The Bethesda system of reporting FNA thyroid – its diagnostic accuracy for benign and malignant thyroid lesions

Pathology ◽  
2014 ◽  
Vol 46 ◽  
pp. S68-S69
Author(s):  
Samra Sameen ◽  
Fakhr Abbas ◽  
Rahat Sarfraz
Keyword(s):  
Diagnostic Accuracy ◽  
Bethesda System ◽  
The Bethesda System ◽  
Thyroid Lesions

scholarly journals The spectrum of thyroid lesions on fine needle aspiration cytology

2020 ◽  
Vol 8 (2) ◽  
pp. 630
Author(s):  
Yashika P. Jaiswal ◽  
Sanjay Chawhan
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
The Bethesda System ◽  
Thyroid Lesions

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.

scholarly journals The Bethesda System thyroid diagnostic categories in the African-American population in conjunction with surgical pathology follow-up

CytoJournal ◽  
2012 ◽  
Vol 9 ◽  
pp. 7 ◽  
Author(s):  
Pamela Anne Archuletta ◽  
Raja Gidwani ◽  
Mujtaba Husain ◽  
Teresa Johnson ◽  
Vinod Shidham ◽  
...  
Keyword(s):  
African American ◽  
The United States ◽  
Needle Aspiration ◽  
Surgical Pathology ◽  
Bethesda System ◽  
Thyroid Fna ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Thyroid Lesions

Background: It has been reported that African-Americans (AA) have a higher prevalence of overall malignancy compared to Caucasians, in the United States, yet the incidence of thyroid malignancy is half. The aim of this study is to assess the rate of malignant versus benign thyroid disease in AA from an urban-based hospital with an academic setting. Our study analyzed the AA population with respect to fine needle aspiration (FNA) of thyroid lesions, in correlation with final surgical pathology. This is the first study of its kind to our knowledge. Design: We retrospectively reviewed thyroid FNA cytology between January 2005 and February 2011. Consecutive FNA specimens with corresponding follow-up surgical pathology were included. The patients were categorized as African- American (AA) and Non-African-American (NAA), which included Caucasians (C), Hispanics (H), and Others (O). The FNA results were classified using the latest edition of The Bethesda System for Reporting Thyroid Cytopathology (TBS-Thy) and the follow-up surgical pathology was used for the final categorization. Results: We studied 258 cases: 144 AA (56%) and 114 NAA [43 C (17%), 3 H (1%), and 68 O (28%)]. The average age for AA was 51 years (range 20 – 88) and for NAA was 53 years (range 25 – 86). There were more females than males in the AA versus the NAA group (85 vs. 75%). The incidence of thyroid lesions in the FNA specimens was similar between these two populations. The distribution of benign versus malignant diagnosis on follow-up surgical pathology was examined across TBS-Thy class. Conclusion: Our data suggest that distribution of benign versus malignant lesions in the thyroid FNA of AA versus NAA, with follow-up surgical pathology, is comparable for TBS-Thy classes, non-diagnostic (I), benign (II), suspicious for malignancy (V), and malignant (VI) in AA versus NAA.

scholarly journals Impact of the Hypoechogenicity Criteria on Thyroid Nodule Malignancy Risk Stratification Performance by Different TIRADS Systems

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5581
Author(s):  
Nina Malika Popova ◽  
Maija Radzina ◽  
Peteris Prieditis ◽  
Mara Liepa ◽  
Madara Rauda ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Diagnostic Accuracy ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Data Systems ◽  
Malignancy Risk ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Sensitivity Specificity ◽  
The Bethesda System

