The Bethesda System for Reporting Thyroid Cytopathology Definitions,
Thyroid fine needle aspiration is one of the most commonly performed cytologic procedures and is the standard diagnostic method for managing the patient with a thyroid nodule. Until now, there has been no uniform system for reporting the r
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Syed Z. Ali • Edmund S. Cibas Editors
The Bethesda System for Reporting Thyroid Cytopathology Definitions, Criteria and Explanatory Notes
Editors Syed Z. Ali, MD The Johns Hopkins Hospital Baltimore, MD USA [email protected]
Edmund S. Cibas, MD Harvard Medical School Brigham and Women’s Hospital Boston, MA USA [email protected]
ISBN 978-0-387-87665-8 e-ISBN 978-0-387-87666-5 DOI 10.1007/978-0-387-87666-5 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2009932423 © Springer Science + Business Media, LLC 2010 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface
This atlas is the offspring of the “The National Cancer Institute (NCI) Thyroid Fine Needle Aspiration (FNA) State of the Science Conference,” hosted by the NCI and organized by Dr. Andrea Abati. Preparations for the conference began 18 months earlier with the designation of a steering committee and the establishment of a dedicated, permanent web site. The meeting took place on October 22 and 23, 2007 in Bethesda, Maryland and was co-moderated by Susan J. Mandel and Edmund S. Cibas. The discussions and conclusions regarding terminology and morphologic criteria from the meeting were summarized in publications by Baloch et al.1, 2 and form the framework for this atlas. The atlas is organized by the general categories of “Nondiagnostic,” “Benign,” “Follicular Neoplasm/Suspicious for a Follicular Neoplasm”, “Suspicious for Malignancy,” and “Malignant,” and it includes the definitions and morphologic criteria of these categories as set forth by Baloch et al. The majority of the conference participants also agreed on a category of “undetermined significance,” which is incorporated in this atlas (Chap. 4). It is critical that the cytopathologist communicate thyroid FNA interpretations to the referring physician in terms that are succinct, unambiguous, and helpful clinically. We recognize that the terminology used here is a flexible framework that can be modified by individual laboratories to meet the needs of their providers and the patients they serve. Historically, terminology for thyroid FNA has varied markedly from one laboratory to another, creating confusion in some instances and hindering the sharing of data among multiple institutions. It is the hop
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