scholarly journals Cytomorphological Study of Various Thyroid Nodules as per Bethesda Criteria

2021 ◽  
Vol 8 (12) ◽  
pp. 722-725
Author(s):  
Sharath Chandra Keshapaga ◽  
Tiwari Sundari Devi ◽  
Byrapuram Vijaya Nirmala ◽  
Durga Hari Prasanna Kumar Kalla
Keyword(s):  
Diagnostic Criteria ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Fine Needle ◽  
Bethesda System ◽  
Thyroid Cytopathology ◽  
Thyroid Lesions

BACKGROUND Thyroid nodules are common and occur in 4 % - 7 % of the general population. Diseases of the thyroid are of great importance because they are most amenable to medical or surgical management. The benefit of thyroid fine needle aspiration (FNA) derives in large part from the ability to make a reliably benign interpretation that avoids unnecessary surgery. A uniform reporting system for thyroid FNA will facilitate effective communication among cytopathologist and the referring physician and allow easy and reliable sharing of data from different laboratories for national and international collaborative studies. For uniformity of reporting cytological smears “The Bethesda System for Reporting Thyroid Cytopathology” was recommended and the smears were divided into 6 diagnostic categories. We wanted to know the age and sex distribution and prevalence of various thyroid lesions as per Bethesda diagnostic criteria. We wanted to study the cytological and morphological features of thyroid lesions by fine needle aspiration cytology (FNAC). METHODS The present study is a prospective type of descriptive study, carried out from January 2016 to December 2017 at Andhra Medical College, Visakhapatnam. A total of 1291 cases were evaluated and classified according to Bethesda system of cytopathology. FNAC was done and the smears were immediately fixed in isopropyl alcohol and stained with haematoxylin and eosin. RESULTS In the present study a total of 1291 cases was analysed out of which 1193 were benign, 13 were AFLUS, 32 were follicular neoplasms, 10 were suspicious of malignancies and 36 malignant. All the lesions were classified as per Bethesda diagnostic criteria. CONCLUSIONS FNAC is a simple and cost-effective procedure which guides the clinical practitioner to choose the right form of treatment for the patient subsequently avoiding unnecessary surgery and ensuing morbidity. KEYWORDS Thyroid, Cytopathology, FNAC, Bethesda, Follicular Neoplasm, Benign, Malignant

scholarly journals Fine Needle Aspiration of Thyroid Nodules Using the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience in a Rural Setting

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Aili Guo ◽  
Yuuki Kaminoh ◽  
Terra Forward ◽  
Frank L. Schwartz ◽  
Scott Jenkinson
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Rural Setting ◽  
Follicular Neoplasm ◽  
Fine Needle ◽  
Bethesda System ◽  
Thyroid Fna ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Background. Fine needle aspiration (FNA) remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC) to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015. Results. A total of 159 patients (18–88 years old) and 236 nodule aspirations were performed and submitted for evaluation. 79% were benign, 3% atypia/follicular lesion of unknown significance (AUS/FLUS), 5% follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 4% suspicious for malignancy (one case was indeed an atypical parathyroid neoplasm by surgical pathology), 2% malignant, and 7% nondiagnostic. Two cases also had advanced molecular analysis on FNA specimens before thyroidectomy. Conclusion. The diagnostic yield of FNA cytology from our practice in a rural setting suggests that accuracy and specificity are comparable to results from larger centers.

scholarly journals Rapid On-site Evaluation (ROSE) for Fine Needle Aspiration of Thyroid: Is It Helpful?

2021 ◽  
Vol 3 (1) ◽  
pp. 1-7
Author(s):  
Ahmed K. Aly ◽  
Mahmoud A. Ali ◽  
Apoorva Sharma ◽  
Michael A. Gubbels ◽  
Xing Zhao ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Significant Difference ◽  
Site Evaluation ◽  
Bethesda System ◽  
The Difference ◽  
Thyroid Cytopathology ◽  
The Bethesda System

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

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.

Accuracy of Fine-Needle Aspiration of Thyroid

2001 ◽  
Vol 125 (4) ◽  
pp. 484-488 ◽  
Author(s):  
Mojghan Amrikachi ◽  
Ibrahim Ramzy ◽  
Sheldon Rubenfeld ◽  
Thomas M. Wheeler
Keyword(s):  
Fine Needle Aspiration ◽  
False Positive ◽  
Thyroid Nodules ◽  
False Negative ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Follicular Variant ◽  
Fine Needle

