I have been aspirating palpable “lumps and bumps” for over 30 years and also interpreting aspirates performed by radiologists, endocrinologists, and other physicians; the last nine years performing mostly thyroidal aspirates. What follows is based on my reflections and on the insight developed into the particular problem of thyroid nodules. We have to understand the limitations of fine needle aspirations (FNA) of thyroidal lesions. FNA is a diagnostic tool. Tools only work if they are handled properly. The five most important things I have learned in all these years are: 1. The role of the aspirator is crucial. 2. The technique is deceptively simple. 3. You have to have a team. 4. Communication with the referring physician is essential. 5. You have to persist.
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