We appreciate the interest of Miller et al in our article on fineneedle biopsy of thyroid nodules. We agree that experience gained by the cytologist and the individuals performing the aspirations is important in achieving a high degree of accuracy in the procedure. Our report included all of our results, dating back to 1972 when we first began to use the technique, and we attempted to provide a cytologic diagnosis even when the amount of cellular material in the aspirate was rather meager. We can make the following additional comments about the eight false-negative aspiration diagnoses that we obtained: four were on nodules smaller than 1.5 cm in diameter, one being "barely palpable"; three of the five false-negative papillary carcinomas had purely follicular architecture and the other two were surrounded by follicular adenomas or colloid nodules; one of the two falsenegative follicular carcinomas had major areas of hemorrhagic degeneration; the
Robbins J, Ramacciotti C, Chu EW, Pretorius HT. Thyroid Needle Biopsy-Reply. Arch Intern Med. 1985;145(4):765. doi:10.1001/archinte.1985.00360040205053
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