The Bethesda system for reporting thyroid fine needle aspiration cytology: A study comparing the results of two centers from two different countries

2012 ◽  
Vol 32 (6) ◽  
pp. e29-e34 ◽  
Author(s):  
Pinar Firat ◽  
Beatrix Cochand-Priollet
Author(s):  
Yashika P. Jaiswal ◽  
Sanjay Chawhan

Background: Fine Needle Aspiration Cytology (FNAC) of thyroid gland is the most common preoperative investigation for diagnosis of thyroid lesions. Though various tests like thyroid profile, ultrasonography and radionuclide scan are available, they are used as adjuvant diagnostic modalities. FNAC is simple, easy to perform, non-invasive and cost-effective procedure. Primary aim is to study the spectrum of various thyroid lesions on FNAC. Also, the study is aimed to categorise the thyroid lesions according to the Bethesda system for Reporting Thyroid Cytopathology (2017).Methods: This is a retrospective observational study carried out in the pathology department at tertiary care academic institute for a period of three years. FNAC was done in a patient with thyroid swelling by non-aspiration technique. Slides were prepared, fixed in 95% ethyl alcohol and processed with routine stains.Results: Out of 210 cases, 150 cases (71.42%) were benign lesions, 15 cases (7.14%) were Follicular neoplasm/Suspicious for follicular neoplasm, 14(6.66%) cases were reported as Atypia of undetermined significance, 13 cases (6.19%) were Unsatisfactory/Nondiagnostic, 11 cases (5.2%) were malignant and 7 cases (3.3%) were suspicious for malignancy.Conclusions: FNAC is the most effective tool for the diagnosis of thyroid lesions. The Bethesda system is used to categorise the thyroid lesions and helps in better communication between clinicians and pathologists for the best surgical and medical management. The number of benign cases were higher and the number of cases in the category of suspicious for malignancy were lower with female preponderance.


2020 ◽  
Vol 7 (52) ◽  
pp. 3171-3175
Author(s):  
Kirthi Nath K.V ◽  
Geetha Sukumaran

BACKGROUND The Bethesda system of reporting thyroid cytopathology is an outstanding and systematic approach of reporting thyroid cytology samples, thereby reducing the communication gap between cytopathologist and clinician, leading to a better patient care approach. We aim to study the thyroid fine needle aspiration (FNA) using the Bethesda system and evaluate its accuracy taking histopathology as gold standard. METHODS This was a descriptive study including 200 consecutive cases which came to our cytology department between January 2014 and December 2014. All thyroid fine needle aspiration cytology (FNAC) were categorised as per the Bethesda system and followed up with corresponding histopathology. RESULTS Out of the 200 cases, adequacy criteria was met in 196 (98 %) cases. 176 (88 %) cases fell in the benign category, 4 (2 %) cases were inadequate samples, 8 (4 %) showed features of follicular neoplasm / suspicious of follicular neoplasm and 12 (6 %) were malignant lesions. Histopathology follow up was available for all cases. Statistical analysis showed a specificity of 100 % (high), sensitivity of 40 % (low). Positive predictive value was 100 %, negative predictive value was 90.4 %. Accuracy rate was 91 %. CONCLUSIONS Interpreting the thyroid FNAC results using Bethesda system allowed a superior interlaboratory agreement leading to improved clinical management. KEYWORDS Thyroid, Cytology, Bethesda


2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
O Iwegbulem ◽  
Z Razzaq ◽  
F Crowley ◽  
M Majeed ◽  
D Cagney ◽  
...  

