Recent Advances in the Fine Needle Aspiration Cytology of Thyroid Lesions: The “Geneva Experience”

Thyroid fine needle aspiration (FNA) is one of the most commonly performed cytologic procedures and has proven to be one of the most effective tools for guiding the initial management of patients with thyroid nodules. The acceptance of FNA as the only reliable pre-operative test for managing patients with thyroid nodules relies entirely on its high sensitivity and specificity and on its maintenance of the lowest unsatisfactory rates. To improve thyroid FNA accuracy, we developed a multidisciplinary approach that, in light of the current literature, is one of the best possible approaches to minimize the limitations of thyroid fine needle aspiration. At the Geneva University Hospitals we manage patients with thyroid nodules in a multidisciplinary consult, with clinical and surgical expertise and on‐site cytopathological evaluation of the adequacy of thyroid FNA. Moreover, the new Bethesda System for Reporting Thyroid Cytopathology, which we have applied since its inception, permits the world‐wide standardization of thyroid reporting and allows the communication with the referring physician to occur in terms that are unambiguous, reproducible, and clinically helpful. The goal of this thesis is to show the importance of a multidisciplinary approach in the management of thyroid nodules and the fundamental role of thyroid cytology as a screening/diagnostic test