International Journal of Cancer Management

Published by: Kowsar

Fine-Needle Aspirations in Atypia of Unknown Significance/Follicular Lesion Undetermined Significance (AUS/FLUS): Usefulness of Repeated FNA of Thyroid Nodules

Masoud Nazem 1 , Behrouz Kaleydari 1 , Mohsen Kolahdouzan 1 , * , Valiollah Kashi 1 and Masoud Amini 2
Authors Information
1 General Surgery Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran
Article information
  • Iranian Journal of Cancer Prevention: December 2016, 9 (6); e7879
  • Published Online: December 7, 2016
  • Article Type: Research Article
  • Received: July 13, 2016
  • Accepted: December 3, 2016
  • DOI: 10.17795/ijcp-7879

To Cite: Nazem M, Kaleydari B, Kolahdouzan M, Kashi V, Amini M. Fine-Needle Aspirations in Atypia of Unknown Significance/Follicular Lesion Undetermined Significance (AUS/FLUS): Usefulness of Repeated FNA of Thyroid Nodules, Int J Cancer Manag. 2016 ; 9(6):e7879. doi: 10.17795/ijcp-7879.

Copyright © 2016, Iranian Journal of Cancer Prevention. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014; 140(4): 317-22[DOI][PubMed]
  • 2. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968; 69(3): 537-40[DOI][PubMed]
  • 3. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009; 19(11): 1159-65[DOI][PubMed]
  • 4. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993; 118(4): 282-9[DOI][PubMed]
  • 5. Baloch ZW, Cibas ES, Clark DP, Layfield LJ, Ljung BM, Pitman MB, et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal. 2008; 5: 6[DOI][PubMed]
  • 6. Sullivan PS, Hirschowitz SL, Fung PC, Apple SK. The impact of atypia/follicular lesion of undetermined significance and repeat fine-needle aspiration: 5 years before and after implementation of the Bethesda System. Cancer Cytopathol. 2014; 122(12): 866-72[DOI][PubMed]
  • 7. Ho AS, Sarti EE, Jain KS, Wang H, Nixon IJ, Shaha AR, et al. Malignancy rate in thyroid nodules classified as Bethesda category III (AUS/FLUS). Thyroid. 2014; 24(5): 832-9[DOI][PubMed]
  • 8. Lopez Vazquez Y, Penin Alvarez M, San Miguel Fraile P, Barragans Perez M. Riesgo de malignidad de los nódulostiroideos con atipia de significado incierto. Endocrinol Nutr. 2015; 62: 507-10
  • 9. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L. AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. J Endocrinol Invest. 2010; 33(5): 1-50[DOI]
  • 10. Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008; 36(6): 425-37[DOI][PubMed]
  • 11. Wong LQ, LiVolsi VA, Baloch ZW. Diagnosis of atypia/follicular lesion of undetermined significance: An institutional experience. Cytojournal. 2014; 11: 23[DOI][PubMed]
  • 12. Nayar R, Ivanovic M. The indeterminate thyroid fine-needle aspiration: experience from an academic center using terminology similar to that proposed in the 2007 National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Cancer. 2009; 117(3): 195-202[DOI]
  • 13. Gweon HM, Son EJ, Youk JH, Kim JA. Thyroid nodules with Bethesda system III cytology: can ultrasonography guide the next step? Ann Surg Oncol. 2013; 20(9): 3083-8[DOI][PubMed]
  • 14. Nagarkatti SS, Faquin WC, Lubitz CC, Garcia DM, Barbesino G, Ross DS, et al. Management of thyroid nodules with atypical cytology on fine-needle aspiration biopsy. Ann Surg Oncol. 2013; 20(1): 60-5[DOI][PubMed]
  • 15. Gocun PU, Karakus E, Bulutay P, Akturk M, Akin M, Poyraz A. What is the malignancy risk for atypia of undetermined significance? Three years' experience at a university hospital in Turkey. Cancer Cytopathol. 2014; 122(8): 604-10[DOI][PubMed]
  • 16. Ustun H, Astarci HM, Altunkaya C, Yilmaz S, Barin A, Ekici S, et al. Fine-needle aspiration of follicular patterned lesions of the thyroid: diagnosis, management, and follow-up according to thyroid Bethesda system. Acta Cytol. 2012; 56(4): 361-9[DOI][PubMed]
  • 17. Faquin WC, Baloch ZW. Fine-needle aspiration of follicular patterned lesions of the thyroid: Diagnosis, management, and follow-up according to National Cancer Institute (NCI) recommendations. Diagn Cytopathol. 2011; 38: 731-9
  • 18. VanderLaan PA, Marqusee E, Krane JF. Clinical outcome for atypia of undetermined significance in thyroid fine-needle aspirations: should repeated fna be the preferred initial approach? Am J Clin Pathol. 2011; 135(5): 770-5[DOI][PubMed]
  • 19. Broome JT, Cate F, Solorzano CC. Utilization and impact of repeat biopsy for follicular lesion/atypia of undetermined significance. World J Surg. 2014; 38(3): 628-33[DOI][PubMed]
  • 20. Lee YS, Kim HK, Chang H, Kim SM, Kim BW, Chang HS, et al. Diagnostic Thyroidectomy May Be Preferable in Patients With Suspicious Ultrasonography Features After Cytopathology Diagnosis of AUS/FLUS in the Bethesda System. Medicine (Baltimore). 2015; 94(51): 2183[DOI][PubMed]
  • 21. Park VY, Kim EK, Kwak JY, Yoon JH, Moon HJ. Malignancy risk and characteristics of thyroid nodules with two consecutive results of atypia of undetermined significance or follicular lesion of undetermined significance on cytology. Eur Radiol. 2015; 25(9): 2601-7[DOI][PubMed]
  • 22. Aragon Han P, Olson MT, Fazeli R, Prescott JD, Pai SI, Schneider EB, et al. The impact of molecular testing on the surgical management of patients with thyroid nodules. Ann Surg Oncol. 2014; 21(6): 1862-9[DOI][PubMed]
  • 23. Kleiman DA, Sporn MJ, Beninato T, Crowley MJ, Nguyen A, Uccelli A, et al. Preoperative BRAF(V600E) mutation screening is unlikely to alter initial surgical treatment of patients with indeterminate thyroid nodules: a prospective case series of 960 patients. Cancer. 2013; 119(8): 1495-502[DOI][PubMed]
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