Abstract Introduction Fine Needle Aspiration Cytology (FNAC) is the best diagnostic tool for evaluating thyroid nodules pre-operatively. The Bethesda System for Reporting Thyroid Cyto-pathology (TBSRTC) in America and THY classification in Europe are standardized reporting systems for thyroid FNAC specimens using six categories. As compared to the first edition in 2009, a second edition of TBSRTC published in 2017 has revised risk of malignancy (ROM) for these categories, with focus on atypia of unknown significance (Thy3A) upgraded to 10-30% from previously 5-15%, and suspicion for follicular neoplasm (Thy3F) 25-40% from previous 15-30%. Method A three-year audit of thyroid surgeries performed in two high volume thyroid institutions from January 2016 to September 2019, was performed retrospectively. The FNAs were performed by thyroid specialist radiologists with a cytopathology technician in attendance for rapid on-site evaluation and reported as per TBSRTC and Thy classification, by a Consultant Cyto-pathologist from a single institution. Result A total of 702 patients were examined. There were 552 patients who had corresponding FNAC prior to surgery (mean age 53.6 years, females 79%). The rates of malignancy were, Thy1: 9.3%, Thy2: 4.6%, Thy3A: 10.8%, Thy3F: 28.7%, Thy4: 82.3% and Thy5: 100%. The main types of thyroid malignancy were Papillary (73.6%), Follicular (14.1%), Medullary (4%), Anaplastic (4.7%) and others (3.6%). Conclusion Pre-operative diagnosis of thyroid nodules using TBSRTC was comparable and the criteria helped avoid misinterpretation of results. Our results were comparable with the risk of malignancy in 2009 edition of TBSRTC, as compared to the 2017 revision. Take-home message Pre-operative diagnosis of thyroid nodules using The Bethesda System for Reporting Thyroid Cyto-pathology (TBSRTC) was comparable and the criteria helped avoid misinterpretation of results. Our results were comparable with the risk of malignancy in 2009 edition of TBSRTC, as compared to the 2017 revision.


CytoJournal ◽  
2018 ◽  
Vol 15 ◽  
pp. 4 ◽  
Author(s):  
Safa Alshaikh ◽  
Zainab Harb ◽  
Eman Aljufairi ◽  
S. Ali Almahari

Background: Fine-needle aspiration cytology (FNAC) of thyroid is the initial screening test for thyroid nodules. The Bethesda system classifies thyroid FNAC into six categories. Each category is linked to a malignancy risk and has a recommended clinical management. The aim of this study is to analyze the thyroid cytology smears by Bethesda system and to correlate the diagnosis of cytopathology with histopathology, whenever surgery was done. Materials and Methods: This study presents our experience with the Bethesda system in 681 thyroid FNAs from 632 patients in the period between January 2013 and December 2016. Results: Categories were as follows: 10.1% were Category I (nondiagnostic), 68.8% Category II (benign), 12.4% were Category III (atypia of undetermined significance), 2.9% were Category IV (suspicious for follicular neoplasm), 2.6% were Category V (suspicious for malignancy), and 4.1% were Category VI (malignant). Surgery was done on 126 nodules from 119 patients with an overall rate of malignancy of 27.8% (35/126 nodules). Conclusion: The Bethesda System for Reporting Thyroid Cytopathology proved to be an excellent reporting system.


2016 ◽  
Vol 6 (11) ◽  
pp. 902-905 ◽  
Author(s):  
PK Choudhary ◽  
N Nepal ◽  
N Mainali ◽  
B Meenakshi

Background: Thyroid lump is a common clinical problem in Nepal. The risk of malignancy has to be judged prior to surgery for which fine needle aspiration cytology is widely used. To bring the uniform reporting of thyroid aspirates, the Bethesda system for reporting thyroid cytopathology (TBSRTC) was introduced in 2007. This study was done to evaluate the various cytomorphological patterns of thyroid aspirate and to correlate the Bethesda system with final histopathology report.Materials and Methods: Fine needle aspiration were performed and were evaluated as per TBSRTC criteria. Fine needle aspiration cytology report were compared with biopsy specimen whenever possible.   Result: A total of 386 cases were studied. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of TBSRTC were 75.2%, 98.2%, 90.0%, 94.7% and 94.03% respectively. Conclusion: Use of TBSRTC in reporting thyroid cytopathology has a greater accuracy; however, benign cases need regular follow up as there are false negative cases.


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