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.

Splenic lymphangiomas are exceedingly rare benign neoplasms that occur mainly in children. They are commonly seen in the neck and axillary region. Abdominal lymphangiomas accounts for less than 5% of cases. So far, fewer than 100 cases of spleen lymphangiomas have been reported in the literature. In this paper, we present one case of solitary splenic lymphangioma in a 34-year-old woman who presented with abdominal pain and weight loss for one month. The patient underwent splenectomy and diagnosis was confirmed by histopathology and immunohistochemistry studies. There was no clinical or radiological evidence of diffuse lymphangiomatosis syndrome. This case indicates that splenic lymphangiomas should be considered in the differential diagnosis of splenic cystic masses, even in adults, and should be managed with splenectomy once diagnosed to prevent complications.

Background: Thyroid gland nodules are common and fine-needle aspiration (FNA) is the gold standard for screening those nodules. The Bethesda system for reporting thyroid cytolopathology standardized reporting thyroid nodules aspirations, but atypia of undetermined significance or follicular lesion of undetermined significance (Bethesda category III) was the most controversial category. The aim of our study is to review our institutional experience and analyze the clinical implications of making a diagnosis of AUS/FLUS (Bethesda category III). Methods: This is a retrospective study of an 889 thyroid FNAs from 825 patients in Salmaniya Medical Complex, during (January 2013–December 2017). Results: The most common cause for designating cases as AUS/FLUS (Bethesda category III) was the presence of features suggestive of papillary thyroid carcinoma, but not quite fulfilling the criteria for such diagnosis. Ninety-six cases were diagnosed as AUS/FLUS (10.7%), in which 26 (27%) patients underwent surgery without repeating the FNA, 25 (26%) underwent a second FNA and 43 (44.7%) patients were followed up by ultrasound. On repeating the FNA, 1 (4%) was unsatisfactory, 13 (52%) were benign, 10 (40%) were AUS/FLUS, and only 1 (4%) was categorized as malignant. Thirty cases were surgically excised, in which 4 (13.3%) were diagnosed as follicular adenoma, 2 (6.6%) as Hurthle cell adenoma, 9 (30%) as multinodular goiter, 5 (16.6%) as multinodular goiter with Hashimoto thyroiditis, 1 (3.3%) as colloid nodule with Hashimoto thyroiditis, and 9 (30%) as papillary thyroid carcinoma. Among all the cases diagnosed initially as AUS/FLUS (Bethesda category III), 9 (9.3%) cases were diagnosed as papillary thyroid carcinoma. Conclusion: Diagnostically, we almost meet the international standards of designating cases with AUS/FLUS (Bethesda category III) and approximate the risk of malignancy. However, the clinical management's guidelines should be followed to decrease the risk of unnecessary surgeries and their complications. There is a statistically significant correlation between the age and gender with the final histopathology report, respectively.

Mediastinum and retroperitoneum are exceedingly rare sites for metastatic prostate cancer to occur. Here, we present the case of a 67-year-old male patient with incidental findings of mediastinal and retroperitoneal masses which were found to be due to metastatic prostate adenocarcinoma based on histopathology and immunohistochemical studies and later on supported by the significantly elevated Prostate Specific Antigen (PSA) levels. Prostate cancer should always be considered in the differential diagnosis of elderly men presenting with metastatic epithelial tumors even in unusual sites.