scholarly journals TO STUDY THYROID CYTOLOGY BY CONVENTIONAL METHOD AND APPLYING BETHESDA SYSTEM TO SAME SMEARS.

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Krishan Kumar Sharma ◽  
Ashik Mullik
Keyword(s):  
Benign Lesion ◽  
Follicular Neoplasm ◽  
Predictive Values ◽  
Medical College ◽  
Thyroid Cytology ◽  
Prospective Group ◽  
Bethesda System ◽  
Sensitivity Specificity ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Method: The thyroid cytology smears reported at the Department of Pathology Index medical College over a two year period from May 2015 to June 2017 and a prospective thyroid FNAC smears from Sep 2017 to Aug 2019 were studied at the Department of Pathology Index Medical College. The conventional and Bethesda system for reporting thyroid cytopathology were followed for reporting. A comparison of old conventional reporting system and Bethesda system were then analyzed.      Result: In Bethesda System None of the patients in both the group showed Inadequate diagnosis which was seen in the retrospective group using conventional system. Bethesda System has revealed that out of 81 patients with Benign Lesion, 41 (50.6%) were in retrospective group and 40 (49.4%) were in prospective group. Malignant was present in 2 (40%) and 3 (60%) patients in Retrospective and prospective group. Similarly out of 4 patients with Follicular Neoplasm, 3 (75%) and 1 (25%) were in retrospective and prospective group. However the distribution was comparable between both the groups. Conclusion: Adapting the Bethesda system of reporting has led to a high to sensitivity, specificity and high negative predictive values. Use of Bethesda systems helps in the prognosis, management and minimizes the unnecessary surgical procedures of thyroid swelling. Keywords: Thyroid, Cytology, Bethesda & Smears.

scholarly journals The Bethesda System for Reporting Thyroid Cytopathology: A Cytohistological Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Bakiarathana Anand ◽  
Anita Ramdas ◽  
Marie Moses Ambroise ◽  
Nirmal P. Kumar
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Follicular Neoplasm ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Sensitivity Specificity ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Undetermined Significance

Introduction. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a significant step to standardize the reporting of thyroid fine needle aspiration (FNA). It has high predictive value, reproducibility, and improved clinical significance. Aim. The study was aimed to evaluate the diagnostic utility and reproducibility of “TBSRTC” at our institute. Methods and Material. The study included 646 thyroid FNAs which were reviewed by three pathologists and classified according to TBSRTC. Cytohistological correlation was done for 100 cases with surgical follow-up and the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and risk of malignancy (ROM) were calculated. The interobserver variation among three pathologists was also assessed. Results. The distribution of cases in various TBSRTC categories is as follows: I—nondiagnostic 13.8%, II—benign 75.9%, III—atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) 1.2%, IV—follicular neoplasm (FN)/suspicious for follicular neoplasm (SFN) 3.7%, V—suspicious for malignancy (SM) 2.6%, and VI—malignant 2.8%. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy are 72.4%, 94.3%, 84%, 89.2%, and 87.9%, respectively. The ROM of various TBSRTC categories were II—8.5%; III—66.7%; IV—63.6%; and V and VI—100%. Cohen’s Weighted Kappa score was 0.99 which indicates almost perfect agreement among the three pathologists. Conclusions. Our study substantiates greater reproducibility among pathologists using TBSRTC to arrive at a precise diagnosis with an added advantage of predicting the risk of malignancy which enables the clinician to plan for follow-up or surgery and also the extent of surgery.

scholarly journals The Bethesda system for reporting thyroid cytology: a prospective study in a tertiary care institute along with review of literature

2020 ◽  
Vol 8 (10) ◽  
pp. 3670
Author(s):  
Avni Bhatnagar ◽  
Kavita Mardi ◽  
Shivani Sood ◽  
Vijay Kaushal ◽  
Kanishk Gupta
Keyword(s):  
Tertiary Care ◽  
Follicular Neoplasm ◽  
Histopathological Diagnosis ◽  
Predictive Values ◽  
Malignancy Risk ◽  
Thyroid Cytology ◽  
Management Protocol ◽  
Bethesda System ◽  
The Bethesda System ◽  
Undetermined Significance

