, Shimizu M, Terayama K, Kanahara T, Sonoo H, Manabe T: Macrofollicular variant of papillary thyroid carcinoma: report of a case with fine needle aspiration biopsy findings. Acta Cytol 1998;42:1441–1443.
28.
Goodell WM, Saboorian MH, Ashfaq R: Fine-needle aspiration diagnosis of the follicular variant of papillary carcinoma. Cancer 1998;84:349–354.
29.
Baloch ZW, Gupta PK, Yu GH, Sack MJ, LiVolsi VA: Follicular variant of papillary carcinoma: cytologic and histologic correlation. Am J Clin Pathol 1999;111:216–222.
30.
Guiter GE, Auger M, Ali SZ, Allen EA, Zakowski MF: Cytopathology of insular carcinoma of the thyroid. Cancer 1999;87:196–202.
31.
Yang YJ, LiVolsi VA, Khurana KK: Papillary thyroid carcinoma with nodular fasciitis-like stroma: pitfalls in fine-needle aspiration cytology. Arch Pathol Lab Med 1999;123:838–841.
32.
Jayaram G: Cytology of columnar-cell variant of papillary thyroid carcinoma. Diagn Cytopathol 2000;22:227–229.
33.
Baloch ZW, LiVolsi VA: Warthin-like papillary carcinoma of the thyroid. Arch Pathol Lab Med 2000;124:1192–1195.
34.
Glant MD, Berger EK, Davey DD: Intranuclear cytoplasmic inclusions in aspirates of follicular neoplasms of the thyroid: a report of two cases. Acta Cytol 1984;28:576–580.
35.
Lew W, Orell S, Henderson DW: Intranuclear vacuoles in nonpapillary carcinoma of the thyroid: a report of three cases. Acta Cytol 1984;28:581–586.
36.
Deligeorgi-Politi H: Nuclear crease as a cytodiagnostic feature of papillary thyroid carcinoma in fine-needle aspiration biopsies. Diagn Cytopathol 1987;3:307–310.
37.
Shurbaji MS, Gupta PK, Frost JK: Nuclear grooves: a useful criterion in the cytopathologic diagnosis of papillary thyroid carcinoma. Diagn Cytopathol 1988;4:91–94.
38.
Cooper DS, Tiamson E, Ladenson PW: Psammoma bodies in fine needle aspiration biopsies of benign thyroid nodules. Thyroidology 1988;1:55–59.
39.
Gould E, Watzak L, Chamizo W, Albores-Saavedra J: Nuclear grooves in cytologic preparations: a study of the utility of this feature in the diagnosis of papillary carcinoma. Acta Cytol 1989;33:16–20.
40.
Bondeson L, Bondeson AG: Clue helping to distinguish hyalinizing trabecular adenoma from carcinoma of the thyroid in fine-needle aspirates. Diagn Cytopathol 1994;10:25–29.
41.
Martínez-Parra D, Campos Fernández J, Hierro-Guilmain CC, Sola Pérez J, Pérez-Guillermo M: Follicular variant of papillary carcinoma of the thyroid: to what extent is fine-needle aspiration reliable? Diagn Cytopathol 1996;15:12–16.
42.
Faser CR, Marley EF, Oertel YC: Papillary tissue fragments as a diagnostic pitfall in fine-needle aspirations of thyroid nodules. Diagn Cytopathol 1997;16:454–459.
43.
Ellison E, Lapuerta P, Martin SE: Psammoma bodies in fine needle aspirates of the thyroid: predictive value for papillary carcinoma. Cancer 1998;84:169–175.
44.
Blumenfeld W, Nair R, Mir R: Diagnostic significance of papillary structures and intranuclear inclusions in Hürthle-cell neoplasms of the thyroid. Diagn Cytopathol 1999;20:185–189.
45.
Chang TC, Kuo SH, How SW: Coefficient of variation of nuclear diameters as a prognostic factor in papillary thyroid carcinoma. Anal Quant Cytol Histol 1991;6:403–406.
46.
Hamburger JI, Husain M: Semiquantitative criteria for fine needle biopsy diagnosis: reduced false-negative diagnoses. Diagn Cytopathol 1988;4:14–17.
47.