Background: Various Thyroid Imaging and Reporting data systems (TIRADS) are used worldwide for risk stratification of thyroid nodules. Their sensitivity is high, while the specificity is suboptimal. The aim of the study was to compare several TIRADS systems and evaluate the effect of hypoechogenicity as a sign of risk of malignancy on the overall assessment of diagnostic accuracy. Methods: The prospective study includes 274 patients with 289 thyroid nodules to whom US and risk of malignancy were assessed according to four TIRADS systems—European (EU-TIRADS), Korean (K-TIRADS), TIRADS by American College of Radiology (ACR TIRADS), and modified Kwak et al. TIRADS (L-TIRADS) systems, in which mild hypoechogenicity is not included in malignancy risk suggestive signs. For all thyroid nodules, a fine needle aspiration (FNA) biopsy was performed and evaluated according to the Bethesda system. For all systems, diagnostic accuracy was calculated. Results: Assessing the echogenicity of the thyroid nodules: from 81 of isoechogenic nodules, 2 were malignant (2.1%), from 151 mild hypoechogenic, 18 (12%) were malignant, and from 48 marked hypoechogenic nodules, 16 (33%) were malignant. In 80 thyroid nodules, mild hypoechogenicity was the only sign of malignancy and none appeared malignant. Assessing various TIRADS systems on the same cohort, sensitivity, specificity, PPV, NPV, and accuracy, firstly for EU-TIRADS, they were 97.2%; 39.9%; 18.7%; 99.0%, and 73.3%, respectively; for K-TIRADS they were 97.2%; 46.6%; 20.6%; 99.2%, and 53.9%; for ACR-TIRADS they were 97.2%; 41.1%, 19.0%; 99.0%, and 48.0%, respectively; finally, for L-TIRADS they were 80.6%; 72.7%; 29.6%; 96.3%, and 73.3%. Conclusions: This comparative research has highlighted that applying different TIRADS systems can alter the number of necessary biopsies by re-categorization of the thyroid nodules. The main pattern that affected differences was inconsistent hypoechogenicity interpretation, giving the accuracy superiority to the systems that raise the malignancy risk with marked hypoechogenicity, at the same time with minor compensation for sensitivity.

scholarly journals Value of preoperative neutrophil-to-lymphocyte ratio in predicting thyroid cancer in intermediate category fine needle aspiration pathology: retrospective study

2019 ◽  
Author(s):  
Yasar Ozdenkaya ◽  
Pelin Basim ◽  
Oktay Olmuscelik ◽  
Naciye Cigdem Arslan
Keyword(s):  
Thyroid Cancer ◽  
Diagnostic Accuracy ◽  
Complete Blood Count ◽  
Needle Aspiration ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Bethesda System ◽  
The Mean ◽  
The Bethesda System

Abstract Background The management of thyroid nodules with intermediate category of the Bethesda System for Reporting Thyroid Cancer (TBSRTC) is still debatable. Aim of this study is to investigate the diagnostic accuracy of neutrophil-to-lymphocyte ratio (NLR) in detecting cancer in intermediate TBSRTC categories.Methods Data of the patients who underwent thyroidectomy between 2012 and 2018 were analyzed retrospectively. Demographic characteristics, complete blood count, TSH value, TBSRTC categories and postoperative pathology of the patients were collected. The association with preoperative NLR and postoperative pathology was assessed.Results Of 146 patients included in the study, 57 (39%) were in TBSRTC III, IV and V category. The mean NLR in this subgroup was 2.1±0.8 and similar between TBSRTC III, IV and IV groups (p=0.737). Thyroid cancer was detected in 38 (66.7%) patients. The mean NLR was 2.4±0.8 in thyroid cancers and significantly higher when compared with patients with benign postoperative pathology (1.6±0.4, p=0.014). There was a significant difference between papillary and follicular cancer; the mean NLR was 2.3±0.8 in papillary cancer and 2.6±0.7 in follicular cancer patients (p=0.005). The cut-off value of NLR for predicting cancer at 89% sensitivity and 53% specificity was 1.6 (Area under curve: 0.769, 95% confidence interval: 0.643-0.895, p=0.001).Conclusions Preoperative NLR is elevated in patients with thyroid cancer in intermediate TBSRTC categories. Despite low diagnostic accuracy, considering its availability and low costs, NLR has merit for further studies.

scholarly journals Cytopathological evaluation of various thyroid lesions based on Bethesda system for reporting thyroid lesions

