eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-08-16 9 11 552 553 10.12691/ajmcr-9-11-9 AJMCR20219119 article Demet Sengul demet.sengul.52@gmail.com 1 Ilker Sengul 2 3 Department of Pathology, Giresun University Faculty of Medicine, 28100 Giresun, Turkey Division of Endocrine Surgery, Giresun University Faculty of Medicine, 28100 Giresun, Turkey Debate is still ongoing in the thyroid gland with indeterminate cytology w/wo suspicious clinics and sonographic features, besides their size selection criteria, in Endocrine Pathology, Endocrine Surgery, and Thyroidology, till today. Real-time elastography (RTE) still have been utilized for this purpose though it remains a controversial determinant. We postulate that the so-called RTE diagnostic tool selectively is enriched by considering nondiagnostic, Category I, and indeterminate cytology, Category III, IV, and V, of The Bethesda System for Reporting Thyroid Cytopathology, TBSRTC, 2nd ed., individually and separately, regarding noninvasive follicular thyroid neoplasm with papillary-like nuclear features, NIFTP, all of which a wide range of implied risk of malignancies. http://pubs.sciepub.com/ajmcr/9/11/9/ajmcr-9-11-9.pdf thyroid gland nondiagnostic cytology indeterminate cytology elastography real-time elastography Endocrine Surgery Endocrine Pathology Thyroidology