Background: The Bethesda system for reporting thyroid cytology (TSBRTC) was devised by the National Cancer Institute (NCI) to obtain uniformity, reproducibility and a defined management protocol while dealing with thyroid lesions. This study was undertaken with the aim to see the benefits of adopting TBSRTC in the diagnosis of thyroid FNAC, and identify the malignancy risk of each category.Methods: This cross-sectional study was conducted in Indira Gandhi Medical College, Shimla, Himachal Pradesh from June 2016 to July 2017 on 181 thyroid FNACs which were reported according to the Bethesda system for reporting thyroid cytopathology (TBSRTC) under six categories: (I) non-diagnostic/unsatisfactory (II) benign (III) atypia of undetermined significance/follicular lesion of undetermined significance (IV) follicular neoplasm/suspicious for follicular neoplasm (specify if Hurthle cell (oncocytic) type (V) suspicious for malignancy (VI) malignant. Histopathological diagnosis was available for 65 cases where thyroidectomy was performed. Malignancy risk was calculated for each category. Sensitivity, specificity, positive and negative predictive values for TBSRCT were also calculated. All the data was analyzed in SPSS software version 22.0 (IBM, USA).Results: Benign lesions constituted the major bulk. After the use of TBSRTC, there was increased ability to look for follicular neoplasms, improvement in making definitive diagnosis of the cases, an improvement in diagnostic accuracy, and we were in line with the implied risk outlined by TBSRTC in most of the cases.Conclusions: Application of TBSRTC results in uniformity in reporting among pathologists and better interdisciplinary communication and patient management.

scholarly journals Performance of the Bethesda System for Reporting Thyroid Cytology in Multi-Institutional Large Cohort of Pediatric Thyroid Nodules: A Detailed Analysis

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 179
Author(s):  
Sule Canberk ◽  
Helena Barroca ◽  
Inês Girão ◽  
Ozlem Aydın ◽  
Aysun Uguz ◽  
...  
Keyword(s):  
Task Force ◽  
Paediatric Population ◽  
High Rate ◽  
Histologic Diagnosis ◽  
Thyroid Cytology ◽  
Risk Of Malignancy ◽  
Institutional Experience ◽  
Bethesda System ◽  
Sensitivity Specificity ◽  
The Bethesda System

Background: To evaluate the performance of TBSRTC through multi-institutional experience in the paediatric population and questioning the management recommendation of ATA Guidelines Task Force on Paediatric Thyroid Cancer; Methods: A retrospective search was conducted in 4 institutions to identify consecutive thyroid FNAC cases in paediatric population between 2000 and 2018. Following the 2nd TBSRTC, the risk of malignancy ratios (ROMs) was given in ranges and calculated by 2 different ways. Sensitivity, specificity, PPV, NPV and DA ratios were calculated using histologic diagnosis as the gold standard; Results: Among a total of 405 specimens, the distribution of cases for each category was, 44 (11%) for ND, 204 (50%) for B category, 40 (10%) for AUS/FLUS, 36 (9%) for FN/SFN, 24 (6%) for SFM and 57 (14%) for M categories. 153 cases have a histological diagnosis. The ratio of surgery was 23% in ND, 16% in the B, 45% for AUS/FLUS, 75% for SFN/FN and 92% for SFM and 75% in M categories; Conclusions: The data underlines the high ROM values in paediatric population which might be clinically meaningful. The high rate of malignancy of the cohort of operated patients (50%) also underlines the need of better preoperative indicators for stratification. Considering that more than half of the nodules in AUS/FLUS category were benign, direct surgery recommendation could be questionable as proposed in ATA 2015 guidelines.

scholarly journals The Bethesda system for reporting of thyroid cytopathology and its category wise management

2019 ◽  
Vol 8 (10) ◽  
pp. 2228
Author(s):  
Varun Gupta ◽  
Pooja Singh
Keyword(s):  
Thyroid Nodules ◽  
Reporting System ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Thyroid Cytology ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Background: Fine-needle aspiration cytology (FNAC) of thyroid is a rapid diagnostic test for thyroid nodules. The Bethesda system classifies thyroid FNAC into six categories. Each category is linked to a malignancy risk and has recommended clinical management. The aim of this study was to analyze the thyroid cytology smears by Bethesda system and to assess the frequency of various categories and to correlate it previous published studies. Category wise management is also discussed in detail.Methods: A total of 388 thyroid FNAC samples were examined from January 2017 to June 2018 in the Department of Pathology, in Medanta- The Medicity Gurugram.Results: A total of 388 cases were reported according to Bethesda system of reporting. Categories were as follows: I (14.69%), II (61.85%), III (11.34%), IV (2.57%), V (2.660%), VI (4.91%) nodules.Conclusions: The Bethesda System for reporting thyroid cytopathology proved to be an excellent reporting system and it puts clinician and the cytopathologist on the same page and easier to communicate regarding diagnosis.

