Thyroid FNA Cytology: Differential Diagnoses and Pitfalls-3판

This is the third edition of a well-received book that recapitulates the thyroid fine-needle aspiration (FNA) cytology. It covers the basics and critical principles of thyroid cytopathology, addresses technical aspects, and presents the latest breakthrough events in the field, including the new editions of the WHO classification of thyroid tumors and the Bethesda system for reporting thyroid cytopathology.

Thyroid FNA Cytology, The Third Edition is a practical handbook for cytopathologists, pathologists, cytotechnologists, endocrinologists, thyroid surgeons, radiologists, thyroid cancer patients, and their families. This edition covers more topics than the previous editions and invites authors from 20 countries from Asia, Europe, and America. It should serve as an individualized guide to readers practicing in various geographic areas with different medical settings and social resources. The book provides multiple chapters on differential diagnosis and pitfalls to show the unique approaches in many countries. The book will broaden their perspectives and serve as a foundation for further advancement in this field.

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Part I Why Are There Significant Differences Among Us in Thyroid Nodule Practices?
1 Addressing the Impact of International Variation in Thyroid Cytology: Which Reporting System Is Best for Patients? 3

2 Diagnostic Criteria of Papillary Thyroid Carcinoma (PTC)-Type Nuclear Features Impacting Thyroid Fine Needle Aspiration (FNA) Cytology 7

3 Differences Among Thyroid FNA Practices Elucidated by Meta-analyses of the Literature 15

4 International Comparison Study of Thyroid Fine Needle Aspiration (FNA) Cytology Reporting System 21

5 Thyroid FNA Terminology: Progress Towards a Single Unified International System for Thyroid FNA Reporting 27


Part II Reporting Systems of Thyroid FNA Cytology

6 Introduction to the Third Edition of the Bethesda System for Reporting Thyroid Cytopathology 33

7 The 2014 Italian Reporting System for Thyroid Cytology: Present and Future 37

8 The UK Royal College of Pathologists (RCPath) Thy Terminology for Reporting Thyroid FNA Cytology 43

9 Australian System for Reporting Thyroid Cytology 51

10 The Japanese System Recommended by the Japan Thyroid Association 59

11 Risk Classification of Follicular-Patterned Lesions in Thyroid FNA 63

12 The Japanese Reporting System for Thyroid Aspiration Cytology (JRSTAC) 67

13 Clinical Management for Follicular Neoplasm Without Molecular Testing 75


Part III Classification of Thyroid Tumors

14 Histological Classification of Thyroid Tumors by the New Fifth Edition of the WHO Classification 83

15 Low-Risk Neoplasms in the Fifth Edition of the WHO Classification of Thyroid Tumors 91

16 Clinically Insignificant Papillary Thyroid Carcinoma and Self-limiting Carcinoma that Do Not Harm Patients 103


17 Whole Tumor Capsule Is Prognostic of Very Good Outcome in the Classic Papillary Thyroid Cancer 109


18 A Framework for Approaching Cytologically Indeterminate Thyroid Nodules with RAS Mutations: A North American Perspective 111