Francis IM, Das DK, Sheikh ZA, Sharma PN, Gupta SK: Role of nuclear grooves in the diagnosis of papillary thyroid carcinoma: a quantitative assessment on fine needle aspiration smears. Acta Cytol 1995;39:409–415.
48.
Sturgis CD, Caraway NP, Johnston DA, Sherman SI, Kidd L, Katz RL: Image analysis of papillary thyroid carcinoma fine needle aspirates: significant association between aneuploidy and death from disease. Cancer 1999;87:155–160.
49.
Karakitsos P, Cochand-Priollet B, Pouliakis A, Guillausseau PJ, Ioakim-Liossi A: Learning vector quantizer in the investigation of thyroid lesions. Anal Quant Cytol Histol 1999;21:201–208.
50.
Harms H, Hofmann M, Ruschenburg I: Fine needle aspiration of the thyroid: can an image processing system improve differentiation? Anal Quant Cytol Histol 2002;24:147–153.
51.
Rupp M, Ehya H: Nuclear grooves in the aspiration cytology of papillary carcinoma of the thyroid. Acta Cytol 1989;33:21–26.
52.
Hedinger C, Williams ED, Sobin LH: The World Health Organization Histological Classification of Tumours: Histological Typing of Thyroid Tumours, ed 2. Berlin, Springer, 1988.
53.
DeLellis RA, Williams ED: Tumours of the thyroid and parathyroid; inDeLellis RA, Lloyd RV, Heitz PU, Eng C (eds): World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Endocrine Organs. Lyon, IARC Press, 2004, pp 49–133.
54.
Williams ED: Two proposals regarding the terminology of thyroid tumours. Int J Surg Pathol 2000;8:181–183.
55.
DeMay RM: The Art and Science of Cytopathology. Chicago, ASCP Press, 1996, pp 703–778.
56.
Davidson HG, Campora RG: Thyroid; in Bibbo M (ed): Comprehensive Cytopathology. Philadelphia, Saunders, 1991, pp 660–662.
57.
Nikiforova MN, Nikiforov YE: Molecular genetics of thyroid cancer: implications for diagnosis, treatment and prognosis. Expert Rev Mol Diagn 2008;8:83–95.
58.
Ying AK, Huh W, Bottomley S, Evans DB, Waguespack SG: Thyroid cancer in young adults. Semin Oncol 2009;36:258–274.
59.
Simpson KW, Albores-Saavedra J: Unusual findings in papillary thyroid microcarcinoma suggesting partial regression: a study of two cases. Ann Diagn Pathol 2007;11:97–102.
60.
Grodski S, Delbridge L: An update on papillary microcarcinoma. Curr Opin Oncol 2009;21:1–4.
61.
Riemann B, Schober O: Therapeutic strategy of papillary microcarcinoma of the thyroid gland: a nuclear medicine perspective. Minerva Endocrinol 2009;34:81–87.
62.
Das DK: Age of patients with papillary thyroid carcinoma: is it a key factor in the development of variants? Gerontology 2005;51:149–154.
63.
Koren J, Opravil Z, Mukensnábl P: Columnar cell carcinoma of the thyroid gland: case report (in Slovak). Cesk Patol 2004;40:72–77.
64.
Köybaşioğlu F, Simşek GG, Onal BU: Tall cell variant of papillary carcinoma arising from a thyroglossal cyst: report of a case with diagnosis by fine needle aspiration cytology. Acta Cytol 2006;50:221–224.
65.
Lam AK, Lo CY: Diffuse sclerosing variant of papillary carcinoma of the thyroid: a 35-year comparative study at a single institution. Ann Surg Oncol 2006;13:176–181.
66.
Yuca K, Unal O, Bayram I, Cankaya H, Kiris M: Papillary thyroid carcinoma presenting as a giant cervical mass: a case report. B-ENT 2005;1:101–105.
67.
Koutkia P, Safer JD: Adrenal metastasis secondary to papillary thyroid carcinoma. Thyroid 2001;11:1077–1079.
68.
Erem C, Hacihasanoglu A, Sari A, Reis A, Alhan E, Cobanoglu U, Onder Ersöz H, Ukinç K: Intrathyroidal papillary thyroid carcinoma presenting with a solitary brain metastasis. Endocrine 2004;25:187–193.
69.
Siddaraju N, Viswanathan VK, Saka VK, Basu D, Shanmugham C: Fine needle aspiration of follicular variant of papillary thyroid carcinoma presenting with pleural effusion: a case report. Acta Cytol 2007;51:911–915.
