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reclassification is unanimously accepted, it will lead to a dramatic reduction of the risk of malignancy for AUS/FLUS, FN/SFN, or indeterminate FNA cytologies [ 14 ] and consequently also a dramatic reduction of the risk of malignancy for associated mutations like
Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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nodules has enhanced the need for endocrinologists to be able to define the risk of malignancy as accurately as possible ( 2 ). Ultrasound (US) is the first-line method to identify malignant thyroid nodules with the advantages of accessibility, cost
Servizio di Endocrinologia e Diabetologia, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
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University of Latvia, Faculty of Medicine, Riga, Latvia
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Facoltà di Scienze Biomediche, Università della Svizzera Italiana (USI), Lugano, Switzerland
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-tiered scoring system (mild, moderate, severe) based on the estimated risk of malignancy. The most renowned TIRADSs from three different continents, specifically ACR-, EU-, and K-TIRADS ( 11 , 12 , 13 ), were evaluated, and their data were directly compared
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non-malignant/benign. Cyst fluid may yield only macrophages, but the risk of malignancy is low for these lesions if they are simple and under 3 cm. For this reason, these cases are separated from inadequate specimens obtained from solid lesions and are
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Departments of Clinical PET Centre, King's College London, London, UK
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Departments of Clinical PET Centre, King's College London, London, UK
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]. The prevalence of focal uptake within the thyroid (incidentaloma) on 18 F-FDG PET has been noted to range from 0.2 to 10.1% in various studies. This is clinically more significant due to its high risk of malignancy in these lesions and the reported
Medical School, University of Milan, Milan, Italy
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Division of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Department of Endocrinology and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Department of Diabetes, Endocrinology & Obesity Medicine, Salford Royal NHS Foundation & University Teaching Trust, Salford, UK
Medical School, European University of Cyprus, Nicosia, Cyprus
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). Reassuringly, a recent long-term study of a 17,500-patient cohort with nodules greater than 10 mm in size showed an even lower risk of malignancy at 1.1% ( 6 ). The latter study differed from previous studies in that there was less selection bias and papillary
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7 Renshaw AA: Does a repeated benign aspirate change the risk of malignancy after an initial atypical thyroid fine-needle aspiration? Am J Clin Pathol 2010;134:788-792. 10.1309/AJCPRA9Y2XQVFOFV 20959662 8 VanderLaan PA, Marqusee E, Krane JF
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achieved its aim of standardizing thyroid-reporting cytopathology, the TIR-3 category remains the most controversial. “Indeterminate” lesions have been associated with a variable risk of malignancy, ranging from 5 to 30% [ 7 ]. For this reason, in 2012 the
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, ultrasound scores are used to determine which nodules should undergo FNAC and the Bethesda classification is used to assess management based on the risk of malignancy ( 7 , 8 ). Suspicious nodules with Bethesda III, Bethesda IV, and Bethesda V cytology
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Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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( 5 ), nodules classified as atypia of undetermined significance or follicular lesion of undetermined significance – AUS/FLUS, Bethesda III – harbor a risk of malignancy of 22% (range: 13–30%) and the recommended management is to repeat cytology or to