Cytological diagnosis of thyroid disease.

Fine needle aspiration biopsy cytology (ABC) is a morphological method, which may be used as an "office" procedure for all palpable lesions. Hyperplastic and inflammatory conditions of the thyroid and various types of neoplasms produce readily recognizable features in cytological smears. About 90% of all thyroid cancers may be diagnosed by aspiration cytology. The method bridges the diagnostic gap between initial palpatory examination and histological diagnosis and can greatly reduce the need for diagnostic surgery. The accuracy of the method has been shown to be superior to that of other non-invasive clinical methods. ABC enables the surgeon not only to better select patients with thyroid nodules who might benefit from surgery, but also to plan a definite operative strategy in papillar medullary and anaplastic cancer. In follicular neoplasms the method can not distinguish with certainty between adenoma and carcinoma. Fine needle aspiration requires no anesthesia. It has no complications and there is good patient acceptance and biopsies can therefore be repeated whenever needed.