70.
Miller JM, Hamburger JI, Kini SR: The needle biopsy diagnosis of papillary thyroid carcinoma. Cancer 1981;48:989–993.
71.
Kini SR, Miller JM, Hamburger JI: Problems in the cytologic diagnosis of the ‘cold’ thyroid nodule in patients with lymphocytic thyroiditis. Acta Cytol 1981;25:506–512.
72.
Fiorella RM, Isley W, Miller LK, Kragel PJ: Multinodular goiter of the thyroid mimicking malignancy: diagnostic pitfalls in fine-needle aspiration biopsy. Diagn Cytopathol 1993;9:351–577.
73.
Flikweert ER, Nugteren WA, Groote AD: Thyroid papillary hyperplasia mistaken for papillary carcinoma in fine needle aspiration cytology and frozen section examination (in Dutch). Ned Tijdschr Geneeskd 2003;147:510–513.
74.
Haberal AN, Toru S, Ozen O, Arat Z, Bilezikçi B: Diagnostic pitfalls in the evaluation of fine needle aspiration cytology of the thyroid: correlation with histopathology in 260 cases. Cytopathology 2009;20:103–108.
75.
Perez-Montiel MD, Suster S: The spectrum of histologic changes in thyroid nodule in patients with lymphocytic thyroiditis. Acta Cytol 1981;25:506–512.
76.
El Hag IA, Kollur SM: Benign follicular thyroid lesions versus follicular variant of papillary carcinoma: differentiation by architectural pattern. Cytopathology 2004;15:200–205.
77.
Akin MR, Nguyen GK: Fine-needle aspiration biopsy cytology of hyalinizing trabecular adenomas of the thyroid. Diagn Cytopathol 1999;20:90–94.
78.
Karak AK, Sahoo M, Bhatnagar D: Hyalinizing trabecular adenoma: a case report with FNAC histologic, MIB-1 proliferative index and immunohistochemical findings. Indian J Pathol Microbiol 1998;41:479–484.
79.
Casey MB, Sebo TJ, Carney JA: Hyalinizing trabecular adenoma of the thyroid gland: cytologic features in 29 cases. Am J Surg Pathol 2004;28:859–867.
80.
Casey MB, Sebo TJ, Carney JA: Hyalinizing trabecular adenoma of the thyroid gland identification through MIB-1 staining of fine-needle aspiration biopsy smears. Am J Clin Pathol 2004;122:506–510.
81.
Carney JA, Hirokawa M, Lloyd RV, Papotti M, Sebo TJ: Hyalinizing trabecular tumors of the thyroid gland are almost all benign. Am J Surg Pathol 2008;32:1877–1889.
82.
González-Cámpora R, Fuentes-Vaamonde E, Hevia-Vázquez A, Otal-Salaverri C, Villar-Rodriguez JL, Galera-Davidson H: Hyalinizing trabecular carcinoma of the thyroid gland: report of two cases of follicular cell thyroid carcinoma with hyalinizing trabecular pattern. Ultrastruct Pathol 1998;22:39–46.
83.
Carney JA: Hyalinizing trabecular tumors of the thyroid gland: quadruply described but not by the discoverer. Am J Surg Pathol 2008;32:622–634.
84.
Baloch ZW, LiVolsi VA: Cytologic and architectural mimics of papillary thyroid carcinoma: diagnostic challenges in fine needle aspiration and surgical pathology specimens. Am J Clin Pathol Suppl 2006;125: S135–S144.
85.
Evenson A, Mowschenson P, Wang H, Connolly J, Mendrinos S, Parangi S, Hasselgren PO: Hyalinizing trabecular adenoma: an uncommon thyroid tumor frequently misdiagnosed as papillary or medullary thyroid carcinoma. Am J Surg 2007;193:707–712.
86.
Kaleem Z, Dávila RM: Hyalinizing trabecular adenoma of the thyroid: a report of two cases with cytologic, histologic and immunohistochemical findings. Acta Cytol 1997;41:883–888.
87.
Carling T, Udelsman R: Follicular neoplasms of the thyroid: what to recommend. Thyroid 2005;15:583–587.
88.
