J Pathol Transl Med.  2017 Nov;51(6):560-564. 10.4132/jptm.2017.09.20.

Thyroid Fine-Needle Aspiration in Taiwan: The History and Current Practice

• Hang JF
• Hsu CY
• Lai CR

• KMID: 2396538
• DOI: http://doi.org/10.4132/jptm.2017.09.20

Abstract

In Taiwan, thyroid cancer is the most common endocrine gland malignancy and the incidence of thyroid cancer has increased four-fold in the past two decades. Fine-needle aspiration is an accurate and cost-effective method of evaluating thyroid nodules and has been the gold-standard diagnostic tool for thyroid tumors in Taiwan since the 1980s. This article reviews the history, current practice, reporting systems, training, and quality assurance for thyroid fine-needle aspiration cytology in Taiwan.

Keyword

Thyroid; Biopsy, fine-needle; Cytology; Taiwan

MeSH Terms

Biopsy, Fine-Needle*
Endocrine Glands
Incidence
Methods
Taiwan*
Thyroid Gland*
Thyroid Neoplasms
Thyroid Nodule

Figure

• 

  Fig. 1. Thyroid cancer statistics from 2004 to 2014. The proportion of papillary thyroid carcinoma (PTC) among thyroid cancers has increased 11% (blue line) and the proportion of thyroid cancer among all cancers has increased 1.1% (red line). Data from the Taiwan Cancer Registry Annual Report [1].

• 

  Fig. 2. The second edition of Thyroid and Parathyroid Cytology (Leader Book Company, 2015) [24] by Prof. Tien-Chung Chang.

Reference

1. Taiwan Cancer Registry annual report [Internet]. Taipei: Health Promotion Administration;Ministry of Health and Welfare;2014. [cited 2017 Jun 1]. Available from: http://www.hpa.gov.tw/Pages/List.aspx? nodeid=269.

2. Ahn HS, Kim HJ, Welch HG. Korea's thyroid-cancer “epidemic”: screening and overdiagnosis. N Engl J Med. 2014; 371:1765–7.

3. Chang TC, Kou SH, Chen FW, et al. Cytopathology of thyroid cancer by fine needle aspiration with Liu's stain. Taiwan Yi Xue Hui Za Zhi. 1982; 81:1404–12.

4. Huang TC, Chang TC, Lin CC, Chang CC, Chen FW. Fine needle aspiration cytology in thyroid disease. Taiwan Yi Xue Hui Za Zhi. 1981; 80:902–8.

5. Chang TC, Chen FW, Chang CC, Huang TS, Lin CC, Kuo SH. The role of fine needle aspiration cytology compared with thyroid antibody determination in the diagnosis of Hashimoto's thyroiditis. Taiwan Yi Xue Hui Za Zhi. 1981; 80:1152–9.

6. Chang TC, Chen FW, Kou SH, Chang CC, Fan JS, Liaw KY. The application of fine needle aspiration cytology in the diagnosis of acute suppurative thyroiditis: a case report. Taiwan Yi Xue Hui Za Zhi. 1983; 82:155–60.

7. Chang TC, Chen FW, Kou SH, Chang CC, Huang SM. Diagnostic criterion of granulomatous thyroiditis by the needle aspiration cytopathology. Taiwan Yi Xue Hui Za Zhi. 1983; 82:496–502.

8. Chang TC, Kou SH, Chen FW, et al. Cytologic presentation and its correlation with clinical stage in papillary carcinoma of the thyroid. Taiwan Yi Xue Hui Za Zhi. 1987; 86:941–6.

9. Chang TC, Liaw KY, Kuo SH, Chang CC, Chen FW. Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis. Taiwan Yi Xue Hui Za Zhi. 1989; 88:551–6.

10. Chang TC. Fine needle aspiration biopsy of the thyroid using the Chinese brush-holding technique. Acta Cytol. 1989; 33:939–40.

11. Chang TC, Kuo SH, How SW. Coefficient of variation of nuclear diameters as a prognostic factor in papillary thyroid carcinoma. Anal Quant Cytol Histol. 1991; 13:403–6.

12. Tung CC, Chang TC, Hsieh HC. Value of immunoperoxidase staining of thyroglobulin in fine needle aspiration cytology of thyroid diseases. Acta Cytol. 1995; 39:396–401.

