The triage efficacy of fine needle aspiration biopsy for follicular variant of XXXX using the Bethesda reporting guidelines.

@entity3557 @entity1 @entity5 @entity1544 @entity1374
Diagnosis of follicular variant of @entity3557 (FVPTC) by ultrasound-guided fine-needle aspiration (FNA) is challenging. In this retrospective review, we evaluated triage efficacy (i.e., potential for triggering surgical intervention) in 44 archived FNA biopsies of surgically confirmed FVPTC obtained between December 2006 and December 2008. We compared the original FNA diagnoses with reclassified diagnoses based on 2007 National @entity5 Institute (NCI)/Bethesda recommendations, and reviewed FNA cytologic features. Original FNA diagnoses included colloid nodule (7%, 3/44), atypical follicular cells (5%, 2/44), follicular lesion (11%, 5/44), @entity5 (16%, 7/44), suspicious for @entity5 / @entity3557 (27%, 12/44), and @entity3557 (34%, 15/44). Reclassified diagnoses included indeterminate (5%, 2/44), colloid nodule (7%, 3/44), atypical cells of undetermined significance [ACUS] (7%, 3/44), @entity1544 (2%, 1/44), @entity5 (7%, 3/44), suspicious for @entity5 / @entity3557 (25%, 11/44), and @entity3557 (48%, 21/44). Triage efficacy was 77% (34/44) for original diagnoses versus 82% (36/44) for reclassified FNA diagnoses. We frequently observed cytologic features of @entity3557 , such as nuclear grooves and fine chromatin; conversely, intranuclear inclusions, though present in 77% cases, were scant. Our review findings suggest that lack of characteristic cytologic features of @entity3557 ,coexistence with other @entity1374 , and small @entity5 size arethe major obstacles to FNA diagnosis of FVPTC. Reclassification of thyroid FNA diagnoses does not significantly improve triage efficacy. Furthermore, FNA diagnoses of @entity5 and suspicious for @entity5 are valuable in @entity1 with FVPTC because they trigger triage toward surgical intervention.
