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      Anatomía patológica de la patología de tiroides y paratiroides. Sistema Bethesda del diagnóstico citológico de la patología de tiroides Translated title: Thyroid and parathyroid gland pathology. The Bethesda System for reporting thyroid cytopathology

      review-article
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      Revista ORL
      Ediciones Universidad de Salamanca
      Tiroides, Bethesda, PAAF, Thyroid, Bethesda, PAAF

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          Abstract

          RESUMEN Introducción y objetivos: La PAAF es el mejor método para el manejo de pacientes con nódulos tiroideos, como método de cribado y para seleccionar a los pacientes que pueden ser sometidos a tratamiento quirúrgico. El objetivo de este artículo es hacer una breve descripción de las categorías diagnósticas del Sistema Bethesda en su segunda edición (2018). Material y métodos: Revisión narrativa. Resultados: El Sistema Bethesda establece 6 categorías diagnósticas: Insatisfactorio /No diagnóstico, Benigno, Atipia de significado Indeterminado/Lesión folicular de significado indeterminado, Neoplasia folicular/Sospechoso de neoplasia folicular, Sospechoso de Malignidad Maligno. Cada categoría lleva implícito el riesgo de malignidad y el manejo de estos pacientes, con lo cual el diagnóstico va a influir en la actitud a seguir. Conclusiones: El Sistema Bethesda permite a los patólogos realizar informes sistematizados y al clínico establecer la actitud a seguir en función de cada categoría diagnóstica.

          Translated abstract

          ABSTRACT Introduction: The FNA is the best method for the management of patients with thyroid nodules, as a screening method and for selecting patients who can undergo surgical treatment. The objective of this article is to make a brief description of the diagnostic categories of the Bethesda System in its second edition (2018). Material and methods: Narrative review. Results: The Bethesda System establishes 6 diagnostic categories: No diagnostic-Unsatisfactory, Benign, Atypia od Undetermined Significance/Follicular Lesion of Undetermined Significance, Follicular Neoplasm/Suspicious for a Follicular Neoplasm, Suspicious for Malignant and Malignant. Conclusions: The Bethesda System allows pathologists to make systematized reports and the clinician to establish the attitude to follow according to each diagnostic category.

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          The Bethesda System For Reporting Thyroid Cytopathology.

          To address terminology and other issues related to thyroid fine-needle aspiration (FNA), the National Cancer Institute (NCI) hosted the NCI Thyroid FNA State of the Science Conference. The conclusions regarding terminology and morphologic criteria from the NCI meeting led to the Bethesda Thyroid Atlas Project and form the framework for The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). For clarity of communication, TBSRTC recommends that each report begin with 1 of 6 general diagnostic categories. The project participants hope that the adoption of this flexible framework will facilitate communication among cytopathologists, endocrinologists, surgeons, radiologists, and other health care providers; facilitate cytologic-histologic correlation for thyroid diseases; facilitate research into the epidemiology, molecular biology, pathology, and diagnosis of thyroid diseases; and allow easy and reliable sharing of data from different laboratories for national and international collaborative studies.
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            US-guided fine-needle aspiration of thyroid nodules: indications, techniques, results.

            Fine-needle aspiration (FNA) biopsy of thyroid nodules is minimally invasive and safe and is usually performed on an outpatient basis. However, the optimal application of FNA requires not only technical skill but also an awareness of the limitations of the procedure, the indications for its use, the factors that affect the adequacy of the biopsy specimen, and the postprocedural management strategy. Ultrasonographic (US) features that are considered indications for FNA include single and multiple thyroid nodules. The results of FNA biopsy are operator dependent. In addition, the results may be affected by the lesion characteristics, the accuracy of lesion and needle localization, the method of guidance, the number of aspirated samples, the needle gauge, the aspiration technique, and the presence or absence of on-site facilities for immediate cytologic examination. With regard to postprocedural management, nodules that are diagnosed as benign on the basis of an adequate FNA specimen should be monitored with follow-up US. Circumstances that necessitate repeat FNA include sample inadequacy, nodule enlargement, cyst recurrence, or clinical or imaging findings that arouse suspicion about the presence of a malignancy even when cytologic findings in the biopsy specimen indicate benignity. Supplemental material available at radiographics.rsnajnls.org/cgi/content/full/28/7/1869/DC1.
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              Diagnosis of ?follicular neoplasm?: A gray zone in thyroid fine-needle aspiration cytology

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                Author and article information

                Journal
                orl
                Revista ORL
                Rev. ORL
                Ediciones Universidad de Salamanca (Salamanca, Salamanca, Spain )
                2444-7986
                September 2020
                : 11
                : 3
                : 259-264
                Affiliations
                [1] Zamora orgnameComplejo Asistencial de Zamora orgdiv1Servicio de Anatomía Patológica España
                Article
                S2444-79862020000300003 S2444-7986(20)01100300003
                10.14201/orl.21596
                c7111db5-9d01-4b29-98da-468935282d53

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 15 October 2019
                : 17 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 6
                Product

                SciELO Spain

                Categories
                Artículo de revisión

                PAAF,Tiroides,Bethesda,Thyroid
                PAAF, Tiroides, Bethesda, Thyroid

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