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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2017.09.26    [Epub ahead of print]
Thyroid Fine Needle Aspiration Cytology Practice in Korea
Yoon Jin Cha1, Ju Yeon Pyo1, Soon Won Hong1, Jae Yeon Seok2, Kyung-Ju Kim3, Jee-Young Han4, Jeong Mo Bae5, Hyeong Ju Kwon6, Yeejeong Kim7, KyuengWhan Min8, Soonae Oak9, Sunhee Chang10
1Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
2Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
3Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea
4Department of Pathology, Inha University Hospital, Incheon, Korea
5Department of Pathology, SMG-SNU Boramae Medical Center, Seoul, Korea
6Department of Pathology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
7National Health Insurance Service Ilsan Hospital, Ilsan, Korea
8Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
9Department of Pathology, Ilsin Christian Hospital, Korea
10Department of Pathology, Inje University Ilsan Paik Hospital, Ilsan, Korea
Corresponding Author: Soon Won Hong ,Tel: +82-2-2019-3540, Fax: +82-2-3463-2103, Email: soonwonh@yuhs.ac
Received: August 12, 2017;  Revised: September 16, 2017  Accepted: September 25, 2017.  Published online: October 11, 2017.
We reviewed the current status of thyroid fine needle aspiration cytology (FNAC) in Korea. Thyroid aspiration biopsy was first introduced in Korea in 1977. Currently, radiologists aspirate the thyroid nodule under the guidance of ultrasonography, and cytologic interpretation is only legally approved when a cytopathologist makes the diagnosis. In 2008, eight thyroid-related societies came together to form the Korean Thyroid Association. The Korean Society for Cytopathology and the endocrine pathology study group of the Korean Society for Pathologist have been updating the cytologic diagnostic guidelines. The Bethesda System for Reporting Thyroid Cytopathology was first introduced in 2009, and has been used by up to 94% of institutions by 2016. The average diagnosis rates are as follows for each category: I (12.4%), II (57.9%), III (10.4%), IV (2.9%), V (3.7%), and VI (12.7%). The malignancy rates in surgical cases are as follows for each category: I (28.7%), II (27.8%), III (50.6%), IV (52.3%), V (90.7%), and VI (100.0%). Liquid-based cytology has been used since 2010, and it was utilized by 68% of institutions in 2016. The categorization of thyroid lesions into “atypia of undetermined significance” or “follicular lesion of undetermined significance” is necessary to draw consensus in our society. Immunocytochemistry for galectin-3 and BRAF is used. Additionally, a molecular test for BRAF in thyroid FNACs is actively used. Core biopsies were performed in only 44% of institutions. Even the institutions that perform core biopsies only perform them for less than 3% of all FNACs. However, only 5% of institutions performed core biopsies up to three times more than FNAC.
Key Words: Bethesda; Fine needle aspiration cytology; Thyroid neoplasms; Korea