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Ana Isabel Álvarez-Mancha Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, General University Hospital of Ciudad Real, Ciudad Real, Spain

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Isabel Mancha-Doblas Department of Medicine, University of Malaga, Malaga, Spain
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain

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María Molina-Vega Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain

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Diego Fernández-García Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain

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Ana María Gómez-Pérez Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain

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Elena Gallego-Domínguez Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain

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María Victoria Ortega-Jiménez Department of Medicine, University of Malaga, Malaga, Spain
Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain

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Isabel Hierro-Martín Department of Pathology, Virgen de la Victoria University Hospital, Málaga, Spain

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Francisco J Tinahones Department of Medicine, University of Malaga, Malaga, Spain
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
The Biomedical Research Institute of Malaga and Platform in Nanomedicine (IBIMA-BIONAND Platform), University of Malaga, Malaga, Spain

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Introduction Clinical management of the thyroid nodules is based on a combination of clinical risk factors, functional status, ultrasound patterns, and cytologic findings when fine needle aspiration (FNA) is indicated ( 1 , 2 , 3 , 4 , 5

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Andrea Leoncini Clinic for Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland

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Chiara Camponovo Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland

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Gaetano Paone Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland

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Elena Gamarra Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland

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Giorgio Treglia Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland

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Pierpaolo Trimboli Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland

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://doi.org/10.1111/cen.14204 ) 12 Noto B Eveslage M Pixberg M Gonzalez Carvalho JM Schäfers M Riemann B & Kies P . Prevalence of hyperfunctioning thyroid nodules among those in need of fine needle aspiration cytology according to ATA 2015, EU

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Tayyab S. Khan Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada

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Esha Sharma LMC Diabetes and Endocrinology, Brampton, Ontario, Canada

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Baldev Singh LMC Diabetes and Endocrinology, Brampton, Ontario, Canada

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Bikram Jammu LMC Diabetes and Endocrinology, Brampton, Ontario, Canada

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Amarinder Chadha LMC Diabetes and Endocrinology, Brampton, Ontario, Canada

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Divya Markanday LMC Diabetes and Endocrinology, Brampton, Ontario, Canada

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Yan Yan Wu Office of Public Health Studies, University of Hawai’i at Manoa, Honolulu, Hawaii, USA

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Harpreet S. Bajaj LMC Diabetes and Endocrinology, Brampton, Ontario, Canada
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada

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Introduction Ultrasound-guided thyroid fine needle aspiration and biopsy (FNAB) has become the test of choice for evaluation of thyroid nodules. It combines ease of access and a high sensitivity and specificity to offer reliable results to aid

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Roberto Negro Division of Endocrinology, “V. Fazzi” Hospital, Lecce

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Roberto Attanasio Endocrinology Service, Galeazzi Institute IRCCS, Milan

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Franco Grimaldi Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia,” Udine

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Andrea Frasoldati Division of Endocrinology, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia

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Rinaldo Guglielmi Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Enrico Papini Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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techniques reveals an epidemic of nonpalpable thyroid nodules that necessitate a complete workup, including US, testing for thyroid-stimulating hormone, and fine-needle aspiration (FNA) [ 3 ]. The first objective in thyroid nodule evaluation is to exclude

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Taha Yusuf Kuzan Department of Radiology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey

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Ceren Canbey Goret Department of Surgical Pathology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey

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thyroid nodules are benign, and 5–15% of them are thyroid malignancies. Fine-needle aspiration biopsy (FNAB) is a reliable, minimally invasive diagnostic method with high sensitivity and specificity in the evaluation of thyroid nodules [ 2 , 4 - 7

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Chitra Choudhary Department of Endocrinology, Medstar Washington Hospital Center, Washington, D.C., USA

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Leonard Wartofsky Department of Endocrinology, Medstar Washington Hospital Center, Washington, D.C., USA

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Eshetu Tefera MedStar Health Research Institute, Washington, D.C., USA

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Kenneth D. Burman Department of Endocrinology, Medstar Washington Hospital Center, Washington, D.C., USA

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can represent benign conditions such as neuromas, postoperative scar, suture granuloma, reactive lymphoid hyperplasia, benign thyroid tissue remnant or, instead, a malignant recurrence of thyroid cancer in which case fine-needle aspiration will show

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Catherine Brophy Departments of Otolaryngology - Head and Neck Surgery, Cork, Ireland

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Rania Mehanna Departments of Otolaryngology - Head and Neck Surgery, Cork, Ireland

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Julie McCarthy Departments of Cytopathology, Cork University Hospital, Cork, Ireland

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Antoinette Tuthill Departments of Endocrinology, Cork University Hospital, Cork, Ireland

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Matthew S. Murphy Departments of Endocrinology, South Infirmary Victoria University Hospital, Cork, Ireland

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Patrick Sheahan Departments of Otolaryngology - Head and Neck Surgery, Cork, Ireland

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clinically apparent thyroid nodules is between 5 and 15% [ 2 ]. Fine-needle aspiration (FNA) cytology has demonstrated high utility in the diagnosis of thyroid nodules. In an effort to stratify thyroid nodules according to risk of malignancy in a consistent

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Mathieu Bergeron Department of Otolaryngology - Head and Neck Surgery, Laval University, Quebec, Que., Canada

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Danielle Beaudoin Enfant-Jésus Hospital, Quebec, Que., Canada

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What Is Known about This Topic So Far? • Although many authors recommend a core-needle biopsy as an alternative modality in cases of inconclusive cytology with fine-needle aspiration for thyroid nodule, it is not in the American Thyroid

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Catarina Silvestre Department of Endocrinology, Diabetes and Metabolism, Santa Maria Hospital, Lisbon, Portugal

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Joaquim Sampaio Matias Department of Laboratorial Medicine, Santa Maria Hospital, Lisbon, Portugal

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Helena Proença Department of Laboratorial Medicine, Santa Maria Hospital, Lisbon, Portugal

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Maria João Bugalho Department of Endocrinology, Diabetes and Metabolism, Santa Maria Hospital, Lisbon, Portugal

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thyroid-stimulating hormone, colonoscopy, and mammography screening. In our series, the sensitivity of serum Ctn was higher than that of cytology by fine-needle aspiration, as reported by others [ 6 , 13 - 16 ]. As a matter of fact, on fine

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José I. López Department of Pathology, Cruces University Hospital, BioCruces Research Institute, University of the Basque Country, Barakaldo

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Rosa Zabala Department of Radiology, Basurto University Hospital, University of the Basque Country, Bilbao, Spain

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José Luís del Cura Department of Radiology, Basurto University Hospital, University of the Basque Country, Bilbao, Spain

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sensitivity and specificity of the technique [ 4 ], and makes it possible to take samples of the solid areas in cystic lesions. Despite fine-needle aspiration cytology (FNAC) being almost universally used to take thyroid samples and, accordingly, there being

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