scholarly journals Evaluation of Bethesda system for reporting thyroid cytology with histopathological correlation

2017 ◽  
Vol 6 (1) ◽  
pp. 247
Author(s):  
Purushotham Reddy ◽  
Akina Prakash ◽  
Sujata S. Giriyan
Keyword(s):  
Predictive Value ◽  
Research Work ◽  
High Sensitivity ◽  
High Specificity ◽  
Follicular Neoplasm ◽  
Thyroid Cytology ◽  
Histopathological Correlation ◽  
Bethesda System ◽  
Management Approaches ◽  
The Bethesda System

Background: The Bethesda system of reporting thyroid cytopathology is a standardised system, improving communication between cytopathologists and clinicians, leading to more consistent management approaches. The aim of the research work was to study the utility of Bethesda system in reporting thyroid cytology with histopathological correlation of all the cases undergoing surgical resection.Methods: We studied all the thyroid cytology cases received between November 2012 to April 2014, and classified them according to the Bethesda system. Histopathological correlation was done for all the cases which underwent surgical resection with evaluation of cyto-histological discrepancies.Results: Out of 484 cases studied, 432(89.2%) were benign lesions, 20(4.1%) were malignant,18 (3.7%) were Unsatisfactory/Nondiagnostic, 10(2%) were Follicular neoplasm/Suspicious for neoplasm, 3 (0.6%) were suspicious for malignancy, and 1(0.002%) case was reported as Atypia of undetermined significance. Out of the 54 cases available for histopathological follow-up, cyto-histological discrepancies were noted in 5 cases (9.2%). Statistical analysis of the present study showed that cytological analysis of thyroid lesions by Bethesda system has got high sensitivity (72.72%), high specificity (95.3%) with a positive predictive value of 80% and negative predictive value of 93.1% and a high accuracy (90.7%).Conclusions: Reviewing the thyroid FNAs (fine needle aspirates) using Bethesda system allowed a more specific cytological diagnosis with better interlaboratory agreement. As evidenced by its high sensitivity and specificity, Bethesda system has proven to be a very effective guide for the clinical management of thyroid nodules.

scholarly journals A Comparative Study of the Bethesda System of Reporting of Fine Needle Aspiration Cytology Thyroid with Histopathology

2020 ◽  
Vol 7 (52) ◽  
pp. 3171-3175
Author(s):  
Kirthi Nath K.V ◽  
Geetha Sukumaran
Keyword(s):  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Thyroid Cytology ◽  
Thyroid Fine Needle Aspiration ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
The Bethesda System

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

scholarly journals Assessment of The Bethesda System for Reporting Thyroid Cytopathology

2019 ◽  
Vol 152 (4) ◽  
pp. 502-511 ◽  
Author(s):  
Jennifer L Sauter ◽  
Heidi Lehrke ◽  
Xiaotun Zhang ◽  
Osamah T Al Badri ◽  
Rene Rodriguez-Gutierrez ◽  
...  
Keyword(s):  
Predictive Value ◽  
Needle Aspiration ◽  
Performance Characteristics ◽  
Follicular Neoplasm ◽  
Bethesda System ◽  
Thyroid Fna ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
The Impact

Abstract Objectives Long-term follow-up is important for determining performance characteristics of thyroid fine-needle aspiration (FNA). Methods Histologic or 3 or more years of clinical follow-up was used to calculate performance characteristics of thyroid FNA before and after implementation of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) classification was also investigated. Results Follow-up was obtained for 1,277/1,134 and 1,616/1,393 aspirates/patients (median clinical follow-up, 9.9 and 4.4 years, pre- and post-TBSRTC, respectively). Nondiagnostic, suspicious for follicular neoplasm, and suspicious for malignancy (SFM) diagnoses decreased and benign diagnoses increased post-TBSRTC, while atypical rate remained less than 1%. Negative predictive value for benign nodules and positive predictive value (PPV) for SFM increased significantly. Eleven nodules were reclassified as NIFTP, slightly decreasing PPV/risk of malignancy (ROM). Conclusions Appropriate ROM for thyroid FNA can be achieved through application of TBSRTC terminology with minimal use of atypical category.

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