Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: Phase I Pilot Retrospective Analysis

Abstract

We analyzed and evaluated our adequacy rate and the classification of our thyroid aspirates using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). All thyroid fine needle aspirates that were collected or referred to our institution were reviewed and reclassified according to the BSRTC. The results were tabulated and analyzed. Those with histological resection were correlated with our revised cytopathological evaluation using the BSRTC. A total of 205 thyroid aspirates from 186 patients were reviewed. There were 149 females (80%) and 37 males (20%) ranging in age from 23 to 81 (average age 48) years. All slides were reclassified using the BSRTC. The previous interpretations were not consistent with any apparent standards. The nondiagnostic rate was found to be 22%. Five cases were considered false negative and were upgraded to a more serious category with higher risk of malignancy. The high unsatisfactory rates can be reduced by an adequacy interpretation at the time of the procedure. The risk of malignancy in our cohort increased with each increase in the BSRTC category (I-VI). Communication about and awareness of the BSRTC and its implications by all our clinicians is a prime target of this study and is still work in progress. Hopefully, this study will increase the awareness of the BSRTC and its intended benefits in our region.

Thyroid Cytopathology with an Emphasis on the ‘Atypical Cells of Uncertain Significance' Category: A 3-Year Audit with Cytohistologic Correlation

“…They also noted an increase in the SFHN reporting rate from 6.1 to 7.1% after TBSRTC. It will also be interesting to see if conscious interdisciplinary communication, pathology seminars and lectures will have a positive impact on the general reporting of thyroid cytopathology cases in our lab, as demonstrated by others [27]. …”

Thyroid Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance: An Indispensable Bethesda 2010 Diagnostic Category or Waste Garbage?

“…For further studies, risk of neoplasia evaluation is an important parameter, which is available only in some studies [3,5,6,7,10,12,14,17,18,19,20,21,23,24,25,28] (table 5). Sixteen studies of 4,964 cases with 39.6% histologically approved showed a risk of neoplasia of 25.1% and a risk of malignancy of 21.5%.…”

“…Up to 6 years of experience has been cumulated at several centres (table 2) [3,4,5,6,7,8]. In addition, retrospective studies have also approved the feasibility of the system (table 2) [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28]. Furthermore, meta-analyses have shown the advantages of the system [29,30,31,32].…”

Correspondence of cytological and histopathological diagnoses in diagnostic category V of the Bethesda system: “suspicious for malignancy”

“…Whether the analysis concerns a few thousands [15] or one thousand FNAs [19], the results obtained by researchers working in different parts of the world and staining their specimens with different methods, are quite similar (Papanicolaou stain [18,19,22,23,24,25,26,27,28,29], Giemsa and Papanicolaou stain [19,20,30] and Giemsa stain [20,31,32]). …”