Implementation of Bethesda system for reporting thyroid cytology in an academic institution: A 2 year retrospective study

Abstract

Thyroid diseases are the most common endocrine diseases in India. Both benign and malignant diseases present as thyroid nodules. Fine needle aspiration cytology (FNAC) has proven to be one of the most effective tools for evaluation of thyroid nodules. Interpretation of FNAC has been standardized by the Bethesda system for reporting thyroid cytopathology (TBSRTC). Aim: To categorize all the thyroid lesions utilizing TBSRTC, in an academic institution for a duration of 2 years and find its histopathological correlation. Materials and Methods: A 2 year retrospective study included all 229 patients who underwent thyroid FNAC in the institution. All the clinical and relevant radiological investigations were retrieved from hospital information system. All Papanicolaou and May Grunwald Giemsa stained smears were categorized under TBSRTC in to 6 categories. Results: Maximum number of cases were between the age group of 31-45yr. Male: Female ratio in our study was 1:13. There were 12 cases (5.2%) under Unsatisfactory/non diagnostic category, 196(85.5%) cases belonged to benign category, 1 case (0.04%) of Atypia of undetermined significance/follicular lesion of undetermined significance,10 cases (4.3%) belonged to follicular/ suspicious for follicular neoplasm,4 cases (1.7%) belonged to suspicious for malignancy & 6 (2.6%) belonged to Malignant category. Cyto histopathology discrepancy rate was 7.14%. Conclusions: TBSRTC brings about uniformity in reporting of thyroid cytology, thereby helping in better patient management and avoiding unwanted surgeries.