T hyroid fine-needle aspiration (FNA) is a modern-day success story. Its clinical value is undisputed-safely and rapidly, FNA provides valuable information about the nature of a thyroid nodule and permits the triage of patients for follow-up or surgery. Because thyroid nodules are so common, in many laboratories, thyroid FNA has become the most common FNA specimen examined.
Our colleagues in endocrinology, surgery, and radiology have already successfully addressed professional consensus on the clinical aspects of thyroid FNA. In 2005 and 2006, they sponsored consensus conferences to develop guidelines that address the clinical questions surrounding thyroid nodules: How big should a thyroid nodule be before it is aspirated? What sonographic features should prompt an FNA? How should patients be managed when they have a benign, suspicious, or malignant thyroid FNA result? Debate on these issues, grounded in peer-reviewed data, resulted in published consensus statements that now serve as valuable clinical management resources. [1][2][3][4] But how about agreement on cytology-related issues, say, terminology for reporting the results of thyroid FNA? To date, nationally (and internationally), there has been no consensus on reporting thyroid FNA results. Some laboratories have used a modification of traditional cytology diagnostic categories (negative, suspicious, positive), 5-7 whereas others have dispensed with categories and relied on descriptive phrases. Understandably, such lack of uniformity creates a challenge for our clinical colleagues, who often are at a loss to understand a cytology report, particularly one from an unfamiliar laboratory that uses unfamiliar terminology. It goes without saying that confusion over the meaning of a thyroid FNA report may seriously harm a patient if thyroid surgery is undertaken or withheld inappropriately. Now, we in cytology can proudly say that we have caught up with our clinical colleagues, and in a big way. Thanks to the leadership of Dr.