In 1995, the author modified Papanicolaou stain so that fine needle aspiration cytology would resemble histology, by hemolyzing aspirated blood, and making the cells flatter and appear larger by air-drying and rehydration in saline. In addition, formalin was added in the alcoholic fixative so that “Orphan Annie eyed” clear nuclei of papillary thyroid carcinoma, a formalin artifact, previously seen only in permanent tissue section, can be predicted in fine needle aspiration (FNA) and intra-operative cytology. Since the modified version can be performed in 90 seconds, it was named Ultrafast Papanicolaou stain. Using this stain in conjunction with Diff-Quik stain, the author has been able to provide immediate diagnosis to the patients in over 10 000 thyroid FNAs in two private radiology offices in New York City. In addition, thousands of cases were examined by me or consulted with me from my colleages from Weill Cornell Medical Center (1992–95, 2006–present) and New York University (NYU) Medical Center (1996–2006).

I wish to thank the referring endocrinologists and thyroid surgeons and patients who responded to my request for follow-up information, essential to seeking the truth and in refining cytologic criteria. I wish to thank radiologist Dr. Karen Fried of Lenox Hill Radiology, whom I have teamed up with since November 2006, for her expertise in fine needle sampling head and neck lesion and her compassion to the patients. My deepest gratitude goes to radiologists Dr. Albert Messina and the late Dr. Doreen Liebeskind for inviting me in November 1994 to provide immediate diagnosis using Ultrafast Papanicolaou stain to CT- and ultrasound-guided fine needle aspirations to the patients at Park Avenue Radiology until October 2010. I have been blessed to work with experienced sonographers. Without their live songraphic scanning, the precise localization would not be possible. Thank you for sharing your sonographic knowledge with me.