Molecular Assessment of Thyroid Nodules

Our understanding of the genomics of benign and malignant thyroid nodules has advanced rapidly, and so have the applications that utilize this information for clinical decision-making. Not long ago, it was “cutting-edge” medicine to test for a single genomic variant. Now, everyday practitioners have access to gene panels and genomic classifiers that utilize hundreds and thousands of genes. Here, we discuss current cytological nomenclature of thyroid aspirates, review cellular genomics, discuss current genomic tests for cytologically indeterminate nodules, consider surgical decision-making, explore the potential role of genomics among suspicious and malignant cytology categories, and consider future directions.