Kim JW, Park IS, Kim BM, Kim YM, Chu YC, Cho YU: The clinical significance of atypia in thyroid fine-needle aspiration. Eur Arch Otorhinolaryngol 2007;264:1053–1057.
89.
Mai KT, Elmontaser G, Perkins DG, Thomas J, Stinson WA: Benign Hürthle cell adenoma with papillary architecture: a benign lesion mimicking oncocytic papillary carcinoma. Int J Surg Pathol 2005;13:37–41.
90.
Mai KT, Landry DC, Thomas J, Burns BF, Commons AS, Yazdi HM, Odell PF: Follicular adenoma with papillary architecture: a lesion mimicking papillary thyroid carcinoma. Histopathology 2001;39:25–32.
91.
Repplinger D, Bargren A, Zhang YW, Adler JT, Haymart M, Chen H: Is Hashimoto’s thyroiditis a risk factor for papillary thyroid cancer? J Surg Res 2008;150:49–52.
92.
Fadda G, Mulè A, Zannoni GF, Vincenzoni C, Ardito G, Capelli A: Fine needle aspiration of a warthin-like thyroid tumor: report of a case with differential diagnostic criteria vs. other lymphocyte-rich thyroid lesions. Acta Cytol 1998;42:998–1002.
93.
Nasser SM, Pitman MB, Pilch BZ, Faquin WC: Fine-needle aspiration biopsy of papillary thyroid carcinoma: diagnostic utility of cytokeratin 19 immunostaining. Cancer 2000;90:307–311.
94.
Flanagan JN, Pineda P, Knapp PE, De Las Morenas A, Lee SL, Braverman LE: Expression of cytokeratin 19 in the diagnosis of thyroid papillary carcinoma by quantitative polymerase chain reaction. Endocr Pract 2008;14:168–174.
95.
Orlandi F, Saggiorato E, Pivano G, Puligheddu B, Termine A, Cappia S, De Giuli P, Angeli A: Galectin-3 is a presurgical marker of human thyroid carcinoma. Cancer Res 1998;58:3015–3020.
96.
Inohara H, Honjo Y, Yoshii T, Akahani S, Yoshida J, Hattori K, Okamoto S, Sawada T, Raz A, Kubo T: Expression of galectin-3 in fine-needle aspirates as a diagnostic marker differentiating benign from malignant thyroid neoplasms. Cancer 1999;85:2475–2484.
97.
Saggiorato E, Cappia S, De Giuli P, Mussa A, Pancani G, Caraci P, Angeli A, Orlandi F: Galectin-3 as a presurgical immunocytodiagnostic marker of minimally invasive follicular thyroid carcinoma. J Clin Endocrinol Metab 2001;86:5152–5158.
98.
Papotti M, Volante M, Saggiorato E, Deandreis D, Veltri A, Orlandi F: Role of galectin-3 immunodetection in the cytological diagnosis of thyroid cystic papillary carcinoma. Eur J Endocrinol 2002;147:515–521.
99.
Pisani T, Vecchione A, Giovagnolii MR: Galectin-3 immunodetection may improve cytological diagnosis of occult papillary thyroid carcinoma. Anticancer Res 2004;24:1111–1112.
100.
Ersoz S, Sert H, Yandi M, Erem C, Mungan S, Ersoz HO, Cobanoglu U, Hacihasanoglu A: The significance of galectin3 expression in the immunocytochemical evaluation of thyroid fine needle aspiration cytology. Pathol Oncol Res 2008;14:457–460.
101.
Volante M, Bozzalla-Cassione F, DePompa R, Saggiorato E, Bartolazzi A, Orlandi F, Papotti M: Galectin-3 and HBME-1 expression in oncocytic cell tumors of the thyroid. Virchow’s Arch 2004;445:183–188.
102.
Mehrotra P, Okpokam A, Bouhaidar R, Johnson SJ, Wilson JA, Davies BR, Lennard TW: Galectin-3 does not reliably distinguish benign from malignant thyroid neoplasms. Histopathology 2004;45:493–500.
103.
Mills LJ, Poller DN, Yiangou C: Galectin-3 is not useful in thyroid FNA. Cytopathology 2005;16:132–138.
104.
Maruta J, Hashimoto H, Yamashita H, Yamashita H, Noguchi S: Immunostaining of galectin-3 and CD44v6 using fine needle aspiration for distinguishing follicular carcinoma from adenoma. Diagn Cytopathol 2004;31:392–396.
