Messages from Kennichi Kakudo, MD, PhD to a person to be an expert of the cytopathology

The second edition of the Bethesda System for Reporting Thyroid Cytopathology was released from Springer recently. I am happy to be a co-author with Professor Layfield in a chapter, Metastatic Tumors, Lymphomas and Rare Tumors of the Thyroid.  

The 4th edition of WHO Classification Tumors of Endocrine Organs was published in July, 2017. Borderline tumors of follicular cell origin were incotporated in this thyroid tumor classification very first time. I hope the introduction of the borderline tumor category in thyroid tumor classification will open a new era where pathologists have 3 choices for their diagnoses: benign, borderline, or malignant. Pathologists are no longer forced to decide between benign and malignant—it can be a borderline or precursor tumor. I believe this causes significant changes not only in pathology practice, but also brings significant impacts on clinical management of patients. It opens a new era for endocrinologists and endocrine surgeons to have 3 treatment options for patients with thyroid nodules, treat, not treat, or close follow-up (active surveillance), which would be different from the current clinical management with 2 choices (treat or not treat).  

Borderline/Precursor Tumours in the 4th Edition, 2017 WHO Classification of Thyroid Tumours.
2		Hyalinizing Trabecular Tumour
2A		Other encapsulated follicular patterned thyroid tumours
	2A-1	Uncertain malignant potential (UMP)
		2A-1-1:Follicular tumour of Uncertain malignant potential (FT-UMP)
		2A-1-2:Well differentiated tumour of Uncertain malignant potential (WDT-UMP)
	2A-2	Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)

I have published a special issue on NIFTP (non-invasive encapsulated follicular neoplasm with papillary-like nuclear features) in the Journal of Basic and Clinical Medicine (http://www.sspublications.org/index.php/JBCM/index). This is a very first special issue focussing on NIFTP in any scientific journals, and which covered both histological and cytological aspects. It is also characterized by international authors from 8 countries, Eastern and Western practice. This approach elucidated significal differences between the two practice. Please enjoy find those differences and underlining different way of thinking and logics.

On March 16th. a symposium conducted by Working Group of Asian Thyroid FNA Cytology was held in Busan, Korea conjointed with the 18th International Congress of Asia Oceania Thyroid Association.  Please refere to a wechat by Dr Liu at  http://mp.weixin.qq.com/s/u5HCPPZMXGoV2wdlJ7OTlg There were 11 presentations by 10 cytopathologists from 6 (Korea, Taiwan, China, Thailand, Turkey and Japan) countries, which elucidate differences between Asian and Western practice and unsolved issues in the newly introduced tumor entity, NIFTP. Particularlly on observer valiation among reviewers on papillary thyroid carcinoma type nuclear features was reported by Dr Liu and low rates of NIFTP in Asian practice was reported by Andrey Bychkov.

Print edition of Thyroid FNA Cytology: Differential Diagnoses and Pitfalls was published from BookWay. The previous eBook edition (distributed by Smashwords) was the first English textbook of thyroid FNA cytology published from Asia. The editors proudly announce that it was the first and only textbook of thyroid FNA cytology that incorporated borderline tumor categories in thyroid tumor classification. In this print edition, we provide you with all of the original illustrations in high quality and have incorporated some more illustrations which were deleted from the eBook edition. With those beautiful illustrations and high quality evidences, this book is designed to provide you helpful consultations in the differential diagnoses of difficult cases. We believe it helps you how to avoid pitfalls of cytology practice, regardless of the reporting system used. The print edition is  distributed by BookWay GLOBAL at $77  (https://bookway-global.com/)