Introduction and objective:

Fine-needle aspiration (FNA) has a primary role in the diagnosis of thyroid nodules. FNA allows us to differentiate benign lesions from malignant ones in most of the cases. However, management of Bethesda System diagnostic categories I (Nondiagnostic or Unsatisfactory) and III (Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance) are a clinical challenge. The aim of this work is to expose the options we have to improve the diagnosis of those categories using a multidisciplinary approach, an active follow-up, repeating FNA, applying immunohistochemical and/or molecular technics or even perform a core needle biopsy.

Synthesis: Conclusions:

Some or all of these choices are especially useful to identify category III, but active follow-up or additional FNA are preferred to detect category I.

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