105.
Bonzanini M, Amadori PL, Sagramoso C, Dalla Palma P: Expression of cytokeratin 19 and protein p63 in fine needle aspiration biopsy of papillary thyroid carcinoma. Acta Cytol 2008;52:541–548.
106.
El Demellawy D, Nasr AL, Babay S, Alowami S: Diagnostic utility of CD56 immunohistochemistry in papillary carcinoma of the thyroid. Pathol Res Pract 2009;205:303–309.
107.
Lerma E, Mora J: Telomerase activity in ‘suspicious’ thyroid cytology. Cancer 2005;105:492–497.
108.
Chen YT, Kitabayashi N, Zhou XK, Fahey TJ 3rd, Scognamiglio T: MicroRNA analysis as a potential diagnostic tool for papillary thyroid carcinoma. Mod Pathol 2008;21:1139–1146.
109.
Renshaw AA, Wang E, Haja J, Wilbur D, Henry MR, Hughes JH, Cytopathology Committee, College of American Pathologists: Fine-needle aspiration of papillary thyroid carcinoma: distinguishing between cases that performed well and those that performed poorly in the College of American Pathologists Nongynecologic Cytology Program. Arch Pathol Lab Med 2006;130:452–455.
110.
Elsheikh TM, Asa SL, Chan JK, DeLellis RA, Heffess CS, LiVolsi VA, Wenig BM: Interobserver and intraobserver variation among experts in the diagnosis of thyroid follicular lesions with borderline nuclear features of papillary carcinoma. Am J Clin Pathol 2008;130:736–744.
111.
Yang GC, Greenebaum E: Clear nuclei of papillary thyroid carcinoma conspicuous in fine-needle aspiration and intraoperative smears processed by ultrafast Papanicolaou stain. Mod Pathol 1997;10:552–555.
112.
Jogai S, Adesina AO, Temmim L, Al-Jassar A, Amir T, Amanguno HG: Follicular variant of papillary thyroid carcinoma: a cytological study. Cytopathology 2004;15:212–216.
113.
Clary KM, Condel JL, Liu Y, Johnson DR, Grzybicki DM, Raab SS: Interobserver variability in the fine needle aspiration biopsy diagnosis of follicular lesions of the thyroid gland. Acta Cytol 2005;49:378–382.
114.
Clary KM, Condel JL, Liu Y, Johnson DR, Grzybicki DM, Raab SS: Interobserver variability in the fine needle aspiration biopsy diagnosis of follicular lesions of the thyroid gland. Acta Cytol 2005;49:378–382.
115.
Harach HR, Saravia Day E, Zusman SB: Occult papillary microcarcinoma of the thyroid: a potential pitfall of fine needle aspiration cytology? J Clin Pathol 1991;44:205–207.
116.
MacDonald L, Yazdi HM: Nondiagnostic fine needle aspiration biopsy of the thyroid gland: a diagnostic dilemma. Acta Cytol 1996;40:423–428.
117.
Perez LA, Gupta PK, Mandel SJ, LiVolsi VA, Baloch ZW: Thyroid papillary microcarcinoma: is it really a pitfall of fine needle aspiration cytology? Acta Cytol 2001;45:341–346.
118.
Gharib H, Papini E, Valcavi R, Baskin HJ, Crescenzi A, Dottorini ME, Duick DS, Guglielmi R, Hamilton CR Jr, Zeiger MA, Zini M, AACE/AME Task Force on Thyroid Nodules: American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 2006;12:63–102.
119.
Ali SZ, Cibas ES (eds): The Bethesda System for Reporting Thyroid Cytopathology: Definitions, Criteria and Explanatory Notes, ed 1. New York, Springer, 2010.
120.
Raab SS, Grzybicki DM, Sudilovsky D, Balassanian R, Janosky JE, Vrbin CM: Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error. Am J Clin Pathol 2006;126:585–592.
121.
Raab SS, Vrbin CM, Grzybicki DM, Sudilovsky D, Balassanian R, Zarbo RJ, Meier FA: Errors in thyroid gland fine-needle aspiration. Am J Clin Pathol 2006;125:873–882.
122.
Poller DN, Stelow EB, Yiangou C: Thyroid FNAC cytology: can we do it better? Cytopathology 2008;19:4–10.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.