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Cytology of thyroid and parathyroid glands in oncology diagnosis – a contemporary review of updates and innovations

Elwira Beata Bakuła-Zalewska1, Agnieszka Żyłka2, Marek Dedecjus2, Piotr Góralski2, Jacek Gałczyński2, Joanna Długosińska2, Monika Durzyńska1, Monika Prochorec-Sobieszek1, Henryk A. Domanski3

Abstract

Fine needle aspiration (FNA) is widely used in the examination of head and neck lesions and has been considered an important diagnostic tool in the evaluation of thyroid and parathyroid nodules. Thyroid nodules are frequent findings in the general population, although 90-95% of these nodules are benign. FNA plays a crucial role to determine which nodules are at greatest risk of malignancy and which nodules are benign and do not require surgical intervention. In the case of the parathyroid glands, the US-guided parathyroid FNA is an effective method for the identification of intrathyroidal or ectopic parathyroid tissue, and distinguish it from thyroid and other surrounding anatomical structures. In addition, the use of FNA can significantly increase the accuracy of parathyroid gland location in patients with hyperparathyroidism who are candidates for surgical treatment in cases where imaging techniques fail to identify the parathyroid. Widespread US guidance in FNA procedures, constellation of clearly defined, reproducible key diagnostic cytopathological criteria for individual lesions in conjunction with images and clinical data as well as evolutions in FNA techniques and ancillary tests facilitate further diagnostic and clinical management. This paper aims to review the current state of the art in cytological evaluation of thyroid and parathyroid lesions.

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