scholarly journals Malignancy Risk for Fine-Needle Aspiration of Thyroid Lesions According to The Bethesda System for Reporting Thyroid Cytopathology

2010 ◽  
Vol 134 (3) ◽  
pp. 450-456 ◽  
Author(s):  
Vickie Y. Jo ◽  
Edward B. Stelow ◽  
Simone M. Dustin ◽  
Krisztina Z. Hanley
2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Sudeep Regmi ◽  
Archana Tiwari ◽  
Rupesh Sharma

Introduction: Thyroid nodule is a common presentation. The estimated prevalence of thyroid nodules is 4-7% by clinical examination and 50-60% on ultrasonographic (USG) evaluation. Most are benign without any symptoms or cosmetic concerns. Only around 5% are found to be malignant. Methods: This prospective study evaluated a total of 54 patients with thyroid lesions presenting to Otorhinolaryngology, Surgery and Internal Medicine out-patient departments of a tertiary hospital for a period of nine months. The thyroid lesions were categorized into different categories using Thyroid Imaging Reporting and Data System (TIRADS) by USG and The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) by fine needle aspiration (FNA). The agreement between TIRADS and TBSRTC was evaluated using Cohen's kappa statistics. Results: By FNA, 68.5% were benign lesions whereas 7.4% were malignant. Follicular Neoplasm (FN) or Suspicious for FN and Suspicious for Malignancy category comprised 5.6% each. 1.9% of the lesions showed Atypia of Unknown Significance (AUS). 11.1% of the lesions were non-diagnostic or unsatisfactory for evaluation. Overall agreement between the cases by USG and FNA using the TIRADS and TBSRTC respectively was 77.77%. There was a substantial agreement between the diagnosis made by these systems, kappa (κ)= .633 (95% CI, 0.41 to 0.85, p<0.05). Conclusion: This study observed a substantial agreement between the diagnosis made by TIRADS on USG and TBSRTC on FNA. Our study advocates the stratification of thyroid lesions according to TIRADS so that only suspicious lesions undergo FNA.


2021 ◽  
Vol 3 (1) ◽  
pp. 1-7
Author(s):  
Ahmed K. Aly ◽  
Mahmoud A. Ali ◽  
Apoorva Sharma ◽  
Michael A. Gubbels ◽  
Xing Zhao ◽  
...  

Introduction: Thyroid nodules are very common. Many are detected incidentally due to increased head and neck imaging. The majority are benign; however, malignancy can’t be excluded in many cases and tissue sampling is needed. Ultrasound guided fine needle aspiration is an easy and effective way to sample g thyroid nodules. Inadequate sampling was reported in 10-40% of the cases. Rapid On-site Evaluation (ROSE) was proposed to assess obtained sample for adequacy. The aim of this study is to identify the benefit of applying ROSE with US-FNA of thyroid nodules within our institution. Materials and methods: Patients who underwent FNA for thyroid nodules with ROSE availability documented in their procedure note between January 2017 to December 2018 were retrospectively included. All procedures were done by experienced radiologists. Aspirated material was Diff Quik stained for immediate evaluation. The final cytological diagnosis and specimen adequacy was based on The Bethesda system for reporting thyroid cytopathology. Specimen adequacy was compared between ROSE and non-ROSE groups. Results: 442 thyroid nodules were biopsied. ROSE was available for 65 nodules. Non-diagnostic rate with ROSE was 10.8% compared to 13.8% without ROSE with the difference being statistically insignificant. ROSE availability improved sample adequacy of nodules less than 3 cm with statistically significant difference of 100.0% with ROSE vs. 87% without ROSE. Conclusion: The current study does not justify the routine use of ROSE. However, ROSE availability is beneficial with smaller sized thyroid nodules and less experienced radiologists performing the procedure. Doi: 10.28991/SciMedJ-2021-0301-1 Full Text: PDF


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.


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