J Pathol Transl Med.  2020 Sep;54(5):361-366. 10.4132/jptm.2020.07.17.

Thyroid fine-needle aspiration cytology in Taiwan: a nationwide survey and literature update

  • 1Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
  • 2Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
  • 3Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • 4School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • 5Division of Pathology, Sijhih Cathay General Hospital, New Taipei City, Taiwan
  • 6College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
  • 7Department of Anatomic Pathology, Taipei Institute of Pathology, Taipei, Taiwan
  • 8Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
  • 9College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan


In Taiwan, thyroid fine-needle aspiration cytology is easily accessible and reliable for evaluating thyroid nodules. The sonographic pattern plays a major role and is the deciding factor for aspiration. We conducted a nationwide survey in 2017 and it revealed that 31% of laboratories had adopted The Bethesda System for Reporting Thyroid Cytopathology. There was a relatively high unsatisfactory rate (24.04%) and low rates of indeterminate diagnoses, including atypia of undetermined significance/follicular lesions of undetermined significance: 4.87%, and follicular neoplasm/suspicious for a follicular neoplasm: 0.35%. Moreover, the risks of malignancy in benign, atypia of undetermined significance, and suspicious for a follicular neoplasm were relatively high. These may reflect strict diagnostic criteria for indeterminate categories and better patient selection for surgery. Improvements in specimen sampling and continuing education programs are crucial. Newly-developed thyroid cytology technologies, such as immunocytochemistry, molecular testing, and computerized cytomorphometry, may further facilitate cytology diagnoses.


Cytology; Fine-needle aspiration; Taiwan; Thyroid; Thyroidectomy
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