Thyroid gland
Competency Assessment
3. Thyroid fine needle aspiration specimen

Author: Ricardo R. Lastra, M.D., Michelle R. Pramick, M.D., Zubair W. Baloch, M.D. (see Authors page)

Revised: 20 January 2017, last major update November 2013

Copyright: (c) 2013-2017, PathologyOutlines.com, Inc.

Cite this page: Fine needle aspiration specimen. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/thyroidcompfineneedlespecimen.html. Accessed October 24th, 2017.
Preparations
Medical knowledge
  1. Understand that tissue or cyst fluid may be directly smeared for air dried and alcohol fixed preparations
  2. Understand that air dried preparations are stained with Romanowsky (Diff-Quik, Wright-Giemsa, Wright) stains
  3. Understand that alcohol fixed preparations are stained with Papanicolaou stain
  4. Understand that liquid based processing can be utilized alone or in addition to direct smears
  5. Understand that for liquid based processing, the needle should be flushed with a small amount of liquid (0.5 cc) of Cytolyt, balanced saline, of Hank's solution
  6. Understand that for liquid based processing, fixative may be necessary for remote transport

Practice based learning
  1. Understand that the cell rich fluid of a liquid based preparation can be used for a cell bock
Staining
Medical knowledge
  1. Understand that there are two types of stains used in thyroid fine needle aspiration biopsy specimens:
    • Romanowsky (Diff-Quik, Wright-Giemsa, Wright) stain
    • Papanicolaou stain
  2. Understand the basic procedure and dye components for both the Romanowski-type and Papanicolaou stains

Practice based learning
  1. Understand the advantages and limitations for both the Romanowski-type and Papanicolaou stains
Onsite Adequacy Evaluation
Medical knowledge
  1. Understand that a direct smear is necessary for immediate assessment
  2. Understand that adequacy defines the quality and quantity of the sample
  3. Understand the criteria for adequacy of the Bethesda System for reporting thyroid cytopathology and the exceptions to these criteria

Practice based learning
  1. Understand that immediate assessment may decrease complications, improve triage of tissue and increase adequacy