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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2017.07.14    [Epub ahead of print]
Thyroid Fine-Needle Aspiration Practice in the Philippines
Agustina D. Abelardo
Department of Pathology, College of Medicine, University of the Philippines Manila, Manila, Philippines
Corresponding Author: Agustina D. Abelardo ,Tel: +63-2-526-45-50, Fax: +63-2-526-45-50, Email: abelardoagustina@yahoo.com
Received: July 4, 2017;  Accepted: July 14, 2017.  Published online: October 5, 2017.
Fine-needle aspiration (FNA) is a well accepted initial approach in the management of thyroid lesions. It has gone a long way since its introduction for nearly a century. In the Philippines, FNA of the thyroid started 30 years ago and has been utilized until now as a mainstay in the diagnosis of thyroid malignancy. The procedure is performed by pathologists, endocrinologists, surgeons and radiologists. Majority of pathologists report the cytodiagnosis using a combination of the aspiration biopsy cytology method that closely resembles the histopathologic diagnosis of thyroid disorders and the six-tier nomenclature of The Bethesda System for Reporting Thyroid Cytopathology. Local endocrinologists and surgeons follow the guidelines of the 2015 American Thyroid Association in the management of thyroid disorders. There is still a paucity of local research studies but available data deal with cytohistologic correlations, sensitivity, specificity and accuracy rates as well as usefulness of ultrasound-guided FNA. Cytohistologic correlations have a wide range of sensitivity from 30.7% to 73% and specificity from 83% to 100%. The low sensitivity can be attributed to poor tissue sampling since majority of thyroid FNA is done only by palpation. The reliability can be improved if FNA is guided by ultrasound as attested in both international and local studies. Overall, FNA of the thyroid is able to diagnose thyroid disorders with an accuracy of 72.8% to 87.2% and correlates well with histopathology.
Key Words: Fine-needle aspiration cytology; Thyroid fine-needle aspiration; The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC)