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Certain philosophical and practical principles need to be accepted by endocrinologists, internists, surgeons and pathologists as we enter the 21st century. These include:
– The primary approach to a single or dominant nodule in the thyroid of a euthyroid patient is FNA.
– FNA can be diagnostic in papillary cancer, (including some examples of the follicular variant), medullary carcinoma and anaplastic carcinoma.
– If FNA is diagnostic, appropriate therapy should be undertaken without further diagnostic tests, i.e., total or near total thyroidectomy for papillary or medullary cancer. If clinician does not trust (enough to act upon) the cytodiagnosis, he/she should find a cytopathologist he/she can trust!
