Thyroid_Cytopathology.pdf

ESSENTIALS IN CYTOPATHOLOGY SERIES

Dorothy L. Rosenthal, MD, FIAC, Series Editor

1. D.P. Clark and W.C. Faquin: Thyroid Cytopathology. 2005

ISBN 0-387-23304-0

Douglas P. Clark, MD

Department of Pathology, The Johns Hopkins Medical

Institutions, Baltimore, Maryland

William C. Faquin, MD, PhD

Department of Pathology, Massachusetts General Hospital,

and Massachusetts Eye and Ear Inﬁrmary, Boston,

Massachusetts

Thyroid

Cytopathology

With 116 Illustrations, 104 in Full Color

Foreword by Edmund S. Cibas, MD

Douglas P. Clark, MD

William C. Faquin, MD, PhD

Department of Pathology

The Johns Hopkins Medical

Massachusetts General Hospital

Institutions

and

Baltimore, MD 21287

Massachusetts Eye and Ear

USA

Inﬁrmary

Boston, MA 02114

USA

Series Editor :

Dorothy L. Rosenthal, MD, FIAC

Professor of Pathology, Oncology, and Gynecology and Obstetrics

The Johns Hopkins Medical Institutions

Director of Pathology

The Johns Hopkins Bayview Medical Center

Baltimore, MD 21287

USA

Library of Congress Cataloging-in-Publication Data

Clark, Douglas P.

Thyroid cytopathology / Douglas P. Clark, William C. Faquin.

p. ; cm. – (Essentials in cytopathology series ; 1)

Includes bibliographical references and index.

ISBN 0-387-23304-0 (alk. paper)

1. Thyroid gland—Cytopathology. I. Faquin, William C. II. Title. III. Series.

[DNLM: 1. Thyroid Nodule—diagnosis. 2. Thyroid Nodule—physiopathology.

3. Biopsy, Fine-Needle—methods. 4. Thyroid Gland—pathology. WK 270 C592t 2005]

RC655.49.C56 2005

616.4¢407—dc22

2004062586

ISBN 0-387-23304-0

Printed on acid-free paper.

without the written permission of the publisher (Springer Science+Business Media, Inc.,

233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection

with reviews or scholarly analysis. Use in connection with any form of information

storage and retrieval, electronic adaptation, computer software, or by similar or dis-

similar methodology now known or hereafter developed is forbidden.

The use in this publication of trade names, trademarks, service marks, and similar terms,

even if they are not identiﬁed as such, is not to be taken as an expression of opinion as

to whether or not they are subject to proprietary rights.

While the advice and information in this book are believed to be true and accurate at

the date of going to press, neither the authors nor the editors nor the publisher can

accept any legal responsibility for any errors or omissions that may be made. The pub-

lisher makes no warranty, express or implied, with respect to the material contained

herein.

Printed in China.

(BS/EVB)

987654321

SPIN 10938645

springeronline.com

Foreword

The evaluation of thyroid nodules by ﬁne needle aspiration

(FNA) is arguably the most challenging task in all of

cytopathology. A cytologist must understand the clinical pre-

sentation of thyroid diseases, their deﬁning histopathologic

and cytopathologic features, and the intricacies of patient

management. Drs. Clark and Faquin have provided a valuable

framework for cytologists learning (and continuing to learn)

this exacting discipline. Organized around a simple algorithm,

the authors have provided a rational and concise approach

towards acquiring skills in the cytologic diagnosis of thyroid

nodules. This book, therefore, is a very welcome addition to

the cytology literature.

Why are we examining such challenging specimens?

Clearly, the clinical need is there. Thyroid nodules are exceed-

ingly common: more than 50% of adults have one or more

nodules. Surgical excision of all nodules is neither practical

nor desirable. Enter FNA, without question the best currently

available screening test for thyroid cancer. Because of it,

thousands of patients with a benign diagnosis are spared

unnecessary surgery every year, and those with cancer are

reliably triaged for appropriate therapy.

The rising number of FNAs performed in the United States

is a tribute to its success as a screening test. In many institu-

tions, a thyroid FNA is the most common FNA specimen. For

a relatively new diagnostic test, this is a remarkable state of

affairs. Twenty-ﬁve years ago, few thyroid cancers were diag-

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