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Table 2 FNAC Diagnostic categories and recommended actions

From: Management of Thyroid nodules in adult patients

Diagnostic category Description Recommended action
Thy 1 Non-diagnostic, insufficient sample.
Cyst containing colloid or histiocytes only, in the absence of epithelial cells.
To repeat FNAC. Ultrasound-guidance may help.
If cyst aspirated to dryness with no residual swelling, clinical/ultrasound follow-up alone may be sufficient.
Thy 2 Benign, non-neoplastic.
Cyst containing benign epithelial cells.
Repeat FNAC in 3 - 6 month. Two non-neoplastic results 3 - 6 months apart should exclude neoplasia.
Thy 3 Follicular or Hurthle cell lesion/suspected follicular or Hurthle neoplasm.
(Figure 1)
MDT discussion - diagnostic lobectomy.
Thy 4 Suspicious of malignancy.
(Figure 2)
MDT discussion - surgical intervention, e.g. Total thyroidectomy.
Thy 5 Diagnostic of malignancy. MDT discussion - surgical intervention, e.g. Total thyroidectomy.