2017 ◽  
Vol 5 (4) ◽  
pp. 1339
Author(s):  
Ashwini S. Khadatkar ◽  
Varsha M. Dhume ◽  
Vikas Kavishwar
Keyword(s):  
Health Care Providers ◽  
Wide Spectrum ◽  
Tertiary Hospital ◽  
Care Providers ◽  
Laboratory Findings ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Thyroid Fna ◽  
The Bethesda System ◽  
Thyroid Lesions

Background: An encouragement for the thyroid proposal was the Bethesda system for reporting cervical cytology interpretations, a uniform reporting system for thyroid FNA will facilitate effective communication among health care providers. The objective of the present study was to classify thyroid lesions in various categories under Bethesda system correlating the cytological findings in various thyroid lesions with clinical and radiological details.Methods: A retrospective study on FNAC thyroid was performed in a tertiary hospital and a Medical teaching institution in Mumbai, Maharashtra, India which included cases which were reported from 1st January 2010 to 31st July 2011. For cytomorphological analysis, all smears (Papanicolaou and MGG) were reviewed and cases were categorized into six Bethesda categories. The FNAC findings were correlated with clinical, radiological and laboratory findings. Discrepancies between original diagnosis and review diagnosis as well as difficulties encountered during application of Bethesda were studied in detail.Results: Total 413 FNACs were received during the study period. The original diagnoses included 10 different categories or labels some of which were descriptive. On application of Bethesda, maximum cases were found in category II (82.32%) followed by category I i.e. inadequate (7.7%). Category III (Atypia of Undetermined significance) included wide spectrum of cases which were previously diagnosed as goitre, suspicious or neoplastic.Conclusions: Bethesda system of reporting thyroid FNAC has brought uniformity in cytology reporting. It has facilitated better understanding between cytopathologist and clinicians as every category connotes specific risk of malignancy and recommends treatment.

scholarly journals The Role of Cytology in the Diagnosis of Subcentimeter Thyroid Lesions

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1043
Author(s):  
Vincenzo Fiorentino ◽  
Marco Dell’ Aquila ◽  
Teresa Musarra ◽  
Maurizio Martini ◽  
Sara Capodimonti ◽  
...  
Keyword(s):  
Follicular Neoplasm ◽  
Control Series ◽  
Bethesda System ◽  
A Minor ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Thyroid Lesions ◽  
Undetermined Significance

Thyroid nodules are common and typically detected by palpation and/or ultrasound (US). Guidelines have defined the management of large nodules, but controversy exists regarding nodules ≤ 1 cm. We evaluated a cohort of patients with subcentimeter nodules to determine their rate of malignancy (ROM). A total of 475 thyroid FNAs of lesions ≤ 1 cm with available follow-up were identified from January 2015–December 2019. For comparative analysis, we added a control series of 606 thyroid lesions larger than 1 cm from the same reference period. All aspirates were processed with liquid-based cytology and classified according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Subcentimeter nodules were stratified as 35 category I—non-diagnostic cases (ND; 7.3%), 144 category II—benign lesions (BL; 30.3%), 12 category III—atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS; 2.5%), 12 category IV—follicular neoplasm/suspicious for follicular neoplasm (FN/SFN; 2.5%), 124 category V—suspicious for malignancy (SM; 26.1%), and 148 category VI—positive for malignancy (PM; 31.1%). A total of 307 cases (64.6%) underwent subsequent surgery. Only one ND and three BLs had a malignant outcome. ROM for indeterminate lesions (III + IV) was 3.2%; with 1.6% for category III and 3.2% for category IV. ROM for the malignant categories (V + VI) was 88.2%. The control cohort of lesions demonstrated a higher number of benign histological diagnoses (67.3%). We documented that 57.2% of suspected subcentimeter lesions were malignant, with a minor proportion that belonged in indeterminate categories. There were very few ND samples, suggesting that aspirates of subcentimeter lesions yield satisfactory results. Suspected US features in subcentimeter lesions should be evaluated and followed by an interdisciplinary team for appropriate patient management.

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