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A series of 7089 FNAs were reviewed and correlated with subsequent resection specimens. Cases of AUS were reviewed and subclassified. Cases could be subcategorized into the following categories: 1) atypical, papillary carcinoma cannot be ruled out, 2) atypical, H��rthle cell neoplasm can not be ruled out, 3) cellular atrophic pattern, 4) scant atrophic pattern, and 5) cytologic atypia alone. Cytologic atypia alone (50%) and both atrophic patterns (21% and 34%) had a significant risk of malignancy. The majority of AUS cases in thyroid FNA can be subcategorized into http://www.selleckchem.com/products/AC-220.html 5 different patterns, all with associated significant risk of malignancy. ��Atrophic�� microfollicles are a significant risk factor for malignancy and should not be diagnosed as benign on the basis of lack of cytologic atypia. Cancer (Cancer Cytopathol) 2011;. ? 2011 American Cancer Society. The category of atypical cells of undetermined significance (AUS, or atypical follicular cells of undetermined significance) in the Bethesda Classification System for thyroid fine-needle aspiration1 is unsatisfying because the cytologic changes identified in such cases are often subtle and rare, there is disagreement about specific diagnostic features,2 the percentage of cases diagnosed as such varies widely3 and may reflect significant diagnostic disagreement, and the overall risk of malignancy for patients with such a diagnosis is relatively http://www.selleckchem.com/products/nutlin-3a.html low. In the Bethesda system, the chapter that describes AUS includes 9 different criteria.1 Although the risks of some criteria are well described, for example the risk of focal papillary carcinoma and atypical cases composed of H��rthle cells,4-5 others, including those composed predominantly of microfollicles, are not known. In contrast, a recent commentary3 suggests that the diagnosis of AUS should be restricted to only cases with both microfollicles and cytologic atypia (represented by nuclear enlargement) and all other cases, including http://www.selleck.cn/products/Romidepsin-FK228.html cases with numerous ��atrophic�� microfollicles without nuclear enlargement and cases with significant cytologic atypia without microfollicles should be diagnosed as benign. This practice results in a very low ��indeterminant�� rate (