Abstract Context.—Fine-needle aspiration has become an accepted and cost-effective procedure for rapid diagnosis of thyroid lesions. The routine use of fine-needle aspiration has reduced the rate of unnecessary surgery for thyroid nodules. Objectives.—To determine the accuracy of fine-needle aspiration biopsy diagnosis and to discuss the possible pitfalls. Design, Setting, and Participants.—Reports of 6226 fine-needle aspiration biopsies of the thyroid performed during a period of 16 years (1982–1998) were reviewed. Computerized reports of the fine-needle aspiration biopsies were sent to the physicians who performed the procedures, and clinical follow-up information regarding the patients was requested. Twenty-four clinicians participated in the study. Histologic diagnoses were available for 354 cases. The cytopathologic diagnoses were correlated with the histologic findings or clinical outcomes. Results.—The cytologic diagnoses were as follows: 210 (3.4%) malignant, 450 (7.2%) suspicious, 3731 (60%) benign, and 1845 (29.5%) unsatisfactory. Most of the cases with negative or unsatisfactory aspirates were followed clinically or by repeat fine-needle aspiration. We identified 11 false-negative and 7 false-positive diagnoses. For aspirates considered sufficient for diagnosis, the sensitivity and specificity levels were 93% and 96%, respectively. Conclusions.—Fine-needle aspiration of the thyroid gland is highly accurate and has a low rate of false-negative and false-positive diagnoses. The major diagnostic problems are caused by diagnosis using a marginally adequate specimen, diagnosis of malignancy based on just 1 or 2 atypical cytologic features, or overlapping cytologic features of follicular neoplasm with those of follicular variant of papillary carcinoma.

scholarly journals A study on fine needle aspiration cytology of thyroid lesions with correlation to histopathological examination with special reference to Bethesda system of reporting at a tertiary care centre

2019 ◽  
Vol 8 (1) ◽  
pp. 260
Author(s):  
Nandinee Lahkar ◽  
Manoj Kumar Deka ◽  
Nitu Mani Khakhlari
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity ◽  
Thyroid Lesions

Background: Annual incidence of thyroid nodules ranges from 40,000 to 70,000 per 1 lac population worldwide. Fine Needle Aspiration (FNA) of the thyroid is widely accepted simple, cost effective and quick to perform outpatient procedure with minimal complication. The National Cancer Institute (NCI) Bethesda, Maryland, United States standardized the reporting system for thyroid FNA by using Bethesda system for reporting thyroid cytopathology.Methods: FNA was performed in total 155 patients presenting with the thyroid swelling with or without Ultrasonography (USG) guidance. All patients were analyzed for age, gender, type of lesions. FNA was done and smears were examined and reported according to Bethesda system of reporting for thyroid cytopathology. Findings were correlated with post-operative histopathological diagnoses in 103 cases who underwent surgery.Results: Out of total 155 patients, 32 were male and 123 were female. Average age of presentation was 38.4 years. On cytology, according to Bethesda system, most cases were in benign category (76.1%) followed by malignant (8.4%). On histopathological study most common diagnosis was colloid goiter followed by papillary thyroid carcinoma. From the study it was found that sensitivity, specificity and accuracy of fine needle aspiration cytology of thyroid lesions were 81.8%, 97.3% and 95.4% respectively.Conclusions: Fine needle aspiration cytology is simple, easy to perform, cost effective procedure with high sensitivity, specificity and diagnostic accuracy in case of thyroid lesions.

A core needle biopsy provides more malignancy-specific results than fine-needle aspiration biopsy in thyroid nodules suspicious for malignancy

2013 ◽  
Vol 66 (12) ◽  
pp. 1046-1050 ◽  
Author(s):  
T Hakala ◽  
I Kholová ◽  
J Sand ◽  
R Saaristo ◽  
P Kellokumpu-Lehtinen
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Follicular Neoplasm ◽  
Core Needle ◽  
Fine Needle ◽  
Needle Aspiration Biopsy ◽  
Thyroid Lesions

Background and aimsThe most commonly used diagnostic method for the preoperative diagnosis of thyroid nodules is ultrasound-guided fine-needle aspiration biopsy (FNA), which often yields non-diagnostic or non-definitive results and seldom produces definite malignant diagnoses. To improve upon the malignancy-specific sensitivity, we tested core needle biopsies (CNBs) of thyroid lesions taken from surgical specimens.Material and methods52 consecutive patients with malignant or malignant-suspicious thyroid nodules were referred to Tampere University Hospital between May 2010 and December 2011. Preoperative FNAs were categorised as follicular neoplasm (48%), suspicion for malignancy (46%) or malignancy (6%). Intraoperative FNA and CNB samples were acquired from surgical specimens removed during surgery. The results of the needle biopsies were compared with the final pathological diagnosis.ResultsCNBs had a high definitive sensitivity for malignancy (61%, CI 41% to 78%) whereas the definitive sensitivity for malignancy of FNAs was significantly lower (22%, CI 10% to 42%). CNB was not beneficial in the diagnosis of follicular thyroid lesions. When all suspected follicular tumours were excluded, the definitive sensitivity of CNB rose to 70% (CI 48% to 86%).ConclusionsCNB may be beneficial for the diagnosis of papillary thyroid carcinoma and other non-follicular thyroid lesions. CNB may be considered as an additional diagnostic procedure in cases with FNA suspicious for malignancy.

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