What could a Thy-3F (Thyroid transcription factor 3, also known as TTF3 or NKX2-1) be in the thyroid?

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Last updated: May 15, 2025View editorial policy

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A Thy3f in the thyroid represents an atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) according to the thyroid cytology classification system. This classification is used in fine needle aspiration (FNA) biopsy results to indicate cells with some atypical features that aren't clearly benign or malignant. The "f" specifically denotes follicular architecture, suggesting the presence of microfollicles or other follicular-pattern abnormalities. For patients with a Thy3f result, the recommended approach typically involves a repeat FNA in 3-6 months or consideration of molecular testing to better assess cancer risk, as seen in general thyroid management strategies 1. Some patients may be referred for a diagnostic hemithyroidectomy (surgical removal of half the thyroid) based on clinical factors, nodule size, or patient preference. Key considerations in the management of thyroid conditions include the use of laboratory tests such as thyroid-stimulating hormone (TSH), free thyroxine, and free triiodothyronine, as well as the potential pitfalls in interpreting these tests 2. The risk of malignancy in Thy3f nodules is approximately 15-30%, which is why further evaluation is necessary rather than simple observation. These indeterminate nodules represent a diagnostic challenge because they fall in a gray zone between clearly benign and clearly suspicious findings. When evaluating Thy3f results, it's essential to consider the clinical context and potential assay interferences, as well as the effects of concurrent medications on thyroid function tests 2. In the absence of strong evidence directly addressing Thy3f, the approach to management is guided by principles of thyroid disease diagnosis and treatment, emphasizing the importance of individualized patient care and careful consideration of clinical factors.

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