13. Wang CY, Chang TC. Preoperative thyroid ultrasonography and fine-needle aspiration cytology in ectopic thyroid. Am Surg. 1995; 61:1029–31.

14. Tsai TH, Chang TC, Chiang CP. Nuclear area measurements of parathyroid adenoma, parathyroid hyperplasia and thyroid follicular adenoma: a comparison. Anal Quant Cytol Histol. 1997; 19:45–8.

15. Chang TC, Tung CC, Hsiao YL, Chen MH. Immunoperoxidase staining in the differential diagnosis of parathyroid from thyroid origin in fine needle aspirates of suspected parathyroid lesions. Acta Cytol. 1998; 42:619–24.

16. Wang CY, Chang TJ, Chang TC, Hsiao YL, Chen MH, Huang SH. Thyroidectomy or radioiodine? The value of ultrasonography and cytology in the assessment of nodular lesions in Graves’ hyperthyroidism. Am Surg. 2001; 67:721–6.

17. Tseng FY, Hsiao YL, Chang TC. Ultrasound-guided fine needle aspiration cytology of parathyroid lesions: a review of 72 cases. Acta Cytol. 2002; 46:1029–36.

18. Tseng FY, Hsiao YL, Chang TC. Cytologic features of metastatic papillary thyroid carcinoma in cervical lymph nodes. Acta Cytol. 2002; 46:1043–8.

19. Tsou PL, Hsiao YL, Chang TC. Multinucleated giant cells in fine needle aspirates: can they help differentiate papillary thyroid cancer from benign nodular goiter? Acta Cytol. 2002; 46:823–7.

20. Su DH, Liao KM, Hsiao YL, Chang TC. Determining when to operate on patients with Hashimoto's thyroiditis with nodular lesions: the role of ultrasound-guided fine needle aspiration cytology. Acta Cytol. 2004; 48:622–9.

21. Chang TC, Wu SL, Hsiao YL. Medullary thyroid carcinoma: pitfalls in diagnosis by fine needle aspiration cytology and relationship of cytomorphology to RET proto-oncogene mutations. Acta Cytol. 2005; 49:477–82.

22. Shih SR, Shun CT, Su DH, Hsiao YL, Chang TC. Follicular variant of papillary thyroid carcinoma: diagnostic limitations of fine needle aspiration cytology. Acta Cytol. 2005; 49:383–6.

23. Chang TC, Hong CT, Chang SL, Hsieh HC, Liaw KY, How SW. Correlation between sonography and pathology in thyroid diseases. J Formos Med Assoc. 1990; 89:777–83.

24. Chang TC. Thyroid and parathyroid cytology. 2nd ed. Taipei: Leader Book Company;2015.

25. Lin JD, Chao TC, Huang BY, Chen ST, Chang HY, Hsueh C. Thyroid cancer in the thyroid nodules evaluated by ultrasonography and fine-needle aspiration cytology. Thyroid. 2005; 15:708–17.

26. Liu FH, Liou MJ, Hsueh C, Chao TC, Lin JD. Thyroid follicular neoplasm: analysis by fine needle aspiration cytology, frozen section, and histopathology. Diagn Cytopathol. 2010; 38:801–5.

27. Chen PY, Chiou SC, Yeh HY, et al. Correlation of ultrasonography with fine needle aspiration cytology and final pathological diagnoses in patients with thyroid nodules. Chin J Radiol. 2010; 35:1–7.

28. Tseng CE, Wei CK, Kuo CS, et al. Fine needle aspiration cytology of thyroid nodules: evaluation of diagnostic accuracy. Tzu Chi Med J. 2008; 20:296–303.

29. Kuo YT, Chang MC, Song YM, et al. Diagnosis and management of thyroid nodules with atypia: a three-year study at an institution in Taiwan. Diagn Pathol Open. 2016; 1:105.

30. Ali SZ, Cibas E. The Bethesda System for Reporting Thyroid Cytopathology: definitions, criteria and explanatory notes. New York: Springer;2010.

31. Cross P, Chandra A, Giles T, et al. Guidance on the reporting of thyroid cytology specimens [Internet]. London: Royal College of Pathologists;2016. [cited 2017 Jun 1]. Available from: http://ukeps.com/docs/thyroidfna.pdf.

32. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis. Acta Cytol. 2012; 56:333–9.