Cytopathology reports from fine needle aspirations of the thyroid gland: can they be improved?

Many endocrinologists are dissatisfied with the cytopathology reports from thyroidal aspirates and unsure of how to proceed with the management of their patients. Endocrinologists and cytopathologists should have a symbiotic or complementary professional relationship if patients are going to be well served. The endocrinologist has responsibilities to the pathologist and vice versa. If the endocrinologist performs the thyroidal fine needle aspirations (FNAs), he or she must provide the pathologist with adequate specimens (in terms of quantity or number of cells) that are well smeared so that cells are well preserved and accurate cytologic diagnosis may be rendered. Also, pertinent clinical history and reasonable differential diagnoses should be stated. The pathologist has responsibilities to the endocrinologist. He or she should strive constantly to provide a clear and definite diagnosis. Cytologic reports must be in a "clinical language." By this I mean a language the clinician can understand. The pathologist should not merely provide morphologic descriptions without any clinical meaning. Here I provide my views and suggestions on improving cytopathology reports based on over 30 years' experience of performing and reporting thyroidal FNAs.