19 Clinical Advantages and Limitations of Tumors Displaying Minimal and Extensive Vascular Invasion 119

20 High-Grade Follicular Cell-Derived Non-anaplastic Thyroid Carcinomas 131

21 Molecular Classification of Thyroid Tumors and Key Molecular Features to Identify High-Grade Thyroid Carcinomas 139



Part IV Criteria for Each Cytological Category

22 Specimen Adequacy and Nondiagnostic Thyroid Nodules 149

23 Cyst Fluid Only Samples 161

24 Cytology of Benign Thyroid Aspirates 167

25 AUS/FLUS in the Third Edition of the Bethesda System 175

26 Cytological Diagnosis of Follicular Neoplasm 183

27 Diagnostic Criteria of Suspicious for Malignancy 191

28 Cytological Diagnoses of Malignancy and Nuclear Features of PTC 199



Part V Cytological Features of Thyroid Lesions

29 Diagnostic Clues for Thyroid Aspiration Cytology 207

30 False Positive in Thyroid FNA: Causes and How to Avoid Them 233

31 Papillae in Thyroid Aspirates 245

32 Papillary Thyroid Carcinoma on LBC Preparations 253

33 Spindle Cells in Thyroid Aspirates 257


Part VI Benign Lesions, Differential Diagnoses and Pitfalls

34 Thyroglossal Duct Cyst and Other Ectopic Thyroid Tissue in the Neck 273

35 Benign Follicular-Patterned Lesions (Thyroid Follicular Nodular Disease) 285

36 Infectious Thyroiditis 291

37 Diagnostic Considerations for Thyroid Nodules in Graves’ Disease 299

38 Subacute Thyroiditis or Papillary Carcinoma 305

39 Hashimoto’s Thyroiditis or Papillary Carcinoma 313


Part VII Low Risk Neoplasms, Differential Diagnoses and Pitfalls

40 NIFTP in Asian Practice 321

41 Role of FNA Cytology in Preoperative Prediction of NIFTP: Practical Experiences in North America 335

42 Hyalinizing Trabecular Tumor 341


Part VIII Papillary Thyroid Carcinoma, Differential Diagnoses and Pitfalls

43 Cystic Papillary Thyroid Carcinoma 349

44 Tall Cell Subtype of Papillary Thyroid Carcinoma 357

45 Papillary Carcinoma, Columnar Cell Variant: Diagnostic Pitfalls and Differential Diagnoses 361

46 Hobnail Papillary Thyroid Carcinoma 365

47 Solid/Trabecular Subtype of Papillary Thyroid Carcinoma 377

48 Aggressive Subtypes of PTC: How to Handle Them in FNA Cytology 383



Part IX High-Grade Carcinomas, Differential Diagnoses and Pitfalls

49 High-Grade Follicular-Derived Carcinomas in FNA Cytology 391

50 Poorly Differentiated Carcinoma and Anaplastic Carcinoma of the Thyroid 397

51 Anaplastic Thyroid Carcinoma 407

52 Metastasis to Thyroid 427


Part X Other Thyroid Lesions, Differential Diagnoses and Pitfalls

53 Cribriform-Morular Thyroid Carcinoma 437

54 Oncocytic Cell Neoplasms in Hematoxylin-Eosin-Stained Samples 447

55 Hürthle Cell Neoplasms in Papanicolaou- and Romanowsky-Stained Specimens 457

56 Medullary (C Cell) Thyroid Carcinoma or Oncocytic Follicular Neoplasms 465

57 Diagnosis of Medullary (C Cell) Thyroid Carcinoma 475

58 Primary Thyroid Lymphoma 487

59 Rare Hematolymphoid Neoplasms of the Thyroid 493

60 Intrathyroid Thymic Carcinoma 505

61 Parathyroid Adenoma and Its Differential Diagnoses 513


Part XI How to Improve Diagnostic Performance in Thyroid FNA Cytology

62 Aspiration Methods and Optimal Smear Preparation Techniques 525

63 Staining Methods in Thyroid Cytology 533

64 Fine Needle Aspiration Biopsy Complications 539

65 Liquid-Based Cytology Technique for Thyroid Cytology 543

66 Rapid On-Site Evaluation (ROSE) 557

67 Mobile Rapid On-Site Evaluation 563

68 Low-Cellularity Thyroid Fine Needle Aspiration Specimens: Differential Diagnosis, the Role of Ancillary Testing and Associated Diagnostic Challenges 567

69 The Role of Repeat FNA in Indeterminate Thyroid Nodules 573

70 Frozen Section and Intraoperative Imprint Cytology 579

71 Core Needle Biopsy for the Diagnosis of Thyroid Nodules: Pathologic Aspects 587

72 Biochemical Test of Fine-Needle Aspirate as an Adjunct to Cytological Diagnosis in Patients with Thyroid Cancer or Primary Hyperparathyroidism 599

73 Quality Control for Cytology Laboratory in the USA 607

74 Infection Control in Cytology Practice and the COVID-19 Pandemic 615


Part XII Immunohistochemistry in Thyroid Nodule Practice

75 Cell Blocks in Cytopathology and Their Role in Evaluation of Thyroid Aspirates 621

76 European Experience and Recommendations for Immunocytochemistry on Cytological Thyroid Fine-Needle Aspiration Specimens 637

77 Application of Immunocytochemistry in Thyroid Aspiration Cytology 643


Part XIII Molecular Tests in Thyroid Nodule Practice

78 Practice of Molecular Detection of Thyroid Fine-Needle Aspiration Specimen in China 653

79 Experience in Molecular Testing Using FNA Cytology in EU Countries 661

80 Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada 675

81 Thyroid Fine Needle Aspiration Cytology Molecular Testing in the USA 685

82 Molecular Target Therapy for Pathologists in Advanced Thyroid Carcinoma 697


Part XIV Image Technology in Thyroid Nodule Practice

83 Pathologic Basis for Thyroid Ultrasound 717

84 Ultrasonography of the Thyroid Gland 731

85 Nuclear Imaging of the Thyroid Gland 743


Part XV Clinical Guidelines in Thyroid Nodule Practice

86 International Comparison of Thyroid Nodule Workup 751

87 How to Follow FNA-Confirmed Benign Thyroid Nodules 759

88 Management of Papillary Microcarcinoma of the Thyroid 761

89 Active Surveillance for Low-Risk Small Papillary Thyroid Cancer in North America 771


Part XVI Thyroid Nodule in Children and Young Adults

90 Thyroid Nodules in Children and Adolescents 783

91 Thyroid Carcinoma of Young Adults and Children 791

92 The Role of Thyroid FNA Cytology in Pediatric Malignant Lesions: Case Illustrations and Literature Review 797

Part XVII Patient Oriented Thyroid Nodule Practice

93 One-Stop Clinic for Thyroid Nodules 809

94 Caring for Patients with Thyroid Nodules: Preventing Overdiagnosis as a Harm of FNA Cytological Examinations 817

95 Consideration of Patients’ Viewpoint and the Role of Pathologists in Reporting Diagnosis of Thyroid Carcinomas 823

Index 829