In 2008, the National Cancer Institute published its review and conclusions from the State of the Science Conference on Thyroid Fine Needle Aspiration (FNA) which resulted in new recommendations regarding the management of thyroid nodules. Specific attention was given to diagnostic terminology and morphologic criteria for follicular thyroid lesions subdividing the atypical, suspicious, indeterminate, or follicular lesion findings into tiered categories based upon expected risk of malignancy (atypia of undetermined significance 5-10%, suspicious for neoplasm 20-30%, and suspicious for malignancy 50-75%). Other committees addressed indications for FNA, training and credentialing, technique, ancillary studies, and post FNA management. Further, the American Thyroid Association has revised guidelines for thyroid nodule management with specific recommendations for which nodules should undergo FNA based upon size and sonographic criteria. This miniseminar will present these updates and changing paradigms in thyroid nodule management with a panel of experts in the field. Particular attention will be given to which nodules to observe, when and how to biopsy, and when to operate. Knowledge of these new consensus recommendations is critically important for otolaryngologists to provide state of the art care for their patients and to enable informed discussion with colleagues in endocrinology, pathology, and radiology.
Educational Objectives
1) Learn the new NCI diagnostic terminology for thyroid cytology reporting. 2) Understand which thyroid nodules should not undergo fine needle biopsy and which may be observed. 3) Learn the correct technique for thyroid fine needle biopsy.
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